Urethritis is a disease of the urinary tract, in which there are inflammatory changes in the wall of the urethra. It manifests itself in painful sensations when urinating, so it gives the patient some discomfort. In this regard, the treatment of urethritis should include symptomatic therapy aimed at reducing inflammation and painful sensations.
Table of contents:
- Classification of urethritis
- Clinical picture of urethritis
- Treatment of urethritis
Classification of urethritis
Depending on the cause of inflammation, all urethritis are divided into two large groups:
Infectious urethritis. Develops as a result of contamination of the urethral lumen by a pathogenic microflora:
1. Specific urethritis:
- Tuberculosis urethritis occurs, as a rule, against tuberculosis of the kidneys, which for a long time can be asymptomatic. The disease is caused by mycobacterium( m. Tuberculosis), which spreads with the current of urine into the lower parts of the urinary tract.
- Gonorrheal urethritis of is caused by gonococci of the Neiseriae family. The disease is transmitted during sexual intercourse, is prone to chronic infection. The leading symptom is pain in the urethra with a delay in urination. Grayish-yellow purulent discharge may appear.
- Trichomonas urethritis is caused, as a rule, by T. vaginalis. The way of transmission is sexual, the disease is prone to chronic current. In women, the infectious process develops in the vagina, in men - in seminal vesicles and prostate, but urethritis can occur in both sexes. Trichomonas urethritis ranks third in the frequency of detection.
2. Nonspecific urethritis:
- Bacterial urethritis. The development of the disease is associated with the spread of infection caused by E. coli, bacteria of the genus Klebsiella, Citrobacter, Serratia, Proteus or Prowidencia. Bacterial urethritis in women can be due to the increased development of gardnerella in vaginosis.
- Viral urethritis is caused by the herpes simplex virus( type 2), which is transmitted sexually. In this case, a vesicular rash specific for herpes appears on the genital organs, and mild mucous discharge from the urethra can appear.
- Chlamydial urethritis of is caused by chlamydia - intracellular parasites. Because of the high pathogenicity of the pathogen, this form of urethritis is the most frequent. The clinical picture is often erased, only minor mucous or purulent discharge from the urethra is observed( especially in the morning).
- Mycotic( fungal) urethritis of is caused by Candida fungi. This is a relatively rare form of the disease. Basically, it occurs against the background of a general decrease in the body's immunity. Mycotic urethritis in women can develop as a complication of vaginal candidiasis.
- Transient( short-term) urethritis develops when the infection spreads up the urethra.
- Urethritis caused by a mixed infection.
Non-infectious urethritis. Develops as a result of physical impact, metabolic disorders or physiological changes:
- Allergic urethritis ;
- Traumatic urethritis ( develops as a result of damage to the urethral mucosa);
- Congestive urethritis occurs against a background of prolonged venous stasis in the pelvic organs;
- Urethritis caused by pathological changes of the in the urethra, for example, with its pathological constriction.
The variety of clinical forms of urethritis is due to different etiology.
Inflammation of the urinary tract can develop as when entering pathogenic microflora from the outside( the sexual way of transmission), and with the increased development of opportunistic bacteria of normal vaginal microflora.
Urethritis in men is most often caused by chlamydia or gonorrhea, but in half the cases, these microorganisms can not be detected in the test material.
Clinical picture and symptoms of urethritis in women and men
The incubation period for different types of urethritis may vary from a few hours( with allergic urethritis) to several months( with virus-induced urethritis).With gonococcal infection, it lasts 3-4 days, with chlamydial infection - 1-2 weeks. The first clinical symptoms of mycotic and trichomonas urethritis appear after 2-3 weeks.
The severity of clinical symptoms is:
- Acute urethritis;
- Torpid( inactive) urethritis;
- Chronic urethritis.
The acute course of the disease is characterized by abundant discharge from the urethral lumen. Urethritis in men is accompanied by the formation of yellowish crusts on the head of the penis. Inflamed paraurethral glands become like fine grains of sand. When palpation, the urethra is thickened, painful. Symptoms of urethritis in women are manifested by swelling and soreness of the urethra in its exit site. The mucous membrane can thus be turned outward.
Subjective disorders are manifested by severe soreness at the beginning of urination. The first waste urine is turbid, contains large rapidly settling threads. If the upper parts of the urethra are affected, the volume of pathological excreta can be negligible. At the same time, the frequency of urination sharply increases, which ends with a sharp pain( sometimes with a small amount of blood).
The manifestations of chronic and torpid urethritis are practically the same. The clinical picture is not expressed, the symptoms may be absent. There is an itch in the urethra area and slight discomfort during urination. As a rule, there are no allocations. In the first portion of the waste urine, a slight precipitate can be observed.
Treatment of urethritis
Etiotropic treatment of urethritis in men and women should be carried out taking into account the cause of its development, therefore, before prescribing antibacterial therapy, it is necessary to take a smear from the urethra in order to isolate the causative agent of the disease. If this is not done, then preparations of a wide spectrum are prescribed.
Antibiotic therapy is prescribed after determining the sensitivity of microorganisms to the drugs used. When glycemic bacteria are detected, aminoglycosides and fluoroquinolones are used. To eliminate the coccal( gram-positive) flora, semi-synthetic penicillins and cephalosporins are prescribed. For the treatment of trichomoniasis urethritis, it is advisable to use preparations of the nitrofuran series( furazolidone).Treatment with antibiotics is recommended to supplement with nonspecific immunotherapy, especially in chronic urethritis.
The urethral mucosa has a good absorption capacity, therefore, local treatment can be used for the treatment of urethritis of various etiologies( in the acute phase it is strictly contraindicated).To this end, wash the urethra with solutions of furacilin, protargol, silver nitrate and other antiseptic drugs. Good results are given by instillations with dioxidine. To relieve pain, you can topically apply a hydrocortisone solution in vaseline oil or glycerin.
In the development of complications such as prostatitis or epididymitis, physiotherapy treatment may be prescribed. It can include UHF therapy, electrophoresis with antibiotics and diathermy. In cases of traumatic urethritis, or with pathological narrowing of the urethra, surgical treatment can be indicated.
Special attention in the treatment of urethritis should be given to epidemiological measures aimed at identifying people with a chronic and asymptomatic course of the disease. In order to prevent the risk of re-infection, the course of antibiotic therapy must be performed not only by the patient with the established diagnosis, but also by his sexual partner.
- Pain when urinating in women
- Severe pain in the vagina