Viral urethritis in men, symptoms and treatment. Urethritis. Pathogens that cause infectious urethritis

It can be infectious or bacterial in nature and cause different symptoms in men and women.

Urogenital infections are the most extensive bacterial infections and represent one of the pressing problems in modern urology and venereology. Inflammatory processes in the urethra appear due to infection in the urethra, but the inflammation can also be non-infectious.

In women, infection from the urinary canal spreads to the area:

• Bladder,
• ureters;
• kidney;
• appendages;
• vagina;
• ovaries and fallopian tubes.

In rare cases, the infection affects the rectum.

Diseases that contribute to the development of non-gonorrheal inflammation:

1. Urethritis. One of the reasons for the appearance is the penetration of infection into the urinary canal.
2. Urolithiasis disease. Passing through the ureters, stones damage the urethra, causing irritation and inflammation.
3. Cystitis. Changes under the influence of the inflammatory process occurring in the walls of the bladder. It has a bacterial and non-bacterial nature. Cystitis is provoked by kidney stones, the development of tumors, polyps in the bladder, and congestion. Often occurs due to the introduction of bacteria during sexual intercourse.
4. Pyelonephritis. The short length of the urethra in women contributes to the spread of infections and the appearance of pyelonephritis much more often than in men. Inflammation of the renal pelvis often occurs in women during pregnancy, and the right side is predominantly affected. Risk factors for the appearance of gestational pyelonephritis are pathogenic flora in the urinary tract.
5. Urogenital tuberculosis. During illness, mycobacteria easily penetrate any organ, including the urethra. This type of inflammation occurs as a complication of tuberculosis.

Inflammation of the urethra in women, the symptoms of which are pronounced, often occurs due to sexual transmission of infections.

Diseases that provoke inflammation in the urinary canal:

1. Gonorrhea. Occurs due to gonococci entering the urethra.
2. Inflammatory processes in the pelvic organs. Chlamydia and herpes simplex virus cause damage to the vagina, cervix, ovaries and fallopian tubes.

Inflammatory processes caused by bacteria occur under the influence of certain conditions:

• when the rules of genital hygiene are violated;
• aggressive detergents are used;
• Immunity is impaired.

Women at risk are more likely to develop urethritis:

• using contraception such as vaginal caps;
• Women in menopause, when hormonal changes make them more susceptible to infections in the urinary tract.

Stages and degrees

In medicine, urethritis is divided into two large groups - infectious and non-infectious.

The first group includes species caused only by infections:

• gonorrheal;
• trichomonas;
• tuberculous.

This also includes nonspecific causes of urethritis:

• bacterial;
• viral;
• mycotic;
• chlamydia;
• candida.

The group of non-infectious species includes:

• traumatic;
• stagnant;
• allergic;
• caused by diseases of the urethra.

In addition to the above types, there are residual, iatrogenic and psychogenic causes of inflammation of the urinary canal.

Urethritis has stages of development:

1. Spicy. It affects up to 80% of women. Characteristic signs: sharp pain in the urethra, frequent urination, increased body temperature.
2. Chronic. From the initial stage with mild symptoms to the transition to a chronic form, it can take 20 or more days.

Symptoms

Inflammation of the urethra, which has a non-gonococcal form caused by opportunistic microflora, is not as pronounced in women as in the gonococcal form.

Symptoms are subtle, which often leads to complications due to late contact with medical professionals:

• burning, pain during urination;
• frequent urge;
• itching in the genital area;
• rare discharge, greenish-yellow in color.

With the gonococcal form, the symptoms are more vivid and unpleasant:

• constant discharge of green or yellow color, often having a bloody structure, with an unpleasant odor;
• sharp pain in the lower abdomen;
• redness of the outlet of the urethra;
• pain when urinating;
• temperature increase;
• the appearance of a small amount of blood after sexual intercourse;
• heavy, painful periods.

Reasons for appearance

The urethra is a thin tube through which the bladder drains urine from the body. Inflammation in the canal is caused by microorganisms that enter the microflora of the lower genital tract during sexual intercourse or when the composition of the vaginal microflora changes.

