Urethritis: symptoms and treatment
Urethritis is an inflammatory disease in which the urethra (or urethra) is exposed. Urethritis, the symptoms of which are manifested against the background of the viruses or bacteria that provoked this inflammation, can correspond in its own course to the nature of the infectious process or the non-infectious process.
The urethra itself is the channel through which urine is drained outward from the bladder. Prevalent urethritis is diagnosed in the active sexually active young patients, and it is the sexual way of transmission that determines the largest number of patients seeking appropriate medical assistance.
Symptoms of urethritis in women, by the way, are sometimes extremely difficult to distinguish from symptoms manifested in cystitis. Actually, cystitis in women, which, as the reader probably knows, is a disease accompanied by inflammation of the bladder, is often a companion of urethritis, due to which, and to some extent, the isolation of both topical variants of the disease. The reason is similar nature and symptomatology. The difference is the actual localization of the inflammatory process and the symptoms manifested in both cases — the main symptomatology of cystitis is based on the increased frequency of urination, while with urethritis, urination only combines with certain unpleasant sensations. Nevertheless, one can not deny the possible interrelation of both these diseases, because urethritis can develop against the background of cystitis, or, conversely, serve as a basis for its future development. These variants are determined by the ascending or descending path of infection.
The disease is not life threatening, but its appearance, it can be assumed, is the cause of some kind of adjustment in life for the period of manifestation.
It should immediately be noted that due to the peculiarities of the urethra, which is somewhat shorter for women, urethritis in men develops almost unhindered. Urethra in men has several physiological constrictions and bends, which determines for them a greater predisposition to urethritis. Returning to the features of the urethra in women, it remains to note that it, as is clear from the comparison, is direct and short enough, which provides a practical flushing during the urination of an actual infection.
So to say, in the «pure» form of urethritis is detected in patients is extremely rare. By «pure» form in particular is meant such a course of this disease, in which the genital organs do not have a typical inflammation. The first symptoms of urethritis necessarily require a doctor. The reason for this is the possible aggravation of the course of this disease in the future, which, in turn, can manifest itself in a slightly different form. Thus, exposure to viruses or pathogens against the background of urethritis, if aggravated, can provoke infection of the prostate gland or testicles in men.
In general, urethritis develops as a result of infection with one or another venereal disease, which, as already noted, contributes to the main method of infection — sexual contact. Also as a provocative urethritis factor is a violation of the rules provided for in terms of personal hygiene. In addition to these reasons, which, however, occurs a little less frequently, microbes can also be introduced into the urethra, which results from several other causes. In particular, in this case, we mean inflammation of the organs located above, or the introduction of microbes through the lymphatic and blood vessels from the inflammatory foci that are relevant to the body. Examples of such inflammatory foci include inflammatory processes in dental diseases, inflammation of the tonsils (what happens with tonsillitis), etc.
Urethritis can be gonococcal (specific urethritis) or, respectively, non-gonococcal (non-specific urethritis), there is also a more advanced version of its classification.
Causes of urethritis
We generally identified the causes of urethritis somewhat higher. For a more detailed consideration, the reasons are determined based on the classification.
First of all, urethritis can be specific or nonspecific.
Specific urethritis is diagnosed if it is caused by infections that are transmitted through sexual contact. As such infections it is possible to isolate the herpes virus, gonococcus, ureaplasma, trichomonas. The specific urethritis is likewise defined as gonococcal urethritis (based on the nature of its occurrence, as can be understood from the definition of this form).
As for the next form, and this is non-specific urethritis, then the conditionally pathogenic microflora is considered as an affecting factor. Examples are staphylococci and streptococci, E. coli, various variants of a variety of fungi.
Specific urethritis also defines a separate group in them, non-gonococcal urethritis. This group is characterized by the fact that urethrites in it are provoked by various types of viruses and infections, but with the exception of gonococci. In turn, this group defines two other forms of urethritis, which is infectious urethritis or non-infectious urethritis. And if with infectious urethritis of questions, in principle, does not arise in terms of the specificity of its occurrence, and it is determined on the basis of the name itself, then noninfectious urethritis, of course, can provoke the reader’s corresponding interest.
The basis for the development of non-infectious urethritis can be a physical lesion of the urethra. For example, it could be a stroke or a diagnostic procedure that led to such damage, a thermal or chemical effect. In accordance with the traumatic nature of noninfectious urethritis, it is also defined as traumatic urethritis. Non-infectious urethritis, among other things, can also be allergic. Allergic urethritis, according to the specificity of the allergy, can act as an organism reaction that occurs in response to food, medicinal 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 already listed options, urethritis may be primary or secondary. Primary urethritis is an independent disease developing directly in the urethra, while secondary urethritis is the result of a complication Or other disease. The infection in secondary urethritis occurs mainly from the bladder, from the vagina or from the prostate gland, etc.
Based on the options considered, urethritis, according to the reasons that triggered it, can also be divided into two groups, venereal urethritis and non-venereal urethritis. As already highlighted, urethritis can be gonorrheal or non-gonorrheal, both of which can be attributed to venereal urethritis, provided that the route of infection was sexual.
Urethritis can be caused by urolithiasis, which is caused by the movement of sand or stone through the urethra, resulting in damage to its walls. As reasons provoking urethritis, you can also note significant physical exertion, the characteristics of sexual life (excessively active sex life, or conversely, the sex life is unstable). Certain foods also contribute to the development of urethritis, and these are salted foods, foods that are acidic, spicy or pickled. In fact, there can be many factors, and those that we listed are just the basis.
