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Urethritis is an inflammatory disease in which the urethra (or urethra) is affected. Urethritis, the symptoms of which appear against the background of exposure to viruses or bacteria that provoked this inflammation, in its course may correspond to the nature of an infectious process or a non-infectious process.

general description

The urethra itself is the channel through which urine is discharged outward from the bladder. Urethritis is predominantly diagnosed in young patients who are sexually active, and it is the sexual route of transmission that determines the largest number of patients seeking appropriate medical help.

Symptoms of urethritis in women, by the way, are sometimes extremely difficult to distinguish from the symptoms that appear with cystitis. Actually, cystitis in women, which, as the reader probably knows, is a disease accompanied by inflammation of the bladder, is often a companion to urethritis, due to which the identification of both actual variants of the disease is somewhat complicated. The reason for this is the similar nature and symptoms. The difference is the actual localization of the inflammatory process and the symptoms that appear in both cases - the main symptoms of cystitis are based on increased urination, while with urethritis, urination is only combined with certain unpleasant sensations. However, one cannot deny the possible relationship between both of these diseases, because urethritis can develop against the background of cystitis, or, conversely, serve as the basis for its future development. These variants are caused by the ascending or descending route of infection.

The disease is not life-threatening, but its appearance, as one might assume, causes a certain kind of adjustment in life during the period of manifestation.

It should immediately be noted that due to the location of the urethra, which is somewhat shorter in women, urethritis in men develops almost unhindered. The urethra in men has several physiological narrowings and bends, which determines their greater predisposition to urethritis. Returning to the characteristics of the urethra in women, it remains to be noted that, as is already clear from the comparison, it is straight and short enough, which ensures practical washing away of the actual infection when urinating.

So to speak, in a “pure” form, urethritis is detected in patients extremely rarely. The “pure” form, in particular, means such a course of this disease in which the inflammation typical for it does not occur in the genitals. The first symptoms of urethritis require consultation with a doctor. The reason for this is the possible worsening of the course of this disease in the future, which, in turn, may manifest itself in a slightly different form. Thus, exposure to viruses or pathogenic bacteria against the background of urethritis, with such aggravation, can provoke infection of the prostate gland or epididymis in men.

Basically, urethritis develops as a result of infection with one or another sexually transmitted disease, which, as already noted, is facilitated by the main method of infection - sexual contact. Also, a violation of the rules provided for personal hygiene acts as a provoking factor for urethritis. In addition to the above reasons, which, however, happens somewhat less frequently, the introduction of microbes into the urethra is also considered possible, which occurs as a result of several other reasons. In particular, in this case it means inflammation of organs located above, or the introduction of microbes through lymphatic and blood vessels from foci of inflammation that are relevant to the body. Examples of such foci of inflammation include inflammatory processes in dental diseases, inflammation of the tonsils (which occurs with tonsillitis), etc.

Urethritis can be gonococcal (specific urethritis) or, accordingly, non-gonococcal (nonspecific urethritis); there is also a more expanded version of its classification.

Structure of female organs: urethra (urethra)

Causes of urethritis

In general terms, we have identified the causes of urethritis somewhat higher. Upon closer examination, the reasons are determined based on the classification compliance.

First of all, urethritis can be specific or nonspecific.

Specific urethritis diagnosed in cases where it is provoked by infections that are transmitted through sexual contact. Such infections include herpes virus, gonococcus, ureaplasma, and trichomonas. Somewhat less commonly, these are mycoplasma, chlamydia, gardnerella, etc. Specific urethritis is similarly defined as gonococcal urethritis (based on the nature of one's own emergence, as can be understood from the definition of this form).

As for the next form, which is nonspecific urethritis, then opportunistic microflora is considered here as an influencing factor. Examples include staphylococci and streptococci, E. coli, and various varieties of fungi.

Specific urethritis also defines a separate group within them, this non-gonococcal urethritis. This group is characterized by the fact that urethritis in it is provoked by various types of viruses and infections, but with the exception of gonococci. In turn, this group defines two other forms of urethritis, and this infectious urethritis or non-infectious urethritis. And if with infectious urethritis, in principle, no questions arise regarding the specifics of its occurrence, and it is determined on the basis of the name itself, then non-infectious urethritis, of course, can provoke the corresponding interest of the reader.

The basis for the development of non-infectious urethritis can be physical damage to the urethra. For example, this could be a blow or a diagnostic procedure that led to such a lesion, thermal or chemical exposure. In accordance with the traumatic nature of non-infectious urethritis, it is also defined as traumatic urethritis. Non-infectious urethritis, among other things, can also be allergic. Allergic urethritis, According to the specifics of allergies, it can act as a reaction of the body that occurs in response to food, drugs or other allergens. In some cases, urethritis is diagnosed in patients with diabetes mellitus and other types of metabolic disorders.

But these options do not complete our classification. In addition to the options already listed, urethritis can be primary or secondary. Primary urethritis is an independent disease that develops directly in the urethra, while secondary urethritis is the result of a complication of a particular disease. Infection in secondary urethritis occurs mainly from the bladder, vagina or prostate gland, etc.

Based on the considered classification options, urethritis, in accordance with the reasons that provoked it, can also be divided into two groups, and this venereal urethritis And non-venereal urethritis. As has already been highlighted, urethritis can be gonorrheal or non-gonorrheal, and both of these options can be classified as venereal urethritis, provided that the route of infection was sexual.

Urolithiasis can provoke urethritis, which is caused by the movement of sand or stone along the urethra, as a result of which its walls are damaged. As reasons that provoke urethritis, one can also note significant physical activity and characteristics of sexual life (excessively active sex life, or, conversely, inconsistent sex life). Certain foods also contribute to the development of urethritis, and these are salty foods, sour, spicy or pickled foods. In reality, there can be many factors, and those that we have listed are only the basis.