The disorder in women is more dangerous than in men due to the structure of the genitourinary organs. The female canal is wider than the male canal, its length is from 2 to 4 cm, and is located near the opening of the rectum, which creates conditions for opportunistic flora to enter the canal.

Thus, it is like an open gate through which infections can pass freely. The inner wall of the canal is lined with epithelium, which promotes the development of bacteria. Normally, in humans, the canal is populated by numerous representatives of microflora, which under normal conditions do not cause inflammatory processes.

The occurrence of nonspecific inflammation of the urethra can be provoked by opportunistic bacteria:

• various types of staphylococci;
• streptococci;
• enterobacteria, in the form of Klebsiella;
• mushrooms;
• coli.

Other reasons for the development of inflammation may be allergic reactions, injuries, or chemical factors that disrupt the integrity of the mucous membrane.

Mechanical causes of urethral inflammation:

• vigorous sexual intercourse;
• catheterization;
• passage of stones through the urethra.

Chemical reasons:

• detergents with aggressive perfume additives;
• lubricants;
• condoms;
• spermicidal creams;
• local flavors.

Urethritis caused by external causes is temporary and goes away on its own after the irritating factor is removed. In the event of a secondary infection, inflammation may develop.

Diagnostics

To diagnose the disease, women initially consult a gynecologist. The doctor conducts a preliminary conversation, but examination and collection of complaints in this case provides little information.

The doctor gets a broader picture after studying clinical and microscopic analyses:

1. Urine examination. An increase in the white blood cell count indicates an existing infection. The cost of the procedure is from 250 rubles.
2. Urinalysis according to Nechiporenko. Based on its results, the doctor determines the exact number of red blood cells, leukocytes, cylinders, an increased level of which indicates the presence of an inflammatory process. The cost of the study is from 300 rubles.
3. Sowing on flora. The analysis is of great importance for identifying infectious diseases. The choice of antibiotics depends on its results. Analysis price from 400 rub.
4. General blood analysis. Cost – 150 rubles.
5. Determination of ESR. This indicator is not specific for infections, but allows you to determine the degree of inflammation occurring in the body. Analysis price from 130 rub.

If renal function is impaired, tests for serum creatinine and urea may be necessary. Each type of analysis costs 140 rubles.

Other studies:

1. Ultrasound of the kidneys, bladder, cost of one session from 190 rubles.
2. CT scan of the urinary system, the price of the procedure is from 2 thousand 500 rubles, the cost depends on the use of a contrast agent.
3. X-ray of the urinary system, Survey urography costs from 4 thousand rubles, review of the kidneys from 1 thousand 500 rubles.
4. Retro- and cystoscopy for suspected cystitis. The cost of the procedure is from 2 thousand rubles.

After establishing the causes of the inflammatory process, you may need to be examined by a venereologist.

When to see a doctor

Inflammation of the urethra in women (symptoms should not be ignored) is not always pronounced. This leads to the fact that women are much less likely to seek help from specialists, as a result of which they lack early diagnosis. For symptoms indicating urethritis, only a doctor can decide what tests need to be taken.

Non-infectious types of inflammation often require specific research methods.

If acute symptoms described above appear, you should immediately consult a doctor. Initially, this may be a gynecologist or therapist, who will subsequently refer you to a urologist or venereologist. But even with minor signs of inflammation, you should seek help from a doctor, because this inflammatory process has a long period of asymptomatic development of microorganisms.

Prevention

As a preventative action, simple rules should be followed:

Treatment methods

Inflammation of the urethra in a woman whose symptoms are pronounced is treated, like any infectious disease, with antibacterial therapy, which includes both local treatment and general medications.

Medications

Prescribed drugs are taken in various forms:

Depending on the root cause of the inflammatory process, medications are prescribed:

The duration of treatment and dose are determined by the doctor depending on the degree of damage, the stage of the disease, and the patient’s tolerability of the drug. Good results are achieved when treating urethritis with Azithromycin. It is used without additional means; it has a gentle effect on the female body.

