The urethral canal in women. Causes of urethritis development. Features of the course in women

Damage to the inflammatory process of the walls urethra, provoked by infectious and non-infectious factors, is called urethritis. The pathology is widespread both among representatives of the stronger half of humanity and among women. However, it is detected faster in men due to their anatomical features.

This circumstance must be taken into account by specialists when urethritis is suspected in women. After all, delaying treatment procedures leads to chronicity inflammatory process and the emergence various complications and consequences.

A peculiarity of the course of the pathology in women is the lack of expression of symptoms - unpleasant sensations may be completely absent.

Most often, the disease is associated with an existing malfunction in the genitourinary system of infectious or inflammatory etiology, for example, cystitis. And the complaints presented by the patient will be characteristic of him.

Only a highly qualified specialist can carry out an adequate differential diagnosis with subsequent selection of appropriate treatment.

Causes

The female urethra is designed by nature to be short, but at the same time quite wide. That's exactly what anatomical structure determines the ease of penetration of infectious agents from the outside or from the inside - from neighboring tissues and organs.

Experts indicate the main causes of non-infectious urethritis:

• Already occurring in a woman urolithiasis when the urethral mucosa is damaged by fine sand or pebbles;
• Focus of atypia in tissues, malignant neoplasm;
• Traumatization of the organ due to cystoscopy and catheterization;
• Increased allergic background;
• Various obstetric and gynecological diseases;
• Tendency to physical inactivity, which contributes to the appearance venous stagnation in the pelvic area.

Against the background of each of the listed conditions, the processes of inflammation of the urethra in women form quite quickly, but practically do not manifest themselves at all.

Reasons infectious variant The disease can be caused by both opportunistic and pathogenic microflora. Nonspecific urethritis is provoked by staphylococci and streptococci, Proteus and Escherichia coli, fungi and adenoviral agents. All of them live in the human body, but the opportunity to cause an inflammatory focus is obtained only with a significant weakening of the protective forces.

The appearance pathogenic flora in the area of ​​the urethra, as a rule, precedes sexual intercourse. This is how gonococci and chlamydia, trichomonas and ureaplasma are transmitted from one partner to another.

Predisposing factors

For the appearance of an inflammatory process that causes the formation of urethritis in women, the symptoms of which may be completely absent, certain conditions must be created. The following predisposing factors contribute to their occurrence:

• Chronic allergic conditions;
• Significant single or prolonged low hypothermia;
• Immunodeficiency processes;
• Psycho-emotional overload, severe stress;
• An uncorrected diet - a predominance of spicy, fatty, heavy foods, sauces, spices, preservatives;
• Vitamin deficiencies;
• Alcohol abuse;
• The period of bearing a baby;
• Ignoring basic rules of personal hygiene;
• Menopausal changes.

Urethritis in women can occur against the background of existing chronic inflammatory pathologies– the same adnexitis, cholecystitis, tonsillitis, and even caries, tuberculosis. Therefore, the elimination of such foci of infection should be given Special attention not only by specialists, but also by the patients themselves.

Symptoms of nonspecific urethritis

After a latent period of the disease, the duration of which can be several hours or several months, urethritis in women either makes itself felt with a clear clinical picture, or no manifestations of pathology are observed at all.

Symptoms common to the specific variant and nonspecific form of urethritis:

• Intense itching in the urethral area;
• Significant discomfort felt at the time of urination;
• Periodic pain impulses in the pubic area;
• Discharge directly from the urethra of varying shades and consistency;
• Presence of bloody impurities in the urine;
• A peculiar “sticking together” of the urethra, especially in the morning.

Similar symptoms may not appear at the same time. Some of them are more pronounced, while others are absent.

Characteristic for female urethritis is the absence of general inflammatory manifestations, for example, fluctuations in temperature parameters, severe weakness, lack of appetite.

When the pathology transitions into, symptoms, as a rule, are completely absent. And only a significant decrease in local immunity provokes the appearance of discomfort and discharge from the urethra.

Symptoms of specific urethritis

Brighter clinical picture will be when affected by specific agents:

Gonorrhea.

For in acute stage characterized by sharp pain with pain during bowel movements Bladder. A distinctive feature is severe discomfort in the projection of the urethra when urination is delayed for any reason.

Trichomonas.

A few weeks after infection, symptoms of the Trichomonas variant of urethritis will be observed - intense, debilitating itching that is not relieved by local baths and frequent showers.

An unpleasant burning sensation in the area of ​​the inflammatory focus, as well as in the genital area. As the process becomes chronic, the symptoms disappear.

Candida (fungus).

Often urethritis, provoked by fungal microflora, is disguised as candidal vaginitis. A woman is worried about severe pain when visiting the toilet. In addition, whitish, viscous discharge. Symptoms are moderate.

Mycoplasma.

The mycoplasma variant of urethritis develops gradually, the patient may only be bothered by minor itching, as well as discomfort during urination. Timely detection of urethritis in a woman, with treatment carried out in accordance with accepted standards, contributes to quick recovery.

Chlamydia infection in most cases is completely asymptomatic. Women most often do not pay attention to mild itching. The only cause of concern is discharge that appears towards the end of the first month after infection.

Deciding how to treat urethritis specific woman The specialist will be there after identifying the causative agent of the infection. Self-medication is unacceptable.

Diagnostics

After a thorough collection of the woman’s history and complaints during the initial consultation, the specialist begins a physical examination. As a rule, upon examination, pronounced hyperemia of the tissues of the urethra and adjacent areas, as well as their soreness, is revealed.