The duration of the incubation period of the disease (which is the time interval between infection and the appearance of the first symptoms) is determined based on the specific pathogen that provoked urethritis. On average, the incubation period for gonococcal urethritis is about 3-10 days after infection occurs (contact itself), although a shortened version is not excluded. Thus, certain strains provoke the development of urethritis already 12 hours after contact. However, the manifestation of this disease even 3 months after this cannot be ruled out - here, of course, we are talking about a different type of strain that determines such a scenario.

Urethritis: symptoms

The main manifestation characterizing the course of urethritis is purulent discharge appearing from the urethra. Such discharge may be either yellow-green or pale yellow.

Symptoms of acute urethritis are characterized by itching, burning and pain; all these manifestations are noted at the very beginning of urination, again, by the appearance of purulent discharge. The edges on the side of the external opening of the urethra begin to become inflamed and, as the process progresses, stick together. At the same time, it is possible to develop urethritis without the concomitant appearance of purulent discharge, but with the listed symptoms that directly accompany the act of urination.

Urethritis, the symptoms of which appear in a rather severe form in men, manifests differently in women. Thus, the symptoms of urethritis in women are characterized by less severity, and in some cases they may not be detected at all.

Types of urethritis are characterized by their own characteristics of the course, despite the characteristics already indicated, depending on the stage of the course, several typical forms are determined, we will dwell on them in more detail.

Acute urethritis: symptoms

This variant of urethritis is accompanied by characteristic painful urination and burning sensation. These symptoms are also combined with copious discharge, which, as already noted, appears from the urethra. The lips of the external opening of the urethra turn red, swelling is noted, and the inflammatory process is concentrated in the area of ​​the wall of the urethra. Slight pressure leads to the expiration of purulent discharge. After a night's sleep, purulent spots can be found on your underwear. Feeling the urethra allows you to identify some of its density.

In general, the sensations that a patient experiences with urethritis are characterized by the scale of the inflammatory process within the urethra (this is posterior urethritis, anterior urethritis, or complete urethritis), and the relevance of complications is also taken into account. Thus, some patients may experience burning or itching in the area of ​​the urethra, while others especially experience pain during urination.

If an acute variant of torpid urethritis (a low-symptomatic form of this disease) is considered, then the urge to urinate is frequent, pain is noted in the urethral area, and body temperature rises. In this case, the completion of the act of urination is the appearance of a minimal amount of bloody discharge, which is defined as terminal hematuria. There is also swelling of the urethra. In general, the course of torpid urethritis, if we are not talking about its acute form, is characterized by its own monotony, such a course does not have sharp boundaries, as a result, it transitions into the chronic form of gonorrhea.

Subacute urethritis: symptoms

This form is characterized by a gradual reduction in swelling and pain in the urethra. Purulent discharge is either scanty or disappears altogether. In some cases, the presence of discharge in the morning is allowed (it looks like a crust, due to which the external opening in the urethra sticks together). The urine also changes: it becomes more transparent, and minor purulent threads are noted in its composition.

Chronic urethritis: symptoms

The transition to a chronic form occurs when therapy for the disease is ineffective or in the absence of proper treatment as such. The appearance of complaints (exacerbation of urethritis) in this case is preceded by the influence of provoking factors, against the background of which a certain amount of purulent discharge appears. Such factors include hypothermia, the patient’s consumption of alcohol, etc. Basically, the symptoms of chronic urethritis coincide with the manifestations characteristic of the torpid form of urethritis, which we previously identified. The course of the disease can be long-term, which means not only months, but also years, which ultimately may lead to a visit to the doctor (if this was done earlier, before the disease progressed to this form). A long course of this form of urethritis can provoke urethral stricture, in which the urethra in the lumen begins to narrow, which is why urination is accompanied by a change in the stream of urine (it becomes weak) and pain.

Total urethritis: symptoms

The peculiarity of this form of urethritis is that the urethra is completely exposed to inflammatory damage. The symptoms of total urethritis are characterized by similarities with the symptoms of prostatitis. In acute total urethritis, the urge to urinate is uncontrollable, and completion of urination is accompanied by pain. There are bloody and purulent components in the urine.

Diagnosis

Diagnosis is based on a physical examination of the patient if he has symptoms indicating possible urethritis. The examination is carried out 1-3 hours after the last act of urination. The diagnosis of acute urethritis or chronic urethritis is established on the basis of swelling and redness of the urethra, as well as on the basis of purulent discharge.

In the future, a Gram smear is done if there is a suspicion of the relevance of gonorrheal urethritis. Diagnosis of the disease is also supported by the results of a urine test by detecting leukocytes in the sediment, analysis of scrapings of the urethra and vagina (the presence of chlamydia is determined). If necessary, a scraping from the rectal area can be done.

Treatment of urethritis

The determination of drug therapy measures is based on the characteristics of the nature of the disease. The main treatment measures are rinsing with antiseptic drugs, aimed directly at the area of ​​the urethra; antibiotics can also be used. Efficacy in the treatment of urethritis is determined by the use of erythromycin and tetracyclines. An additional effect is achieved through physiotherapy procedures (warming applications, electrophoresis, etc.), local treatment (for example, sitz baths based on herbal decoction), taking immunostimulants and immunomodulators.

Diet during treatment is mandatory. It specifically excludes salty, smoked and spicy foods and alcohol. In the acute stage of the disease, the diet is based on products of lactic acid origin, and drinking plenty of fluids is also recommended. The influence of negative provoking factors (physical overload, hypothermia) is excluded; restrictions also apply to sexual activity during this period.

If urethritis is not treated, there is a risk of developing already noted prostatitis (in chronic form), and in some cases, epididymitis, and this disease subsequently becomes the cause of infertility (obstructive form). Vesiculitis may also develop.

The main method of preventing urethritis is the implementation of the barrier method, which consists of contraception using condoms, which is especially important during sexual intercourse with non-regular partners. Also important in the prevention of gonorrhea is proper hygiene measures.

If you suspect the relevance of urethritis, you should visit a venereologist; in case of nonspecific urethritis, the patient is referred to a urologist.