The drug is well absorbed, quickly penetrates into cells, suppressing the protein synthesis of microorganisms. The daily dose for adults is 0.25 mg.

The drug Ciprofloxacin has a wider spectrum of action. It is prescribed as the main drug, it has no side effects and does not affect the gastrointestinal tract. The duration of treatment is up to 20 days. Prescribed doses are 0.25–0.5 g twice daily. Can be administered by injection, 0.1 g 2 times a day.

Traditional methods

Inflammation of the urethra in women (symptoms must be accurately correlated by the doctor with the type of disease) can be treated with supportive care, in the form of home remedies.

When treating inflammation, you should follow an integrated approach:

1. At the initial stage of the disease, doctors advise drinking plenty of fluids. This helps flush out bacteria from the body.
2. At the second stage, you should start taking the prescribed medications. Traditional home remedies should be in addition to the main treatment. And it would be good to consult a doctor before starting to use them.
3. At subsequent stages of treatment, thermal procedures in the form of sitz baths, to which herbal decoctions are added, help.

Relieve inflammation and unpleasant symptoms with herbal decoctions, which should be taken for at least 15–20 days. After this course, you should take a 2-week break and then continue treatment.

Recipes:

1. Leaves of nettle, mint, calamus, and horsetail are taken in equal proportions, poured into 500 ml of water, and boiled for 30 minutes. The decoction should be drunk before bed, ½ tbsp.
2. Take 100 chopped parsley leaves and pour in milk until it covers the herb. Place everything in the microwave and keep until the milk evaporates. Take the resulting product during the day, 40–50 g, every hour.
3. Herbal mixture consisting of rose hips, horsetail, juniper berries, pour 500 ml of water. The collection should be no more than 2 tbsp. l. Boil everything and leave for 15–20 minutes. Then strain and take 1 glass in the morning on an empty stomach and before bedtime.
4. Take 2 tbsp. l. dry black currant leaves. Pour 500 ml of water, boil a little and leave for 20-30 minutes. After straining, take the decoction throughout the day.
5. Infusion of blue cornflower flowers. Add 80 g of freshly picked flowers to 200 ml of boiling water. Infuse the collection for 1–1.5 hours. After straining, take 2-3 tbsp 2 times a day. l. before eating.

All decoctions are taken outside of exacerbation, they are prepared daily and should be drunk regularly, without skipping days. For better infusion, decoctions should be wrapped in a warm cloth.

For pain in the lower abdomen, local warming baths are used. They are made from decoctions of St. John's wort, yarrow and chamomile. Take 3 tbsp. l. each herb, pour 1–15 liters of boiling water, then pour into a basin prepared for the bath, diluting with warm water. The warming procedure should not last more than 20 minutes.

To enhance the diuretic effect and remove infections from the body, you can drink a homemade drink made from apple cider vinegar and honey (1 teaspoon each) added to a glass of water. The drink is consumed within a month.

Freshly squeezed juices from vegetables and berries help with urethritis. They should be taken daily, no more than ½ tbsp.

1. Carrot.
2. Cranberry.
3. Parsley juice.
4. Currant.
5. Beetroot.
6. Cranberry.

Sweet juices go well with sour ones. Eating these foods fresh will also help overcome the disease.

Cranberry juice increases the acidity of urine and increases the effectiveness of anti-infective drugs. Pharmacy tinctures based on Rhodiola rosea, Schisandra chinensis and aralia are used as maintenance therapy. The drugs are taken 20–25 drops daily for half a month.

Other methods

To speed up the recovery process, drug treatment is complemented by physical procedures:

After the sessions, your health improves noticeably; you don’t have to worry about relapses or the disease becoming chronic. Physiotherapeutic procedures are contraindicated for patients with a narrowed urinary canal.

In order to reduce spasms in smooth muscles, doctors advise taking warm sitz baths. Mud therapy, which is carried out on an outpatient basis in physiotherapy clinics or at mud and balneological resorts, is very helpful.