At acute course diseases will be observed and pathological discharge , up to purulent. They must be collected for research. Urethritis in women will be confirmed using the following methods diagnostics:

• General urine and blood tests;
• Bacteriological culture of urine;
• Determination of the sensitivity of the identified pathogen to antibacterial drugs;
• Urine examination for mycobacteria.

The PCR diagnostic technique is recognized as the most accurate - biomaterial is taken directly from the urethra. Among the instrumental techniques recommended for implementation:

To determine the treatment tactics for urethritis in women, a specialist needs all the information from the above laboratory and instrumental diagnostic methods.

Therapeutic measures

After determining which pathogen or provoking factor became the root cause of the inflammatory process in the urethra, a specialist will select healing procedures. Basic recommendations:

• Wearing underwear only from natural materials;
• Sexual rest;
• Correction of the diet - exclusion of heavy, fatty, spicy foods;
• Drink plenty of fluids – at least 1.5–2 liters. per day;
• No excessive physical activity;
• Elimination of hypothermia.

Drug therapy – antibacterial agents or antifungal medications are prescribed only by a specialist. Taking them on your own only aggravates the situation; microorganisms become resistant to medications.

In addition, the general health of the woman must be taken into account. age group, susceptibility to treatment.

Local anti-inflammatory procedures are also required.– antiseptic sprays, solutions, and decoction baths are used medicinal herbs. Comprehensive and timely treatment can quickly eliminate negative symptoms.

If the root cause is pathogenic specific agents, therapeutic measures should also be carried out for the sexual partner.

Previously, it was believed that men were more susceptible to this disease, but urethritis in women is common. Quite a few women different ages become victims of this disease various reasons, however, the main one is infectious infection. Whatever the prerequisites for the appearance of urethritis, its treatment should be approached seriously and thoroughly.

What is urethritis?

Urethritis is an inflammatory process of the urethra and its mucous membrane (urethra). A woman who has become a victim of this disease experiences pain, pain, and burning while passing urine through the urethra. This disease does not pose a threat to the patient’s life, but it causes enormous discomfort, which interferes with everyday activities and disrupts plans.

As a rule, urethritis in women occurs in several stages. It is important to try to prevent the disease when it is in its early stages, so as not to cause irreversible consequences for the body. Flow stages:

1. Periodic exacerbations - pain accompanying urination. As a rule, at this stage of development of urethritis, patients rarely consult a doctor, because such symptoms quickly pass. It may even seem to them that this is an episodic case, but the disease, which has once manifested itself, continues to develop.
2. Painful sensations occur more and more often, but only when passing urine. A woman stops deceiving herself and knows that next exacerbation urethritis is inevitable. During the second stage of the disease, patients often turn to doctors.
3. Now exacerbations of urethritis are accompanied by constant pain and pain, and not just at the time of urination. At this stage, in the absence of proper treatment, deformation of the canal and further infection are possible - first of the bladder, then of the kidneys.

The duration of each stage of urethritis is individual and depends on the characteristics of the body - one can drag on for a long period, the other passes quickly. Inflammation of the bladder (cystitis), which occurs if left untreated, should be distinguished from urethritis. With cystitis, a woman experiences discomfort at the end of the process of urine output, during urethritis - during the entire urination. However, these two diseases tend to develop side by side.

Look detailed video about what urethritis in women is:

Knowing the factors that provoke the appearance of urethritis in women will help you avoid the disease or understand its causes. Depending on the nature of its occurrence, the disease is divided into two types:

• Infectious urethritis (specific pathogens - chlamydia, gardnerella, trichomonas, ureaplasma, mycoplasma; nonspecific - streptococcus, staphylococcus and gonococcus, causing gonorrheal urethritis).
• A disease caused by other factors.

Both varieties are associated with decreased immune function. The main factors influencing the development of urethritis are:

• Severe hypothermia can cause urethritis, regardless of whether the woman was exposed to it once or whether minor cold constantly affected the genitourinary system. Therefore, from childhood, adults teach girls “not to sit in the cold” - the consequences can be terrible.
• Sexual contacts. After the first experience with a man, some women notice symptoms of the disease. This may be due to the impact of “foreign” microflora on the body and provoke the development of infection.
• Sexually transmitted sexually transmitted diseases. Be careful when intimacy with a new partner, use contraception to avoid infection.
• Temporary decrease in immunity due to certain factors - pregnancy, childbirth, menstrual cycle, menopause. The hormonal background, which is unstable at these moments, can cause immunity disorders, as a result - the appearance of urethritis.
• Gynecological problems of acute and chronic course, reducing local immunity.
• Poor nutrition. Excessively spicy, salty foods, consumption alcoholic drinks– all this aggravates the manifestations of urethritis.
• Medical procedures that may cause undesirable consequences: a swab taken from the woman’s urethra and a catheter inserted into the urethra. These procedures are carried out to alleviate urethritis, but can cause further exacerbation.
• Cystitis. Inflammation of the bladder can be both a consequence and a cause of urethritis.
• Urolithiasis disease. Excess salts excreted from the body in the urine injure the urinary tract, causing inflammation.
• Radiation sickness.

In order not to harm your body, you should not try to determine the cause of urethritis on your own and self-medicate. Contact a professional uro-gynecologist who will carry out all the necessary diagnostic procedures. A woman’s genital organs are closely connected with the urinary system, and urethritis mainly appears due to a violation of the vaginal microflora, where suitable conditions for development are created. pathogenic microorganisms.