Pathogens of a bacterial, viral or fungal nature enter the urethra.

Pathogenic bioflora causes inflammation, suppuration, severe back pain and burning.

The patient experiences pain not only in the urethra, but also in the scrotum, lower abdomen and even in the lower back. The discomfort intensifies when going to the toilet; the patient often experiences the urge to urinate, which does not bring relief.

A characteristic sign of urethritis is discharge from the urethra.

They can be abundant or very slight, have a light yellow, milky white, brownish or bloody tint.

With a prolonged form of the disease, the urethra sticks together, crusts appear on the head of the penis, causing irritation and itching.

If left untreated, the disease becomes chronic, in which unpleasant symptoms become less obvious, but during exacerbations they make themselves felt with severe attacks. Long-term activity of pathogenic organisms damages the walls of the urethra; bacteria and viruses cause inflammatory diseases of other organs of the genitourinary system. The disease is highly contagious and sexually transmitted.

Experts identify several types of the disease. Before starting treatment, it is important to find out exactly the nature of the ailment.

Urethritis is divided into 2 large groups. They get into one. The cause of the disease may be injury to the urethra, an allergic reaction or reduced immunity.

A larger group is infectious urethritis. They occur against the background of sexually transmitted diseases: gonorrhea, trichomoniasis, genital herpes. Tuberculous urethritis also falls into this group. If you pay attention to your own health, it is impossible to miss alarming symptoms; depending on the nature of the disease, they appear on days 3-7.

Home treatment: is it possible?

The main tasks in the treatment of urethritis are to eliminate the causative agent of the disease and restore the tissue of the urethra. Only an appropriately qualified doctor can cope with a sexually transmitted or tuberculosis infection. The issue of hospitalization is discussed individually, depending on the condition of the patients, the stage of the disease and a number of other reasons.

Urethritis of the infectious group is treated on an outpatient basis, the patient receives a course of antibiotics in tablets or injections. The drugs can destroy pathogenic bacteria, eliminate inflammation and prevent relapses of the disease.

You cannot self-medicate. If the drugs are selected incorrectly, the acute phase can turn into a chronic phase, which requires longer and more complex treatment.

The doctor selects the necessary medications, and he also calculates the course and dosage.

For successful recovery, you need a complex of remedies, including oral medications and external agents.

Therefore, before treating urethritis at home, consultation with a specialist is required!

They can be used at home; it is important to show up for examinations on time and strictly follow the doctor’s instructions. If necessary, the specialist will supplement the therapeutic regimen, replace an ineffective drug or a drug that gives negative side effects.

Choosing a medicine: the right therapeutic complex

The selection of drugs depends on the nature of the disease. Acute urethritis of a non-infectious nature and any variants of bacterial infections are treated with antibiotics, selecting them according to the type of pathogen.

Chronic non-infectious urethritis requires a combination of immunostimulants and antibacterial agents; homeopathic preparations have a good effect.

Treatment must be supplemented with balanced vitamin complexes that restore the body's natural defenses.

Antibacterial drugs

The choice of antibiotics depends on the type of infection.

For gonorrheal urethritis, drugs of the tetracycline, cephalospolin, and erythromycin group are prescribed.

For complicated acute urethritis, 2 medications can be used at once, for example, Gentamicin and Azithromycin.

Microplasma or gardenella urethritis requires the use of macrolides (for example, Claritomecin) and tetracyclines (Doxyceline). Azithromycin, which is supplemented with immunostimulants and vitamin complexes, helps with chlamydia urethritis.

Viral urethritis cannot be treated with antibiotics.

It is advisable to use a complex of specialized antiviral drugs: Riboverine, Acyclovir, Famciclovir.

For external treatment of affected areas, antibacterial aqueous solutions are used: Miramistin, Chlorhexilin and their analogues.

The preparations are suitable for washing, lotions, and douching.

Immunostimulants

Potent antibiotics suppress not only pathogenic microflora, but also beneficial bacteria. Complex immunomodulators will help restore the body's defenses. They are taken after a course of antibiotics along with vitamins. The task of immunostimulants is to accelerate tissue regeneration, improve blood flow, stimulate the production of red blood cells, and accelerate the outflow of lymph.

The choice of drug depends on the doctor.

Among the most popular drugs are Betaleukin, Ronoleukin, and various interferons. The drugs are available in the form of capsules, tablets, and solutions for injection.

Homeopathic medicines

In the chronic form of the disease, patients may be prescribed hormonal medications.

Tablets, dragees and granules based on medicinal plants are well tolerated by the body, have a minimum of contraindications and can be combined with other drugs.

Homeopathic medicines can relieve swelling and inflammation, soothe pain and burning, and facilitate urine excretion.

Among the popular remedies are Cyston, Canephron, Phytolysin and other drugs.

Vitamin complexes

These drugs can be taken only after taking antibacterial agents, since some macroelements reduce the effectiveness of antibiotics.

The vitamin course lasts 2-3 months, after six months it must be repeated.

Folk remedies and methods

Tested folk recipes that stimulate urination, prevent inflammation, and increase the body's defenses will help supplement the medication regimen. Patients are recommended decoctions of medicinal herbs: lingonberry, raspberry and currant leaves, bear's ears, nettle, chamomile, yarrow, shepherd's purse, wheatgrass roots, linden blossom.

To prepare the decoction, a handful of dried or fresh raw materials is brewed with a liter of boiling water and infused in a warm place. Infusions and decoctions are taken before meals, a single dose is 100 ml.

It is useful to wash the affected areas with a decoction of chamomile, oak or willow bark, and stinging nettle. To enhance the effect, external procedures should be combined with oral decoction.

Right way of life

A very important point is to maintain a balanced diet. It is recommended to exclude fast food, smoked meats and pickles, canned food, and sausages from the menu. Hot spices and seasonings. Food should be cooked in the oven, steamer or microwave, avoiding frying or deep-frying. Food should not irritate the gastrointestinal tract and provoke inflammatory processes.