Possible complications

In the absence of timely treatment, complications may develop:

Women with infectious urethral inflammation should begin treatment immediately as soon as symptoms are identified and a diagnosis is made. Delayed therapy can lead to undesirable consequences, and life-threatening sepsis often occurs.

Video about inflammation of the urethra

What is urethritis:

Urethritis essentially an inflammatory process that develops in the tissues that form the urethra (urethra). Any inflammation is characterized by swelling and local stagnation of blood, leading to pain and subsequently to disruption of the normal functioning of the affected organ. With urethritis, the wall of the urethra swells, preventing the passage of urine, and the integrity of the epithelium is disrupted, which manifests itself in pain or pain.

Common signs of urethritis are pain of varying intensity when urinating, mucous or purulent discharge from the urethral canal and redness of the tissues that surround the urethral outlet.

The severity of symptoms depends on the clinical form of the disease - acute, subacute or chronic. Symptoms of urethritis vary depending on the type of pathogen and the anatomical features in the structure of the male or female urethra.

Anatomical features of the urethra In men, the length of the urethra is on average 20-23 cm . Conventionally, it is divided into the posterior part, which unites the membranous and prostatic parts of the canal, and the cavernous part, which is called anterior urethra . Topography is important for choosing medical tactics: for inflammation of the anterior or posterior urethra, different approaches to the treatment of urethritis are used. Anterior urethritis is complicated in 90-95% of cases

, posterior – inflammation of the bladder with ascending infection, frequent urge to urinate.

The male urethra is distinguished by physiological local expansions and narrowings of its lumen. The wide part (scaphoid fossa) extends up to several centimeters and ends with an external opening, the narrow part falls on the posterior urethra. Several depressions in the mucosa are formed by the exits of the urethral glands. The walls of the urethra are always closed outside of urination, the external opening is covered by folds of the skin of the head of the penis.

structure of the female (left) and male (right) urethra In women, the urethra is short, only 1.5-3 cm , and is about one and a half times wider than the male one. The external opening is covered by the labia minora, inflammation from the urethra easily spreads to the vagina and then to the cervix. Urethritis is very often combined with inflammation of the bladder - cystitis

, is complicated by ascending infection of the ureters and renal pelvis. In the chronic form of urethritis, urinary incontinence may develop.

Video: urethritis and its consequences in medical animation

Clinical forms of urethritis, during the day – multiple times, which may not stop even after urination. For subacute urethritis, the main symptom is the appearance of discharge only after active pressure on the urethra.

Chronic urethritis is more difficult to notice: discharge occurs mainly after provocations, which can occur in men - alcohol, spicy food, in women - the beginning of menstruation, withdrawal of contraceptives, menopause. The diagnosis of chronic urethritis is made in cases where the duration of the disease is more than two months or the patient is not exactly sure about the time of onset of the first symptoms.

Urethritis, nonspecific and specific

According to the type of causative agent of the disease, urethritis can be bacterial, viral and fungal, that is, infectious. Non-infectious urethritis develops with inflammation of the urethra due to allergic reactions, after injuries to the urethra with catheters or bougies, and with strictures.

Urethritis caused by a sexually transmitted infection is called specific, all others are called nonspecific.

Nonspecific urethritis is caused by bacteria for which sexual transmission is not the main route. Bacterial nonspecific urethritis can be obtained through household contact (through linen or a towel, toilet paper, “public” solid soap), failure to comply with normal hygiene rules, or the spread of infection from a source of inflammation inside the body. The main pathogens are streptococci and staphylococci, Escherichia coli, Klebsiella, and Haemophilus influenzae.

Manifestations of gonorrheal (gonococcal) urethritis

Wu mu In women, acute urethritis is the most common manifestation. After infection, on average, 2 to 7 days pass quietly, gonococci multiply in the urethra asymptomatically. When a certain critical number of pathogens is reached, symptoms of urethritis appear. The time elapsed from the moment of infection to the pronounced onset of the disease is called the incubation period. For gonorrheal urethritis it varies from 2 days to 2 weeks.