Symptoms of inflammation of the urethra

The main signs of urethritis in all women are:

• Painful, burning sensations during the entire process of urination, increased sensitivity of the urethra.
• The presence of redness on the skin of the external genitalia, as well as the urethra.
• Discharge of pus from the urethra. The color of the pus varies from white to green, depending on the nature of the occurrence.
• Feeling constant itching in the vagina, which becomes stronger before menstruation.
• Permanent nagging pain lower abdomen. Usually the nature of such sensations is not acute, the pain is mild.

Many people cannot correctly distinguish between the symptomatic features of urethritis and cystitis. To avoid misdiagnosis, please note that cystitis is characterized burning pain, pain at the end of urination, causes constant urge go to the toilet, and urethritis provokes a painful sensation during the entire process of urine exiting through the inflamed urethra (pictured).

Symptoms may vary, because urethritis occurs in women different types– herpetic urethritis, candidiasis, purulent, allergic, tuberculosis, etc. Will be different external manifestations each type of urethritis and treatment of the disease.

How to treat urethritis in women - drugs

When treating urethritis in women, a regimen is used that involves comprehensive solution Problems. Medicines are used as separate agents and during certain procedures. At complex treatment urethritis is prescribed:

• Antibiotics – mandatory remedy which will help fight infection. Their use is possible only after a series of tests that determine the sensitivity of the infection to certain antibiotic drugs. Taking general antibiotic Without first identifying the pathogen, in some cases you may not achieve the effect of treatment.
• Special antiseptic sitz baths, which will additionally help neutralize the infection.
• Physiotherapy, which involves the use of electrophoresis on areas of the disease, heating applications.
• Tampons treated with medicinal ointments that are inserted into the vagina.
• All kinds of drugs that stimulate and support the immune system - immunomodulators, immunostimulants. Vitamin complex will also help the body cope with urethritis.

Urethritis in women requires not only powerful drug therapy, but also the right image life. Prerequisite for recovery - a diet that includes proper nutrition, no salty, spicy food. You should eat as many vegetables and fruits as possible, avoid fried foods, and drink at least a liter of water per day. During exacerbations of urethritis, it is recommended to drink milk.

People with a predisposition to urethritis need to pay close attention to genital hygiene, limit the number of sexual acts, and not overdo it with sports. In case of a serious complication of urethritis - deformation of the urethra, leading to constant painful sensations, a procedure is carried out to cauterize the walls to restore their properties.

After treatment of urethritis, if any positive result, it is necessary to undergo regular examinations, observe preventive indications doctors to prevent new inflammation.

Antibiotics

When the diagnosis has been completed and the causative agent has been identified, the woman is prescribed a course of antibiotics to treat urethritis. The type of medicine itself depends on the microorganisms against which it has to fight. This may be ceftriaxone, tetracycline, ornidazole, metronidazole, doxycycline, azithromycin. Antibiotics wide range actions are an indispensable part of the treatment of urethritis.

They can be given as tablets, intravenous or intramuscular injections, suppositories, “installations” (when an antibiotic is injected into the urethra through a catheter). Doctors can also prescribe combinations of several antibiotics - two, three, four. The latter is typical for severe cases of urethritis.

Candles

The use of suppositories is a common practice during the treatment of urethritis in healthy woman and prevention. This local remedy affects directly the problem itself. The drug helps relieve itching, burning, and pain. Vaginal antibacterial, anti-inflammatory suppositories are also prescribed by doctors when a large dose of antibiotics is contraindicated.

Treatment of urethritis with folk remedies

Medication therapy has come a long way, but urethritis in women is often treated with folk remedies that are still not outdated to this day. Natural components contain microelements and vitamins that help reduce the symptoms of the disease and improve the health of the body. However, it is recommended to use folk remedies as an addition to the treatment of urethritis.

Here are a few folk recipes that will help you cure this unpleasant disease:

• Parsley tincture. This remedy must be taken every few hours, three tablespoons. To prepare the tincture, pour one tablespoon of raw material with half a liter of water and leave to infuse overnight. In the morning the tincture will be ready.

• Two glasses of yellow zelenchuk tincture ( daily norm) will help get rid of the problem. To prepare the tincture, pour a quarter liter hot water one tablespoon of herb. In twelve hours it will be ready to eat.
• Blackcurrant leaves (3 tsp) should be poured with half a liter of boiling water and drunk as tea.
• Cornflower flower tincture. Take two tablespoons of this remedy twice a day, before meals. The remedy is prepared as follows: the flowers of the plant are poured with a quarter liter of boiling water. Afterwards you need to wait a few hours.

Taking various tinctures, you are approaching the moment of recovery. They are easy to prepare at home.

Prevention of urethritis at home

Take care of your health yourself: follow preventive procedures to avoid the disease or its recurrence:

• After anal intercourse or caresses of this area, you should not proceed to vaginal intercourse.
• Go to the toilet before and after sexual intercourse.
• Don't forget about mandatory contraception.
• Eat right.
• Hygiene is the basis of a healthy genitourinary system.
• Avoid stress.
• Support your immune system with periodic courses of vitamins.
• Check the vaginal microflora with a gynecologist to avoid dysbiosis, which can lead to disease.

Remember that you can prevent urethritis by initial stage, if you pay attention to your body. Support healthy image life, avoid factors that provoke the development of the disease, and you will not encounter it.