Foods rich in sodium, potassium, calcium, magnesium and iodine will help speed up recovery: fresh vegetables and fruits.

Seafood, seaweed, dairy products. Poultry and sea fish will be a complete source of protein.

The menu includes natural diuretic and anti-inflammatory products: fresh berries, watermelons, melons, zucchini, cucumbers, jelly and fruit drinks from cranberries, lingonberries, raspberries, black currants.

It is necessary to avoid foods that retain fluid in the body and drinks with caffeine, which can cause an exacerbation of the disease.

During treatment, alcohol of any kind is strictly prohibited; quitting smoking will speed up recovery and help avoid complications.

During home treatment for urethritis in men, the patient should lead a measured life, avoid stress and overexertion, and get as much rest as possible. It is recommended to avoid sexual contact, since urethritis in any form is highly contagious. It is necessary to observe the rules of hygiene, take a shower daily, and use antibacterial wipes after each visit to the toilet. You should refrain from visiting the gym, bathhouse or swimming pool.

Treating urethritis at home can bring very good results. For therapy to be effective, it is important to maintain a daily routine, follow the doctor’s instructions, and under no circumstances interrupt the treatment course.

An inflammatory process that develops in the urethra due to factors of infectious or non-infectious origin. It develops in representatives of both sexes, but in mature men it is diagnosed more often, because due to anatomical features it is felt more acutely, which forces them to seek medical help. In women, the manifestations of urethritis are less pronounced; in certain cases, the disease is not treated with due attention.

Causes of urethritis include infection with pathogenic microorganisms (in the majority of cases) or the development of inflammation in the urethra due to allergies or injury. In the latter case, there is non-infectious urethritis, which can become the basis for the development of an infectious lesion. The group of infectious urethritis includes specific urethritis (such as gonorrheal, trichomonas) and nonspecific (such as chlamydial, mycoplasma).

Specific infectious urethritis are those in the development of which sexually transmitted microorganisms are involved - these are usually gonococcus and Trichomonas. A wide variety of microorganisms are related to the development of nonspecific urethritis - staphylococci, enterococci, pneumococci, streptococci, Proteus, E. coli, mycoplasmas, chlamydia, yeast fungi, viruses and various combinations of them at the same time.

It is important in the etiology of the disease to determine the factors that determine the routes of infection into the body and shape its level of susceptibility:

• violation of hygiene standards;
• promiscuous sexual intercourse;
• prolonged and overly active sexual intercourse;
• sexual intercourse during menstruation;
• sexual intercourse while heavily intoxicated;
• decreased immunity and protective properties of the body;
• hypovitaminosis;
• hypothermia;
• narrowing of the urethra (for example, due to tumors of the urethra or urolithiasis);
• development of local allergic reactions;
• irritation of the urethra with chemicals (for example, spermicides);
• trauma to the urethra (eg, foreign bodies, urinary catheter).

In medical practice, primary and secondary urethritis are distinguished:

• primary begins exclusively with inflammation in the urethra;
• The secondary one basically contains a focus of inflammation somewhat distant from the urethra - be it bacterial diseases of the pelvic organs (prostatitis, vaginitis) or pneumonia or sore throat with such a distant spread of infection.

Primary urethritis is considered more common.

There are also anterior and posterior urethritis:

• anterior - inflammation affects the anterior urethra to the external sphincter;
• posterior - inflammation develops in the posterior part of the urethra.

Symptoms of urethritis differs in diversity and depends on the nature of the occurrence and nature of the inflammatory reaction. It is noteworthy that, depending on the origin, urethritis can manifest itself either a few hours or several weeks after infection:

• the incubation period of allergic urethritis is the shortest - a few hours;
• nonspecific bacterial urethritis appears after 3-6 days, under certain circumstances and after 6-10 weeks;
• gonorrheal urethritis makes itself known 4-7 days after infection, sometimes the incubation period can be 4-6 weeks;
• Trichomonas urethritis appears after 10 days;
• viral, mycoplasma and chlamydial urethritis appear as the first symptoms after several months.

The clinical picture of urethritis is determined by the form of its course - acute or chronic. Traditionally, chronic urethritis is a complicated form of acute urethritis, the development of which is more typical for trichomonas, chlamydial, and mycoplasma infections. Chronic urethritis reminds itself of:

• mild itching;
• slight burning sensation along the urethra;
• slight discharge from the urethra - mucopurulent, in the amount of a few drops;
• clumping of the urethral sponges.

Acute anterior urethritis is accompanied by the following symptoms:

• itching and burning along the hanging part of the urethra;
• gluing of the external opening of the urethra in the morning;
• urethral sponges are swollen;
• pain when urinating;
• abundant mucopurulent or purulent discharge from the external opening of the urethra (may differ depending on the type of pathogen);
• discharge may form yellowish crusts on the glans penis;
• general condition is often satisfactory.

In acute posterior urethritis, along with local symptoms, a noticeable worsening of general symptoms comes to the fore:

• weakness;
• brokenness;
• increased body temperature;
• painful and frequent, with scanty urination;
• sometimes at the end of urination, blood is released from the external opening of the urethra;
• Painful erections are sometimes observed.

How to treat urethritis?

Treatment of urethritis is determined to a greater extent by its causative agent, as well as the presence of concomitant diseases, which no less require attention.

Treatment of gonorrheal urethritis suggests the need to use cephalosporins, preferably second and third generation, fluoroquinolones, macrolides. Modern medical developments show that gonococci are often resistant to penicillin, and therefore its use is minimized. Local treatment is carried out by instillation of medicinal solutions into the urethra, and the predominance of scar-sclerotic processes and solid infiltrate determines the need for dilation of the urethra and inductotherapy. Internal optical urethrotomy is used for the formation of urethral strictures, which usually have a distinct shape and are located at the pendulous part of the urethra.