The main symptoms are discharge from the urethra and acute pain when urinating. At first, the urethral discharge is quite scanty and mucous, but quickly turns into copious and purulent. It is these signs that distinguish gonococcal urethritis from non-gonococcal urethritis. Men with “erased” forms of gonorrheal urethritis, the development of which is possible when the disease becomes chronic or due to improper treatment, are especially dangerous as spreaders of the infection. In addition, this group is more likely to suffer from complications that can lead to male infertility.

Among women diagnosed with gonococcal urethritis, more than 70% do not experience any discomfort from the urethra. There may be nagging pain in the lower abdomen, mild irritation and hyperemia (redness) of the labia minora. Discharge from the urethral canal is scanty, often women do not notice it at all. Sometimes the disease is detected quite late, when inflammation affects the internal genital organs - the vagina, uterus and fallopian tubes.

In this case, the pain intensifies, there is more discharge, and heavy bleeding (menorrhagia) begins during menstruation. Gonococci can also spread through the bloodstream, causing inflammation of the kidneys and liver, brain and heart, muscles and joints.

Chlamydial urethritis

The incubation period lasts on average from 4 days to 4 weeks, then There is a tingling and burning sensation in the urethra when urinating. Men have mucous discharge, can be completely transparent or slightly cloudy, turning into purulent . In women, the symptoms of urethritis are an increased urge to urinate, during sexual intercourse - pain in the lower abdomen, yellowish mucous or purulent discharge from the urethra and

Without adequate treatment, nongonorrheal urethritis becomes chronic, with inflammation continuing for many months and years.

As a result, women develop scars in the fallopian tubes, leading to ectopic pregnancy or infertility. In men, chronic urethritis is complicated by inflammation of the testicular appendages (), which is manifested by unilateral or bilateral swelling of the scrotum and prostatitis. Complications:

inflammation can result in the formation of persistent narrowing or partial fusion of the walls of the urethra, leading to female and male infertility, and impaired sexual function.

Candidiasis and viral urethritis

Candidal urethritis manifests itself through direct (sexual or household) infection with yeast fungi of the genus Candida, as well as as a complication after treatment with antibiotics or when the body’s immune defense is reduced. Often combined with vaginal candidiasis, commonly known as. Characterized by copious liquid discharge and a grayish coating in the area of ​​the external opening of the urethra.

Viral urethritis is caused by a simple human. The reproduction cycle of this virus is only 14 hours, and it is transmitted primarily through sexual contact. So patients’ suspicions that urethritis appeared after sex are completely justified. Symptoms can develop quickly, within 24 hours, especially due to stress or hypothermia. In men, discharge from the urethra is mucous, mainly noticeable in the morning in the form of a drop. During urination, a tingling sensation is felt, then the pain intensifies. The inguinal lymph nodes may become enlarged and the body temperature may rise.

The distinctive visible signs of viral urethritis are the appearance of small blisters, erosions and ulcers grouped around the external opening of the urethra. Elements of the rash can merge, ultimately forming lesions covered with a yellowish crust and having jagged edges. The duration of viral urethritis is up to 2 weeks, relapses are possible at intervals from a month to several years.

Trichomonas urethritis

The asymptomatic presence of Trichomonas, called carriage, is found in 20-37% of infected people.

The inflammation is moderate, but the waste products of Trichomonas are toxic to the human body: they loosen the surrounding tissues, facilitating the spread of the process. A distinctive feature of Trichomonas urethritis is constant itching. At the beginning of the disease, men may experience a sensation of “pins and needles” in the area of ​​the head of the penis, on the first day - small watery grayish-white discharge, semen mixed with blood. Within a month, these manifestations subside, then torpid urethritis develops, which is aggravated by drinking alcohol, after sexual intercourse, and with general and local hypothermia.

Local complications of Trichomonas urethritis - erosions and ulcers on the genitals, reminiscent of. Ulcers often have a clean, bright red bottom, less often with a purulent coating, and soft, rolled edges of irregular shape.