Have you ever struggled with this disease? Tell us about your experience in the comments after the article.

Perhaps of all sick women, those with urethritis suffer the most. The main symptoms of urethritis in women are painful sensations along the urethra, which may have a burning or stinging character. Initially, pain is noted only when urinating, and over time it also manifests itself at rest. The main cause of urethritis in women is infection.

Urethritis is the process of inflammation of the urethra, the thin duct through which urine is removed from the bladder. Symptoms of urethritis in women include pain and pain during urination. If you do not pay attention to the symptoms of urethritis in women, that is, start the disease, then the disease can develop into chronic form.

In women, the symptoms of urethritis are extremely difficult, if not impossible, to distinguish from the symptoms of cystitis, and urethritis in its pure form (without an accompanying inflammatory process in the genital organs) is extremely rare.

The main symptoms and signs of urethritis in women include:

• Discharge from the urethra (the nature of the discharge depends on the causative agent of urethritis, most often greenish or white-yellow or bloody discharge with an unpleasant odor is observed)
• Lower abdominal pain. As a rule, pain with urethritis in women is localized in the lower abdomen. Pain with urethritis in women is constant and of low intensity
• Burning (itching) in the area of ​​the urethra, redness of the outlet of the urethra.

Most often, symptoms of urethritis in women appear several hours or days after sexual intercourse.
Due to the anatomical features of the structure of the urethra in women already described above, urethritis in them is often associated with cystitis.

Symptoms of urethritis in women appear several hours or days after sexual intercourse. Due to the anatomical features of the female urethra, urethritis is usually associated with the disease cystitis.

Symptoms of urethritis in women are often confused with manifestations of cystitis. The latter disease is inflammation in the bladder. The main manifestation of cystitis is frequent urge to empty the bladder. With the development of cystitis, pain in the lower abdomen and pain in the urethra at the end of urination are noted. With the development of symptoms of urethritis in women, a slightly different picture is observed - pain occurs at the very beginning of the process or evenly accompanies the entire process of emptying the bladder. In addition, at an advanced stage of the disease, pain in the urethra does not go away.

Urethritis in women is much more complicated than in men. He deprives a woman full life.

Meanwhile, cystitis and urethritis can develop in parallel. Under such circumstances, the symptoms of urethritis in women may be similar to the symptoms of cystitis, or dominate the latter disease.

Previously, there was an opinion that only men were susceptible to urethritis. In reality, this is not at all true - every woman can get urethritis.

There are two types of urethritis - non-infectious and infectious. The causative agents of the latter can be microorganisms:

- specific- those that cause exclusively venereal diseases(Trichomonas, gonococcus, mycoplasma, chlamydia, ureaplasma, less often - gardnerella). Moreover, infections are often combined with each other or with concomitant diseases caused by other fungi, bacteria and viruses.

- nonspecific(a group of opportunistic microflora - staphylococcus, proteus, streptococcus, E. coli and others).

What is Urethritis

Urethritis is an inflammation of the urethra. Its main manifestation is burning, stinging or pain when urinating, but at some stage of the disease the urethra begins to hurt constantly, day and night, day after day.

There is no need to confuse urethritis with cystitis - inflammation of the bladder. The manifestation of cystitis is frequent urination, or frequent false urges for urination. Cystitis is characterized by pain in the lower abdomen or sharp pain in the urethra at the end of urination. With urethritis, the pain is strongest at the beginning of urination or the same throughout it. In addition, as already mentioned, the urethra can hurt constantly, without any connection with urination at all.

Cystitis and urethritis often occur simultaneously. At the same time, their manifestations can be equally pronounced, or the symptoms of one of the diseases can sharply predominate. In women, the symptoms of urethritis are less pronounced than in men and may go unnoticed altogether.

Who suffers from urethritis

Any woman can get urethritis. Moreover, rare woman at an older age she can say that she has never had similar symptoms in her life. Of course, the more predisposing factors, the greater the chance of developing urethritis, but there are so many of these predisposing factors, and they occur so often that literally any woman has a chance of getting sick.

Still, let’s list some of these factors here to make it clear what I’m talking about.

• Hypothermia - one-time strong or periodic not too strong, both can lead to the occurrence of urethritis.
• Sex life. The beginning of sexual activity under certain conditions becomes the beginning of suffering associated with urethritis. Violent sexual intercourse can cause symptoms of urethritis in any woman at any time. Women suffering from urethritis long time, usually note an exacerbation of urethritis after each sexual intercourse.
• Errors in diet. Hot, sour, salty, spicy, fried, pickled, bitter, alcoholic - all these substances enter the urine and, when released, irritate the urethra.
• Gynecological diseases. This is perhaps the most serious of all predisposing factors. Almost any disease in this area leads to disruption of the vaginal microflora and a decrease in local immunity. And any disease can thus lead to the development of urethritis.
• Urolithiasis disease. If crystals constantly form in the kidneys, they, released in the urine, can injure the walls of the urethra and cause symptoms of urethritis. Usually, sooner or later inflammation occurs, and severe urethritis develops.
• Medical procedures and interventions. A smear from the urethra in a woman can cause the development of urethritis. Catheterization of the bladder, cystoscopy - all this is familiar to women suffering from urethritis, and all this leads to an exacerbation of the disease, although it is carried out to treat it.
• Decreased immunity. In fact, all of the above is in one way or another connected with the immunity of the wall of the urethra, so there is little left to mention here. Pregnancy, childbirth, breastfeeding and the menstrual cycle are associated with changes hormonal levels in a woman, which cannot but affect the pelvic immune system and can lead to the appearance of urethritis without other visible reasons. We will talk more about immunity problems with urethritis a little later.
• Toxic and radiation factors. This is already exotic and very rare. But I will tell you a case that my patient told me. In one respected and very expensive Moscow clinic (I am not giving its name here, but if you ask me, I will not hesitate to name it) this lady was offered a course of physiotherapeutic procedures involving the insertion of an electrode directly into the bladder. The interesting thing is that the lady was treated exclusively for a gynecological disease, and why they needed to touch the bladder, I can’t imagine. After the first procedure, the lady developed such acute radiation cystitis and urethritis that all other problems were immediately relegated to the back burner. She had the prudence to refuse further procedures, and in this state she came to me. Fortunately, treating all diseases was not difficult.