Treatment of chlamydial and mycoplasma urethritis can occur through the use of etiotropic, pathogenetic and symptomatic therapy. It is advisable to prescribe antibiotics - azithromycins, josamycins, tetracyclines. Urologists note a noticeable and immediate therapeutic effect from the use of fluoroquinolones - ofloxacin or pefloxacin.

Treatment of trichomonas urethritis necessitates the use of metronidazole in accordance with the regimen determined by the doctor; in some cases, a repeated course of the drug is appropriate. If urethritis becomes chronic, it is advisable to increase single doses of metronidazole and the frequency of its administration. In addition, it would be appropriate to instill medicinal solutions into the urethra.

Treatment of bacterial urethritis impossible without the use of broad-spectrum antibiotics in combination with immunostimulating therapy.

Treatment of candidomycotic urethritis requires the prescription of broad-spectrum antifungal drugs (nystatin or levorin), it is important to ensure a prolonged effect. It is advisable to supplement the effect of medications with the action of vitamin therapy and immunomodulators.

Immunostimulating therapy is strictly recommended as part of the treatment of urethritis, regardless of the type of pathogen. The specific drug and its dosage are determined by the attending physician in each individual case, and today Viferon, Lykopid, Timalin, Timogen, Immunal are popular.

What diseases can it be associated with?

In women, the concentration of infection in the urethra creates favorable conditions for the development of an infectious process in the vagina, and in men it can lead to inflammation of the prostate gland, bladder, and scrotal organs:

• (vaginitis) - an inflammatory process that develops in the vaginal mucosa, the causative agent of which is usually chlamydia, trichomonas, mycoplasma, streptococcus, staphylococcus and similar microorganisms or their association;
• - an inflammatory process localized in the prostate gland, one of the causes of which may be infection;
• epididymitis is an inflammatory process affecting the epididymis and manifested by hyperemia, swelling and swelling of the scrotal area;
• orchitis is an inflammation of the male testicle, usually developing as a complication of gonorrhea, mumps, and influenza.

Male diseases in their spread can cause and.

(inflammation of the mucous membrane of the bladder) and disruption of the vaginal microflora () are the most associated diseases among women with urethritis.

Compression of the urethra, and therefore the development of urethritis, can be facilitated by the presence of a stone in the area of ​​the urethra or narrowing of the urethra due to the passage of a stone.

Secondary urethritis becomes a consequence of the spread of infection throughout the body from inflammation of the pelvic organs, and also, which is rare, but does occur.

Treating urethritis at home

Treatment of urethritis occurs mainly at home, but it should not involve self-medication. At the first symptoms of the disease, it is important to contact a qualified specialist, undergo the necessary diagnostic procedure and follow the course of medications prescribed by the doctor. Changing the course on your own is strictly contraindicated. It is important to note that the main element of treatment is antibacterial therapy, the course of which is important to complete, and not until the first noticeable improvement in the condition. Otherwise, there is a high probability of development of resistance of the pathogenic microorganism to the previously used drug and its ineffectiveness with further use.

During the treatment of urethritis, urologists recommend following a certain regimen - in nutrition and in organizing the day in general. It is necessary to observe significant dietary restrictions - avoid spicy, irritating foods, alcohol, caffeine, focus on fruits and vegetables as sources of vitamins, consume plenty of fluids to ensure a diuretic effect.

An additional course of tableted vitamins and immunomodulators will not be superfluous.

What drugs are used to treat urethritis?

The use of medications should be carried out exclusively in accordance with the prescription prescribed by the attending physician, however, depending on the causative agent of the disease, the list may be approximately as follows:

Treatment of urethritis with traditional methods

Treatment of urethritis folk remedies should not be used as part of self-medication, but rather be an adjuvant to traditional drug therapy and used on the recommendation of the attending physician. At a minimum, the doctor will recommend taking diuretic drinks (cranberry juice or fruit drink, black currant fruit drink), and it is useful to diversify the diet with beets, celery, carrots, green vegetables, and salads.

Among folk recipes, preference is given to drugs that have a diuretic, anti-inflammatory and antibacterial effect:

• infusion of dried cornflowers- 1 tsp. Brew dried cornflower flowers with a glass of boiling water, leave for an hour, strain, take 2 tbsp three times a day. before eating;
• infusion of black currant leaves- 1.5 tbsp. Brew a glass of boiling water of dried currant leaves, leave for 45 minutes, strain, take 1/3 glass three times a day before meals;
• parsley infusion- chop 80 grams of parsley and pour milk to the top, place in a preheated oven until the milk has evaporated; take 2 tbsp. hourly throughout the day;
• linden blossom decoction- 2 tbsp. pour linden inflorescences with 2 cups of hot water and simmer over low heat for 10 minutes, cool, strain; take at night;
• infusion of wheatgrass rhizomes- 4 tsp. pour crushed wheatgrass rhizomes into a glass of cold water, leave for 12 hours in a cool place, strain; pour the squeezed liquid with a glass of boiling water, strain after 10 minutes and combine with the first infusion; take 0.5 cups 4 times a day.

The following medicinal herbs in equal proportions have the necessary effect:

• horsetail, St. John's wort, wheatgrass rhizomes, sage, caraway fruits, cuff leaves;
• meadowsweet, ivy grass, tansy flowers, knotweed leaves, shepherd's purse;
• motherwort madder root, heather grass, black poplar buds, immortelle flowers, fennel fruits.

2 tbsp. The collection must be brewed in ½ liter of boiling water, boil for about 5-7 minutes, strain after it has cooled. Take 2 tbsp. three times a day. In case of acute urethritis, herbal treatment is carried out for a month, then additional two-month courses are carried out with two-week breaks. For chronic urethritis, taking medicinal herbs can last for years.

Treatment of urethritis during pregnancy

Treatment of urethritis in pregnant women should be performed exclusively under the guidance of specialists from related fields of medicine. Drugs are prescribed based on the ratio of benefits to the mother and risks to the fetus.