The duration of the incubation period of the disease (and this is the time interval between infection and the appearance of the first symptoms) is determined on the basis of a specific causative agent that provoked urethritis. On average, the incubation period with gonococcal urethritis is about 3-10 days after the infection (actually contact), although its reduced version is not excluded. So, certain strains provoke the development of urethritis after 12 hours after contact. Nevertheless, the manifestation of this disease is not excluded, and 3 months after this — here, of course, we are talking about another kind of strain that defines such a scenario.
As the main manifestation, which characterizes the course of urethritis, purulent discharge appearing from the urethra. Such discharge may be either yellow-green or pale yellow.
Symptoms of acute urethritis are characterized by the occurrence of itching, burning and soreness, all these manifestations are noted at the very beginning of the act of urination, again, the appearance of purulent discharge. Edges from 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 accompanying the act of urination itself.
Urethritis, the symptoms in men in which manifest themselves in a rather sharp form, in women manifests itself differently. Thus, the symptoms of urethritis in women are less pronounced, in some cases and may not be determined at all.
Types of urethritis are characterized by their own peculiarities of flow, in spite of the already mentioned features, depending on the stage of the flow, several typical forms are determined, we will dwell on them in more detail.
Acute urethritis: symptoms
This variant of urethritis is accompanied by a characteristic painful urination and burning. These symptoms are also combined with abundant secretions, which, as already noted, appear from the urethra. The sponges of the external opening of the urethra turn red, swelling is noted, the inflammatory process is concentrated in the area of the urethra wall. Minor pressure leads to the expiration of the purulent discharge. After a night’s sleep on the laundry, you can find purulent stains. The feeling of the urethra allows us to isolate some of its density.
In general, the sensations that the patient experiences with urethritis are characterized by the scale of the inflammatory process within the urethra (this is the posterior urethritis, anterior urethritis or full urethritis), and the urgency of the complications is also taken into account. Thus, some patients may experience burning or itching in the urethra, while others may experience pain during urination.
If an acute variant of the flow of torpid urethritis is considered (the low-symptom form of this disease), then urge to urinate is frequent, in the urethra area pain is noted, the body temperature rises. Completion of the act of urination in this case becomes the appearance of a minimum amount of bleeding, they are defined as terminal hematuria. There is also edema of the urethra. In general, the course of torpid urethritis, if it is not about its acute form, is characterized by its own monotony, there are no sharp boundaries, as a result, its transition to a chronic form of gonorrhea.
Subacute urethritis: symptoms
This form is characterized by a gradual reduction in puffiness and pain in the urethra. Purulent discharge or have a meager character, or disappear at all. In some cases, the presence of excretions in the morning (they have the appearance of a crust, due to which the external hole in the urethra is glued) is allowed. The urine also changes: it becomes more transparent, there are insignificant purulent threads in its composition.
Chronic urethritis: symptoms
Transition to a chronic form takes place with ineffective therapy for a disease or in the absence of proper treatment as such. Appearance of complaints (exacerbation of urethritis) in this case is preceded by the effect of provoking factors, against which background a certain amount of purulent discharge is noted. Such factors include hypothermia, alcohol consumption by the patient, etc. In general, the symptoms of chronic urethritis coincide with the manifestations typical of the torpid form of urethritis, which we previously isolated. The course of the disease can be of a lasting nature, which implies not only months, but also years, which can ultimately lead to a doctor (if this was done before the disease passed to this form). Prolonged flow of this form of urethritis can provoke stricture of the urethra, in which the urethra in the lumen begins to narrow, which causes urination to be accompanied by a change in the urine stream (it becomes weak) and soreness.
Total Urethritis: Symptoms
The peculiarity of this form of urethritis flow is that the urethra in this case is completely exposed to the inflammatory lesion. Symptoms of total urethritis are characterized by similarity to the symptoms of prostatitis. With acute total urethritis, the urge to urinate has an irrepressible nature of manifestation, the completion of urination is accompanied by soreness. In the urine, bloody and purulent components are noted.
Diagnosis is based on conducting a physical examination of the patient in the presence of his symptoms, indicating a possible urethritis. Inspection 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, and also on the basis of purulent discharge.
In the future, a smear is performed on Gram, if there is a suspicion of the urgency of gonorrheic urethritis. Diagnosis of the disease is also supported by the results of urinalysis when leukocytes are detected in the sediment, the analysis of the urethra scraping and vagina (the presence of chlamydia is determined). If necessary, scrapings can be made from the rectal area.
Treatment of urethritis
The definition of drug therapy measures is based on the nature of the onset of the disease. As the main treatment measures, washings with the use of antiseptic drugs directed directly to the urethra area are used, 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 (warming applications, electrophoresis, etc.), local treatment (for example, sessile trays based on herb decoction), the use of immunostimulants and immunomodulators.
The diet is mandatory during treatment. In particular, it excludes salted, smoked and spicy food, alcohol. In the acute stage of the disease manifestation, the diet is based on products of lactic-acid origin, and abundant drinking is also shown. The effect of negative provoking factors (physical overload, hypothermia) is excluded, and restrictions apply to sexual activity within this period.
If you do not treat urethritis, 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 (obturation form). Vesiculitis can also develop.
As the main way to prevent urethritis is the implementation of the barrier method, which consists in contraception with the use of condoms, which is especially important when having sexual intercourse with non-regular partners. Also, an important aspect in the prevention of gonorrhea is proper hygiene measures.
If suspected of the relevance of urethritis, you should visit a venereologist, with nonspecific urethritis, the patient goes to the urologist.