How does urethritis develop?

I was able to divide the course of female urethritis into three stages. It is characteristic that any of these stages can last for a very long time and does not necessarily go into the next one. Or, on the contrary, it may be very short-lived.

Stage 1. It all starts with periodic exacerbations of urethritis. They occur infrequently and can be expressed in different ways, from minor manifestations to very severe ones. The point is that exacerbations pass quickly and nothing bothers the woman in the intervals between exacerbations. Most often, exacerbations are not so frequent as to force a woman to see a doctor, but even if she visits a regular urologist or gynecologist, everything will end with the prescription of mild antibiotics and will be postponed until the next exacerbation. As a rule, any antibiotics at this stage quickly relieve the exacerbation.

Stage 2. Exacerbations are happening more and more often, antibiotics are helping worse and worse. To relieve an exacerbation, only the strongest and most expensive drugs. In the interval between exacerbations there are no (or almost no) symptoms, but a calm life has already been replaced by anxious anticipation. The woman begins to visit doctors. It all starts with a visit to a urologist and gynecologist at a district clinic, then through friends or commercial medical centers. Are being found and are being treated various diseases, accepted a large number of different medications, and nothing changes. You begin to limit yourself in many things - food, clothing, sex life. Life takes on clear stages - from exacerbation to exacerbation.

Stage 3 is the hardest. Remission of the disease actually does not occur; the woman feels either bad or very bad. The urethra constantly “aches” or “feels”, it hurts when urinating, and during exacerbations it constantly hurts. Antibiotics at this stage either bring significant and short-term relief, or have no effect, or even provoke an exacerbation. A woman begins to be afraid of the cold, tasty food, and sex life. My patients told me that during these periods they lost Good work, their husbands abandoned them, they attempted suicide. To be honest, I still feel a little uneasy when I listen to these stories, and only one thing consoles me - now I can cure these women, I can give them back a normal life.

Causes and development of the disease

Let's now talk about the most interesting thing - why everything happens this way.

So, I would venture to say that all cases of urethritis in women are associated with gynecological disease- violation of the vaginal microflora, or vaginal dysbiosis. Dysbacteriosis is that instead of normal microflora appears in the vagina large quantities some kind of bacterium that normally should not be there at all, or should be there, but in very small quantities. This bacterium can also become a sexually transmitted infection - chlamydia, ureaplasma, trichomonas, etc., but most often it is either a mixed flora or an opportunistic pathogen.

I constantly hear the question - where does it (flora) come from there? I answer. The term "opportunistic" means that the bacterium becomes pathogenic, that is, causes inflammation, only under certain conditions. In fact, this only happens when there are a lot of bacteria, that is, when there are conditions for their reproduction. And in small quantities, all these pathogens are found in our body in the most different places- on the skin, in the intestines, in the lungs, etc.

Numerous factors can lead to disruption of the vaginal microflora - hypothermia, gynecological diseases, antibiotic treatment, stress, poor nutrition etc. In my life, I have seen only a few women whose vaginal microflora was not disturbed, and I have never seen normal microflora in the vagina in women suffering from urethritis or cystitis.

So, we have a pathogen in the vagina. It constantly gets into the urethra and causes it chronic inflammation. As long as the immunity of the urethral wall copes with the situation, no symptoms of the disease arise.

During sexual intercourse, a more intense discharge of microflora into the urethra occurs; in addition, sexual intercourse itself is a considerable load for the urethra. Therefore, exacerbations of urethritis are almost always associated with sexual activity. But not only with her.

The role of immunity in the development of urethritis

As soon as the described situation develops, everything begins to be in the pathogen-immune balance. The immune system maintains the number of pathogens at a certain level, preventing them from developing further. This can go on for years and decades, and very often this is what happens. Furthermore, there may be a sharp sudden increase immune system, and then the woman will think that the disease has gone away on its own. This happens extremely rarely.

But overall it is like a time bomb where no one knows when it will explode. Sooner or later, a failure occurs in the immune system, the number of pathogens increases sharply, and the disease enters a new stage.
In addition, the woman begins to periodically take antibiotics, and antibiotics tend to reduce immunity. While the flora is sensitive to them, these processes seem to compensate for each other - when taking an antibiotic, immunity decreases, but the number of bacteria in the vagina also decreases. But when the microflora loses sensitivity to antibiotics, taking them either does not bring relief or even provokes an exacerbation.