The goal of treatment for any type of urethritis is certainly to restore the properties of the walls of the urethra, restore the vaginal microflora and strengthen the protective functions of the immune system. Treatment of infectious urethritis should occur in a hospital setting under the constant supervision of qualified specialists. Here the most conservative antibiotics are selected, which will affect the development of the fetus as little as possible. Local medications and a course of immunotherapy are also prescribed.

Non-infectious urethritis can be treated at home, in this case anti-inflammatory drugs are prescribed.

Traditional methods are especially popular in this case, however, they should also be discussed with a physician and not used as part of self-medication.

Which doctors should you contact if you have urethritis?

Urethritis- a group of diseases most often of an infectious nature, which determines the subtleties of diagnostic procedures. The examination begins with a detailed history of the disease - it is important to establish some of the nuances of the patient’s sexual life, the presence of certain diseases in the past, and for such, the treatment regimen and the results of clinical observation.

The material for laboratory examinations is discharge and scrapings from the urethra and urethra. In the chronic form of gonorrheal urethritis, chlamydial urethritis, prostate secretions and ejaculate in men are examined, and suspicion of Trichomonas determines the need to take a smear from the vagina in women. Of the laboratory examination methods, preference is given to bacterioscopic and bacteriological, immunomicrobiological (direct and indirect immunofluorescence) and molecular biological (polymerase chain reaction) methods. In addition to the polymerase chain reaction, a culture method is used to diagnose trichomonas, and the detection of vaginal trichomonas in a patient is a direct indication for immediate initiation of treatment. The most reliable method is to inoculate pathological material on artificial nutrient media, and its value increases in the case of a chronic process. To diagnose mycoplasma infection, liquid nutrient media are used.

Microscopy of material taken from the lesion is performed with a special spatula, which allows one to obtain the required amount of substrate from the mucous membrane of the canal by actively scraping it. From the obtained material, preparations for research are produced in colored and uncolored states. In laboratory diagnostics, among other things, fluorescent microscopy is performed, which allows for qualitative and quantitative identification of the pathogen.

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Urethritis is inflammation of the urethral mucosa. The disease occurs equally often in both sexes. Due to the structure of the urethra in women, the symptoms are not as pronounced as in men, but complications develop more often. Urethritis has infectious and non-infectious etiology. The causative agents are sexually transmitted infections, staphylococci, streptococci, E. coli, and fungi. Non-infectious inflammations occur due to injuries to the urethra, burns, mechanical damage, and congestive processes in the pelvic organs.

Prescribed drugs

All medications must be prescribed by a doctor based on the results of examination and clinical tests. Bacterial culture of urine and culture of the mucous membrane of the urethra are required to identify pathogenic pathogens and determine their sensitivity to drugs. Treatment is carried out at home, there is no need for hospitalization. After completing the therapeutic course, the woman must undergo repeated tests to assess its effectiveness.

In case of acute infectious urethritis, medications are prescribed aimed at destroying the pathogenic pathogen and restoring healthy microflora in the urethra:

• antibacterial;
• antiseptic;
• antimicrobial;
• antiviral;
• antifungal.

When using antibacterial drugs, probiotics or symbiotics are also prescribed in parallel. For example, Linex, Normoflorin, Acipol, Bifiform. This is necessary to prevent negative effects on beneficial intestinal microflora and disorders of the digestive tract during antibiotic therapy.

In addition to the medications listed above, women are prescribed the following for urethritis:

• diuretics to flush out pathogenic microflora and prevent congestion;
• antispasmodics to relieve spasm of the urethra caused by inflammation;
• antihistamines to relieve itching and prevent allergic reactions while taking other medications.

Infectious pathogens most often become pathogenic bacteria: streptococci, staphylococci, Escherichia coli. This form is called nonspecific. Specific urethritis is provoked by sexually transmitted infections: gonococci, trichomonas, chlamydia, mycoplasma, candida fungi. Viral urethritis caused by the herpes virus and genital warts is possible. Non-infectious inflammation of the urethra is caused by injuries, burns, tumors, urolithiasis, and congestion in the pelvic organs.

Treatment of chronic urethritis

In case of chronic urethritis, vitamins and immunomodulating agents are used to generally strengthen and increase the body's resistance. They help reduce the frequency of exacerbations under the influence of provoking factors. It is difficult to completely get rid of the disease. Long-term therapy is required over several months.

During treatment, a woman must adhere to the following recommendations:

• avoid hypothermia;
• observe the rules of personal hygiene;
• follow a diet, exclude sweet, hot, spicy and salty foods that irritate the urinary system;
• drink plenty of fluids;
• stop drinking alcoholic beverages;
• wear only natural soft underwear;
• Avoid sexual relations until complete recovery.

The treatment course ranges from several days to weeks, depending on the form of the disease. The sooner you see a doctor, undergo an examination and find out the cause, the faster the recovery will be. Prolongation leads to chronicity of the inflammatory process in the urethra, to the spread of infection and the development of complications. The consequence may be cystitis, colpitis, adnexitis, endometritis, vaginitis.

In case of inflammation of the urethra, drugs are usually prescribed to restore the vaginal microflora in women in order to prevent re-infection if the cause is sexually transmitted infections. If the infection occurs through sexual contact, both partners undergo a course of treatment aimed at eliminating the pathogen at the same time.

Antibiotics

Antibiotics are prescribed for bacterial urethritis. Considering that bacterial culture of urine takes quite a long time, and treatment must be started as early as possible, broad-spectrum agents are usually immediately used in order to quickly stop the proliferation of pathogenic microflora. Subsequently, after receiving the culture results, if necessary, the prescription is adjusted and a drug to which the identified pathogen strain is sensitive is added.

Antibiotics are taken orally in the form of tablets or capsules for a course of 5 to 10 days; in severe cases, injections may be required. They try to choose the most safe and effective drugs that are not addictive, create maximum concentrations in the organs of the urinary system, have a minimum of side effects, and are used in short courses.