Trichomonas urethritis is especially dangerous for the female body., since in most cases it occurs without specific treatment and leads to complications during pregnancy or to infertility. In men, inflammation spreads from the anterior part of the urethra to the posterior part, causing prostatitis, epididymitis and subsequently also infertility. Trichomonas have been nicknamed “silent killers” for the contrast between the insignificance of symptoms and the severity of general complications.

Urethritis in pregnant women

Urethritis during pregnancy often occurs due to pharyngitis(inflammation of the pharynx) caused by chlamydia, mycoplasma or ureaplasma infection, gonorrhea. Infection can occur before or during pregnancy. Exacerbation of asymptomatic chronic infection occurs due to increased internal pressure on the urethra and expansion of its external opening; infection in early pregnancy is caused by increased libido.

Symptoms of urethritis are the same as in non-pregnant women. Worry about frequent urge to urinate, burning and pain in the urethra, itching in the perineum, discharge from the vagina and urethra.

The main danger of urethritis during pregnancy is the negative impact on the child and the development of complications during pregnancy and childbirth. The risk for the newborn is sepsis, infection of the membranes, intrauterine death. The infection can be transmitted to the child during childbirth: a common form of gonorrhea is specific conjunctivitis or gonoblenorea, which doctors should suspect first of all if they notice discharge from the eyes of a newborn before 2-3 days of life.

Chlamydia can cause pneumonia, inflammation of the conjunctiva, and nasopharyngitis in a child. Mycoplasmas and ureaplasmas easily penetrate the amniotic fluid and the fetus, but appear only in premature babies.

The risk for the mother is premature birth, spontaneous abortion and bleeding.

Pregnant women with chlamydial and mycoplasma infections belong to the risk group and are treated before birth and, if necessary, after. Chlamydial urethritis is treated in both sexual partners with the use of antibiotics, prescribing them to pregnant women only after 12-16 weeks; use josamycin, amoxicycline. For gonorrheal urethritis, specinomycin, ceftriaxone, and cefixime are prescribed. Ureaplasma and mycoplasma urethritis: treatment is carried out with josamycin, starting from the second trimester of pregnancy.

Diagnosis of urethritis

1. Survey, analysis of information received. The doctor is interested in what exactly worries the patient and when the first manifestations of urethritis appeared, and finds out the time connection between the symptoms of the disease and sexual intercourse.
2. Urological examination performed by a urologist or gynecologist. The external opening of the urethra is visually assessed, the presence and nature of the discharge - serous or purulent, liquid or viscous, abundant or scanty. Examination of the perineal area and external genitalia: detection of hyperemia, plaque, rash, erosions and ulcers, external scar changes.
3. from the urethra for inoculation on a nutrient medium and microscopic examination of the cellular composition of the material. With trichomonas urethritis, in fresh secretions under a microscope you can see actively moving flagellates: the phenomenon is called “Trichomonas dancing”.
4. Urethroscopy, instrumental examination method. A thin probe with fiber light guides is inserted into the urethra, thanks to which you can examine the condition of the walls of the canal and assess the degree of its narrowing. A contraindication for urethroscopy is urethritis in the acute phase.
5. Urethrography, X-ray examination of the urethra with the introduction of an X-ray contrast agent into it.
6. Traditional tests:
   1. A general blood test for urethritis will indicate signs of acute or chronic inflammation - leukocytosis; for purulent inflammation - an increase in the number of neutrophils;
   2. biochemical analysis - increased inflammation marker, c-reactive protein;
   3. urine test, first portion - the presence of epithelial cells, leukocytes, traces of blood.
7. (polymerase chain reaction), a fast and reliable option for diagnosing specific urethritis infections. Suitable materials include epithelial scrapings, urethral discharge, blood and serum.
8. Ultrasound of the pelvic organs: in women – monitoring the condition of the ovaries, uterus and bladder; in men - the bladder, seminal vesicles and prostate gland.