Urethritis in women and sexually transmitted infections

Bacterial sexually transmitted infections, namely gonococcus, chlamydia, mycoplasma, ureaplasma and trichomonas, can cause urethritis when located on the wall of the urethra. They can also cause disruption of the vaginal microflora, against which various opportunistic microflora easily develop, which in turn causes urethritis. It turns out that sexually transmitted infections can cause inflammation of the urethra in two ways.

Treatment of urethritis due to sexually transmitted infection is no different from treatment ordinary urethritis. The only difference is the selection medicines for antibacterial therapy.

Urethritis and urolithiasis

At urolithiasis Crystals, so-called salts or sand, constantly form in the urine. Excreted in the urine, they injure and irritate the wall of the urethra, causing symptoms of urethritis.
If at this time all the above-described processes occur in the vagina, then the wall of the urethra will develop infectious inflammation. If not, then the symptoms of urethritis will periodically bother the woman, but usually not too much. But, as practice shows, sooner or later bacterial inflammation develops, and the course of the disease noticeably worsens.

Treatment of urethritis against the background of urolithiasis, among other things, aims to reduce the formation of salts to a minimum. This is greatly facilitated by the strengthening drinking regime and forced diuresis.

Complications of urethritis

We won’t have to talk about the complications of urethritis for a long time; there are very few of them. The most serious complication- this is the transition of inflammation of the urethra to the stage when it constantly hurts and no treatment can change it.

With urethritis, the inflammatory process can spread to the bladder, and then cystitis will develop. This happens very often; these two diseases constantly accompany each other. Further, the inflammatory process can spread to the kidneys with the development of pyelonephritis.

Long-term neglected chronic urethritis can lead to deformation of the urethra and the development of its stricture - narrowing. This is manifested in the fact that when urinating, urine is not released in a vigorous, cheerful stream, but with difficulty, as if overcoming an obstacle. Sclerosis of the bladder neck manifests itself in the same way, which sometimes develops with cystitis. But all this happens relatively rarely.

Other complications of urethritis are so exotic that they will not be discussed here.

Treatment of urethritis in women

In the treatment of urethritis, antibiotics and anti-inflammatory drugs that are active against the pathogen, and immunostimulating drugs, including multivitamins, are traditionally prescribed. Physiotherapeutic procedures are recommended - especially for urethritis complicated by cystitis. It is important to follow these dietary rules: drink plenty of fluids, avoid alcohol, spicy and spicy food. For acute gonorrheal urethritis, a gonorrhea treatment regimen is applicable; local treatment this involves insertion into the urethra antiseptic solutions.

If the patient's treatment was timely, the treatment outcome is favorable. Prevention of urethritis consists of maintaining personal hygiene, culture of sexual activity, timely detection and treatment of those diseases that can cause the development of inflammation of the urethra.

How should treatment be carried out?

When treating chronic urethritis in women, three main tasks are solved.

1. Restoring the properties of the wall of the urethra. This must be done in any case, but special meaning this task becomes severe cases diseases when inflammation is no longer directly associated with infection.

2. Restoration of normal vaginal microflora. As long as there is a constant infection of the wall of the urethra with microorganisms from the vagina, urethritis will return again and again. There is only one way to interrupt this - to populate the vagina with the microorganisms that should live there. This is not at all easy to do; this part of the course of treatment cannot be standard and can only be selected individually.

3. Restoration of the immune system. If there is a violation of the vaginal microflora, with long-term inflammation urethra, and very often when trying to treat, the body’s immunity in general and the immunity of the bladder wall in particular suffers. If it is not restored, the treatment will not have a lasting effect. It is very important to constantly remember that general and local immunity are restored in different ways, in completely different ways. Limiting yourself to prescribing a weak immunomodulator is the same as doing nothing.

Prevention of urethritis

Prevention of urethritis is to minimize all factors that can lead to disruption of the microflora in the vagina and to a decrease in immunity. Let's list the main ones.

• Severe hypothermia.
• Hormonal changes: pregnancy, childbirth, abortion, disorders menstrual cycle, cancel oral contraceptives, menopause, etc.
• Severe stress.
• Irregular sex life.
• Neglect of hygiene rules.
• Sexual infections.
• Treatment with antibiotics.
• Problems with bowel movements, both constipation and diarrhea. Especially if these problems are chronic.
• Irregular and unhealthy diet, lack of essential nutrients and vitamins.
• Sleep problems, regular lack of sleep.

Here it is appropriate to remember the rules of sexual hygiene, since failure to comply with these rules also contributes to the appearance of urethritis.

• You cannot move from anal intercourse to vaginal intercourse, from anal sex to caresses in the vaginal area.
• Try to visit the toilet before and after each sexual intercourse.
• Try to keep regular sex life without episodes of prolonged abstinence and, on the contrary, excessive activity.
• Never forget about contraception and STD prevention. It is best to combine a condom with antiseptics or spermicides. Don't forget that STDs can be transmitted through both oral and anal sex!
• Even if there is no reason, you should visit a gynecologist and get checked for STDs every six months.

Predisposing factors are so common in the life of any modern person that it is completely impossible to exclude them. Therefore, all that remains to be done is to be regularly observed by a doctor, and if the slightest deviation is detected, carry out preventive treatment. I can say with confidence that prevention is much easier and more enjoyable than treatment.

Inflammatory diseases of the urinary organs are very common among female population. They can provoke the occurrence of pathological processes various factors: hypothermia, decreased reactivity of the body due to stress, intense physical activity, associated infectious diseases other organs and systems. The appearance of discomfort when urinating in women is most often associated with the development of cystitis. However, often the reason discomfort There is an inflammatory process in the mucous membrane of the urethra, which is called urethritis.