Broad-spectrum antibacterial drugs are indicated for nonspecific urethritis accompanied by purulent discharge. These include:

• cephalosporins (Ceftriaxone, Cefuroxime, Cefotaxime, Cefazolin);
• macrolides (Azithromycin, Roxithromycin, Clarithromycin, Josamycin);
• fluoroquinolones (Ofloxacin, Ciprofloxacin, Nevigramon, Levofloxacin, Clinafloxacin);
• penicillins (Amoxiclav, Augmentin, Flemoxin).

For inflammation caused by mycoplasma and chlamydia, drugs from the tetracycline and macrolide group are used: Tetracycline, Doxycycline, Erythromycin, Azithromycin, Clarithromycin.

For gonorrheal urethritis, Erythromycin, Oletetrin, Spectinomycin, Ceftriaxone, Cefuroxime, Rifampicin, Cefaclor are indicated.

Sometimes antibiotics are prescribed to women in the form of ointments that are used to lubricate the urethra. They help eliminate irritation, heal wounds, and relieve redness. Of these drugs, Levomekol, Sintomycin, Baneocin, Cortomycetin, Pimafukort and others are most often used.

Antibiotics are also used for non-infectious cystitis to prevent bacterial complications.

Antifungal agents

Drugs in this group are the basis of therapy for inflammation in the urethra due to a fungal infection. Most often, candidiasis occurs, caused by an opportunistic yeast fungus. The disease remains asymptomatic for a long time after infection. A characteristic symptom is discharge from the urethra of a white, viscous consistency, moderate burning and itching.

For treatment, antifungal agents are prescribed orally in the form of tablets, capsules and topically in the form of ointments. The most effective drugs are Nystatin, Levorin, Clotrimazole, Natamycin, Fluconazole, Lamisil, Miconazole. Vaginal suppositories with antifungal agents are also prescribed. A combination of systemic and local treatment accelerates recovery and quickly relieves discomfort.

Video: Doctor about the characteristics of inflammation of the urethra in women

Antimicrobials

Antimicrobial drugs are indicated for urethritis caused by chlamydia, mycoplasma, and trichomonas. The mechanism of action is associated with disruption of vital processes in the bacterial cell, leading to their death or cessation of reproduction. They are prescribed in a course lasting 7-10 days. These medications include:

• nitrofuran derivatives (Furadonin, Furamag, Furagin);
• sulfonamides (Co-trimoxazole, Sulfalen, Urosulfan, Sulfatone, Etazol);
• imidazole derivatives (Metronidazole, Ornidazole, Tinidazole);
• hydroxyquinoline derivatives (5-HOC).

Antimicrobial drugs are of synthetic origin and can cause severe side effects. They should not be prescribed to patients with severely impaired liver and kidney function. The advantage of antimicrobial drugs is that they are not addictive and are effective in cases where pathogens are resistant to antibiotics.

Antiseptics

Antiseptics for urethritis are used topically in the form of sitz baths, washing and instillation of the urethra. The last procedure is performed only by a doctor on an outpatient basis, since if the technique is performed incorrectly, there is a risk of pathogenic pathogens spreading upward into the bladder. Antiseptics act only on the surface of the mucous membranes and are not absorbed into the systemic circulation. Local treatment of affected areas with them helps to temporarily relieve irritation, discomfort and pain.

The following drugs are used to prepare antiseptic solutions:

• dekasan;
• chlorhexidine;
• miramistin;
• protargol;
• collargol;
• Furacilin.

Antiseptics have a wide activity profile. They are used for various types of infectious urethritis and help destroy pathogenic bacteria, viruses and fungi.

Antiviral agents

Antiviral drugs will be effective if the cause of urethritis is a viral infection. Most often this is damage to the mucous membrane by the herpes virus. To treat the disease, ointments containing recombinant interferons, inducers of endogenous interferon and substances with a direct antiviral effect are used topically. These include:

• cycloferon;
• Viferon;
• famciclovir;
• acyclovir;
• valacyclovir.

Also, with viral urethritis in women, it is possible to prescribe immunomodulatory drugs that increase the body's protective function.

For urethritis, herbal preparations Canephron, Urolesan, Fitolysin are used as auxiliary agents. They have a complex effect on inflammatory processes in various parts of the urinary system (kidneys, ureters, bladder, urethra): they relieve spasms, reduce inflammation, have a mild diuretic effect, have an antimicrobial effect, and relieve pain.

The active components in them are:

• Canephron – powder of centaury herb, lovage root, rosemary leaves;
• Urolesan – extracts of hop cones, oregano, wild carrots, fir, mint;
• Phytolysin - extracts of wheatgrass root, onion peel, parsley, knotweed, horsetail, birch leaves, lovage, hernia, goldenrod and fenugreek.

The drugs are considered safe, have virtually no side effects or contraindications, with the exception of allergic reactions to plants.

Folk remedies

In consultation with your doctor, you can also use folk remedies. But such treatment will only be of an auxiliary nature, since without medications it will be ineffective.

Decoctions and infusions are prepared from medicinal plants that have antiseptic, antispasmodic, restorative and diuretic effects. They are used for internal use, baths, douching, and wetting tampons. Such plants include:

• cranberry leaves and berries;
• lingonberry leaf;
• black currant leaves and berries;
• parsley;
• blue cornflower flowers;
• linden leaves;
• chamomile flowers;
• St. John's wort herb;
• sage leaves.

Folk remedies do not give quick results. Treatment is carried out for 1-3 months. They have a mild and gentle effect, and are more often used in the chronic form of urethritis and to reduce the severity of symptoms in the acute form, to consolidate the therapeutic effect.

Video: Folk remedies for urethritis

Urethritis - inflammation of the urethra , a very common urological disease. As a rule, urethritis in men is more severe than urethritis in women. The cause of urethritis is most often the presence of a sexually transmitted infection in one of the partners.