Signs of urethritis in women are very easy to confuse with symptoms developing inflammation in the walls of the bladder. Therefore, it is necessary to seek help at the first symptoms of the disease. medical care see a urologist.

Information about the causes of the disease plays a role key role in definition further tactics treatment. Urethritis is considered a polyetiological pathology. Its development can be triggered by two large groups of factors:

1. Infectious factors: urethritis often develops due to the penetration of pathogenic microbes into the body. Depending on the species of the pathogen, specific and nonspecific urethritis are distinguished. The cause of progression of a specific inflammatory process in the urethra is considered to be gonococcal infection. Another name for specific urethritis is gonorrhea. Microorganisms such as chlamydia, mycoplasma, ureaplasma, staphylococcal and streptococcal, as well as intestinal flora cause nonspecific urethritis;
2. Non-infectious factors: inflammation in the urethra can be caused by trauma during therapeutic and diagnostic procedures: cystoscopy, installation of a catheter for acute urinary retention. Allergic reaction on local administration medicines(douching), hygiene items (soap, shower gels with dyes and fragrances) is also manifested by the development of inflammation in the urethra. IN in rare cases the mucous membrane of the urethra is injured due to the movement of stones through the urethra. Stones in the organs of the genitourinary tract are formed due to urolithiasis; in addition to urethritis, they are the cause of other inflammatory diseases genitourinary organs(pyelonephritis, cystitis). Urethritis of non-infectious etiology often occurs with the subsequent addition of infection due to a violation of the protective properties of the affected mucosa;

Typically, symptoms of urethritis in women develop acutely. Incubation period the disease lasts no more than 7 days from the moment of infection. If a woman does not consult a doctor when symptoms appear or does not follow his recommendations, then the acute form can become chronic, which is much more difficult to treat drug treatment. An important condition for the occurrence of an acute episode of urethritis or exacerbations in the chronic form is the presence of predisposing factors. The disease develops rapidly after hypothermia, acute respiratory infections, or excessive consumption of alcoholic beverages. Unprotected sex is also considered one of the main causes of specific or nonspecific urethritis.

Clinical picture of urethritis in women

An acute inflammatory process in the urethra is accompanied by pronounced clinical symptoms. As a rule, a woman cannot ignore the symptoms that arise, so it is during acute episodes that most patients visit a urologist. Most characteristic features urethritis in women:

• Painful sensations during urination;
• Increased urge to urinate;
• Pathological impurities may be found in the urine: blood, pus, mucus clots;
• Discomfort during sexual intercourse;

At the onset of the disease, the above symptoms may be accompanied by fever, weakness, and chills. If the inflammatory process, due to untimely or incomplete treatment, has become chronic, then over the course of several months or even years the woman will experience exacerbations of urethritis. Exacerbation is characterized by the same complaints as acute process. However, the disease progresses in more mild form, the symptoms are much less pronounced. The danger of chronic urethritis lies in the fact that many representatives of the fair sex do not pay attention to the short-term deterioration in their health or try to treat themselves. Exacerbations most often occur during menstruation, after unprotected intercourse or hypothermia.

Consequences of the disease for a woman’s body

Many women mistakenly believe that inflammation of the urethra does not threaten further complications. Relatively mild manifestations of the disease (especially in the chronic form of urethritis) mislead a woman, and that is why she interrupts the course of treatment earlier, immediately after the disappearance of the main symptoms, or does not consult a doctor at all. Treating urethritis at home with medications recommended by friends or relatives can lead to the following unpleasant consequences:

1. Pathogenic microflora can ascend into the bladder and provoke the development of inflammation in it. Often, urethritis caused by E. coli causes the development of pyelonephritis. Special group the risk of these pathologies is women with concomitant urolithiasis;
2. For urethritis bacterial pathogens often affects the Bartholin glands. Infection occurs due to contact of urine secreted from the infected urethra with the vestibule of the vagina, where these paired glands are localized. Bartholinitis is characterized by symptoms such as swelling and hyperemia of the affected area, mechanical pain, and discomfort during sex. The inflammatory process in the Bartholin glands often becomes chronic;
3. With urethritis there is a violation natural microflora vagina. Dysbacteriosis leads to the development fungal infection mucous membrane, and also facilitates the penetration of pathogenic microorganisms into the internal female genital organs with subsequent inflammation (, and others);
4. Prolonged inflammation in the walls of the urethra leads to a narrowing of its lumen and difficulty in the outflow of urine;

Remember that even a sluggish inflammatory process of viral, fungal or bacterial etiology- This chronic lesion infections in your body. Considering the anatomical features of the female reproductive system, urethritis can become a serious threat to your health and disrupt reproductive function.

Diagnostics

If you experience discomfort or difficulty during urination, you should consult a urologist. Before treating urethritis, it is necessary to establish the cause of the disease. For urethritis of non-infectious etiology, collecting the patient’s medical history will help: invasive interventions in the recent past (cystoscopy, catheterization), the presence of urolithiasis, a tendency to allergic reactions.

If the doctor suspects an infectious etiology of development pathological process, That diagnostic measures will be aimed at identifying the pathogen.

To do this, they will take your vagina, and then send it for microscopy and bacteriological research. If you suspect viral etiology urethritis may be needed PCR method, it is used to identify the genetic material of an infectious agent. Antibiotics for urethritis in women are selected based on the results of a test to determine the sensitivity of the isolated microorganism to them.