Symptoms of urethritis

The insidiousness of the disease lies in the fact that the usual general inflammatory manifestations (fever, weakness, malaise) are most often not observed with urethritis. The disease urethritis can generally occur without pronounced symptoms. In this case, one of the partners may suffer the disease much more severely. Urethritis can make itself felt even after a considerable time after infection - from several hours to several months with nonspecific infectious urethritis.

The main symptoms of urethritis may be as follows:

• pain and burning when urinating (in women they are localized mainly at the end of the urethra (outside), in men - along the entire length of the urethra);
• copious mucopurulent discharge from the urethra (mainly in the morning) with a sharp, specific odor;
• frequent urge (with an interval of 15-20 minutes) to urinate;
• incomplete emptying of the bladder;
• urinary disorders;
• cloudy urine, drops of blood may appear in it at the end of urination;
• change in the external opening of the urethra in color and shape;
• irritation of the glans penis and foreskin in men;
• pain during erection in men;
• high content of leukocytes in a general urine test.

Types of urethritis

Depending on the degree of intensity of the process and the duration of the disease, there are acute urethritis And chronic urethritis .

For acute urethritis characterized by a bright onset and severity of all symptoms, the duration of the disease is up to 2 months.

Chronic urethritis (disease lasting more than 2 months) is characterized by a duration of course, erased symptoms and the development of complications.

Based on the nature of occurrence, the following types of urethritis are distinguished:

• primary (after sexual intercourse or therapeutic manipulations in the groin area) and secondary urethritis (the appearance of infection from other organs of the genitourinary system);
• allergic urethritis (allergy to medications, shampoos, soaps, condoms);
• chemical urethritis (reaction to drugs entering the urethra);
• mechanical urethritis (occurs due to mechanical damage to the urethra);
• infectious urethritis (caused by specific pathogens, such as chlamydia, mycoplasma, ureaplasma, gardnerella, gonococcus, and nonspecific pathogens (streptococcus, staphylococcus, E. coli);
• non-infectious urethritis , occurs due to injuries to the urethra (due to the passage of a stone during urolithiasis, when using a bladder catheter), as well as due to narrowing of the urethra and congestion in the pelvis;
• nonspecific urethritis - purulent inflammation, which is caused by streptococci, staphylococci and E. coli;
• specific infectious urethritis - appears as a result of a sexually transmitted infection.

According to pathological signs, the following types of urethritis can be distinguished:

• gonorrheal urethritis (the causative agent of the disease is gonococcus, infection through sexual intercourse with an infected person, through underwear, general hygiene and personal items - washcloths, towels, etc.);
• bacterial urethritis (the causative agent is a nonspecific bacterial flora, the disease can appear as a result of endoscopic manipulations or long-term use of a catheter);
• trichomonas urethritis (characterized by the presence of foamy, whitish discharge, itching, and in the absence of treatment quickly becomes chronic and trichomonas prostatitis);
• candidal urethritis (the causative agent is a yeast fungus that affects the mucous surface of the urethra, appears after long-term use of antibacterial drugs, less often after contact with an infected partner);
• chlamydial urethritis (viral urethritis, affects the urethra, conjunctiva, vagina and cervix).

Features of urethritis in men and women

Men (due to their anatomical structure - a longer and narrower urethra) feel the manifestations of urethritis earlier and more acutely, while a woman may not notice its symptoms at all. Men may experience redness and sticking of the sponges of the external opening of the urethra in the morning.

Urethritis in men

The cause of urethritis in representatives of the stronger sex can be the following factors:

• infection through sexual intercourse;
• hypothermia of the body;
• presence of stress;
• unbalanced diet with a lot of spicy, sour, salty foods;
• inflammatory process in the body;
• the presence of urolithiasis.

Chronic urethritis in men occurs rarely when the following conditions occur:

• untreated acute urethritis;
• expansion of the inflammatory process to the entire urethra and prostate gland;
• weakening of the immune system.

Urethritis in women

Compared to urethritis in the stronger sex, female urethritis appears as a result of various infections. If the disease is not treated, then due to the female anatomical structure, urethritis can quickly develop into cystitis.

Various infections play a major role in the disease of urethritis in women. Among the infectious types of urethritis in women, the most common is gonorrheal. Within 12 hours of infection, a woman may experience symptoms of acute urethritis. If left untreated, after 20 days the disease becomes chronic.

Quite often, women become infected with the following types of urethritis: chlamydial , trichomonas or candida .

Candidal urethritis in women can occur with long-term use of antibacterial agents.

Typically, the first signs of the disease occur at the beginning of menstruation, the cessation of contraceptives, or the onset of menopause.

Diagnosis and treatment of urethritis

Treatment of urethritis requires careful diagnosis; you need to undergo special tests for urethritis. First of all, this is the collection and culture of secretions from the urethra (if they are absent, an analysis of the first portion of urine is collected). Laboratory diagnostics makes it possible to determine the causative agent of urethritis and its sensitivity to various groups of antibiotics. This allows you to make a correct diagnosis and prescribe adequate therapy.

An important diagnostic method is urethroscopy.

In addition, additional studies (ultrasound, MRI) may be required to exclude an inflammatory process in other organs (in women - in the bladder, in men - in the prostate gland and seminal vesicles).

Treatment of urethritis

The standard treatment program for urethritis consists of 3 stages:

• establishing and clarifying the diagnosis;
• drug therapy;
• conducting a re-examination.

Drugs for the treatment of urethritis

A typical treatment program for urethritis includes the following treatments for urethritis:

• antibiotics (for urethritis they vary depending on the type of disease);
• medicines that restore intestinal microflora;
• anti-inflammatory drugs;
• antihistamines;
• immunostimulants;
• vitamin complexes.

Self-medication in this case can lead to serious complications. Only a urologist can select the correct medications for the treatment of urethritis based on the results of the examination.

The course of treatment can last from several days to several weeks and depends on the form of the disease. Treatment of urethritis is usually carried out on an outpatient basis, but severe purulent complications require hospitalization.

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