Treatment and prevention

The acute form of urethritis is much easier to treat with medication, so you should not delay going to the doctor. You need to follow the doctor’s recommendations as accurately as possible; do not stop taking the medications immediately after you feel better. Remember, how and with what to treat urethritis in women is decided exclusively by the urologist after the examination and receipt of test results; self-medication is strictly contraindicated.

Treatment of urethritis is primarily aimed at eliminating the cause of the disease. When treating urethritis in women, antimicrobial or antiviral action depending on the pathogen identified. You should not take antibiotics on your own; they may eliminate the symptoms for a while. unpleasant symptoms, but will not affect immediate cause development of urethritis. Based on the main symptoms of urethritis in women, treatment may include anti-inflammatory and analgesic drugs. For greater effectiveness, local medications are used; they are injected into the urethra using douching.

In order to avoid developing urethritis, the first priority is to eliminate predisposing factors as much as possible. Avoid hypothermia, have protected sex with a regular sexual partner, and promptly seek medical help at the first signs of infectious diseases.

Urethritis is a widespread disease characterized by inflammatory damage to the mucous epithelium of the urethra. There is a false belief that men are most susceptible to this pathology. In reality, women face this problem just as often as representatives of the stronger sex.

Inflammation of the urethra is not a life-threatening disease for the patient, but it is a factor contributing to the development of inflammatory diseases of other organs of the genitourinary system. For this reason, identifying any symptoms of urethritis is sufficient reason to visit a urologist and begin comprehensive treatment.

Causes of urethritis in women

Depending on the causes of occurrence, urethritis is divided into the following groups:

• non-infectious;
• infectious.

Reasons non-infectious inflammation the urethra can become:

• allergic reactions;
• injuries sustained during diagnostic or therapeutic procedures;
• anatomical features of the structure of the organs of the genitourinary system.

Urethritis of infectious origin are divided into specific and nonspecific. Main reason specific inflammation The urethra is considered to be infected with an STD during sexual intercourse with an infected partner. The causative agents of the disease in this case may be:

• other microorganisms that provoke the development of sexually transmitted diseases.

The cause of nonspecific urethritis is the uncontrolled reproduction of opportunistic microflora in the urethra ( coli, Proteus, fungi, staphylococci, streptococci, etc.). A factor contributing to the development of the inflammatory process is the weakening of local or systemic immunity, which occurs against the background of:

• hypothermia of the body;
• lack of nutrients and vitamins;
• incorrect approach to diet planning;
• transferred common diseases.

Often, non-infectious urethritis in women is complicated by infection and becomes infectious.

Symptoms of urethritis in women

The main signs of urethritis in women are:

• redness of the genitals, external opening of the urethra;
• acute pain and;
• the appearance of unusual (the appearance of the discharge may vary depending on the causative agent of the disease).

It is worth noting that urethritis in women is often asymptomatic. In this case, the patient does not experience any discomfort and may not even suspect that she has a serious genitourinary disease.

Treatment of urethritis in women

The standard treatment program for urethral inflammation in women includes:

• usage antibacterial drugs, active against pathogens;
• taking medications that improve immunity;
• instillation of antiseptic solutions into the urethra;
• sitz baths with decoctions medicinal herbs or pharmaceutical antiseptics;
• physiotherapy (electrophoresis on the pubic and sacral area, warming applications).

In addition, diet must be included in the treatment regimen. Women exclude spicy and too salty foods, smoked foods, marinades and alcohol from their diet. During the treatment period, the patient must give up excessive physical activity, smoking and sexual intercourse.

Drugs for the treatment of urethritis in women

Now a few words about how to treat urethritis in women, and what means are considered the most effective in combating this unpleasant illness. During treatment inflammatory lesion the following groups of medications are used in the urethra:

• antibiotics prescribed after determining the sensitivity of pathogens to drugs (norfloxacin, amoxiclav, nolicin, pefloxacin, ciprofloxacin, doxycycline, azithromycin and others);
• antiseptic solutions intended for preparing sitz baths (potassium permanganate solution);
• uroseptic solutions used for instillation into the urethra (collargol, protargol, chlorhexidine, miramistin);
• immunostimulants and immunomodulators;
• multivitamin complexes.

Prescribing medications, establishing their dosage and duration of treatment is in exclusive competence a urologist who conducted an in-person examination of the woman and reviewed the results of all necessary laboratory tests.

Chronic urethritis in women

If left untreated, urethritis quickly becomes chronic. In this case, the symptoms of the disease either become less pronounced or disappear, which gives the patient reason to believe that the body was able to overcome the inflammatory process on its own, without a course of drug therapy. Meanwhile, infectious agents continue to actively multiply in the ducts of the Bartholin and small vaginal glands, provoking exacerbations of the disease when conditions favorable for this occur (for example, during hypothermia or alcohol abuse).

The treatment regimen for chronic urethritis is similar to that used to eliminate acute inflammatory process in the urethra. Meanwhile, treatment of this pathology in most cases requires additional effort and significant time expenditure. The criterion for recovery is the improvement of the patient’s general condition and the normalization of the results of all laboratory tests.

It is important to understand that an illiterate approach to drawing up a treatment program for urethritis is the main reason for the spread of the inflammatory process to nearby organs and tissues. For this reason, doctors recommend abandoning any attempts at self-medication and undergoing a course of therapy only under the supervision of experienced specialists in the field of urology.