The diagnosis is made after evaluating the data obtained from examinations. A correctly completed diagnosis must be entered into the medical history (or outpatient card) in Latin and contain an indication of the location of the process - urethritis, the clinical form - acute, subacute or chronic, and the causative agent. In the Russian version, the diagnosis looks somewhat different, in the first place is the form, then the pathogen, and finally urethritis. For example, acute gonococcal urethritis.

Principles of treatment of urethritis

Treatment of urethritis begins with antibiotics. The medicine is selected depending on the causative agent and the severity of the inflammation. In case of an acute process, broad-spectrum antibiotics are immediately prescribed, then they switch to drugs to which the sensitivity of the microflora in a particular case of urethritis has been identified.

• Nonspecific urethritis: cephalosporins (cefataxime, ceftriaxone), macrolides (clarithromycin), a group of fluoroquinolones (clinafloxacin).
• Gonorrheal urethritis: cefacor, spectinomycin, ceftriaxone. Antibiotics are selected to which both gonococci and chlamydia are sensitive.
• Trichomonas urethritis: imorazole, trichopolum (metronidazole), iodovidone suppositories.
• Candidal urethritis: clotrimazole (vaginal tablets or cream, capsules), fluconazole.
• Mycoplasma and chlamydial urethritis: group of tetracyclines (doxycycline), macrolides (clarithromycin).
• Viral urethritis: ganciclovir, ribavirin - antiviral drugs.

To reduce inflammatory and reactive edema it is used non-steroidal anti-inflammatory drugs(aspirin), antihistamines (suprastin), antispasmodics (no-spa, papaverine) and diuretics.

Immunostimulants and probiotics prescribed to activate the body's natural defenses: injections of cycloferon, ribomunil, vitamins (B-group, PP, A, E, C), Linex or yogurt.

Biostimulants– aloe, homeopathic preparations – used for targeted exacerbation of chronic urethritis. As a result, susceptibility to treatment increases and the susceptibility of pathogens to antibiotics increases.

Enzyme therapy: Enzymes that break down proteins are prescribed. Action – anti-inflammatory, immunomodulatory.

Local treatment: instillation - the introduction of liquid medications into the urethra. Silver preparations (collargol) are used, the procedure is performed only in honey. institution using a sterile catheter.

Bougienage– instrumental dilatation of the urethra with the development of strictures of the urethra.

Physiotherapy: locally - medicinal baths, UHF exposure, electrophoresis with antibiotics.

Folk remedies only complement the main treatment. Chamomile tea, parsley roots and greens, carrots and celery, lingonberries and cranberries, beets - these products are introduced into the daily diet. Herbal infusions are prepared separately and taken for at least a month (St. John's wort, sage, horsetail).

Diet: It is recommended to exclude spicy and salty foods and alcohol. Drink more clean water, focus on fresh vegetables and fruits. When using diuretics, potassium is removed, so the diet is supplemented with dried apricots, prunes, and raisins.

Urethritis can be treated at home; only patients with an acute form of the disease are hospitalized. Treatment at home allows you to take medications, use vaginal suppositories, use medicinal baths, adhere to a regimen and a therapeutic diet. All manipulations (injections, instillations, bougienage) are carried out in a hospital.

Video: folk remedies useful for urethritis

Prevention of urethritis

1. Use a condom.
2. Follow the rules of personal hygiene. If sexual intercourse took place without a condom: urinate, wash the external genitalia with plenty of warm water and liquid soap. Use antiseptic solutions (Miramistin, Gibitan) for a maximum of 2 hours after sexual intercourse.
3. Avoid hypothermia, promptly treat diseases of the genitourinary system.
4. Periodically (1-2 times a year) undergo a medical examination.
5. Refrain from casual sex.

Video: urethritis in the program “Live Healthy!”

Urethritis is an inflammation process that can occur on the walls of the urethra. The disease is diagnosed quite often and can be detected in any person, regardless of age and gender. The reasons for its occurrence are very different: from lack of personal hygiene to damage to the urethra by various pathogens. How to treat urethritis in men?

In men and women, the disease has different manifestations, which is associated with the characteristics of their genitourinary system. And if female urethritis passes with virtually no symptoms, then inflammation of the urethra in men is accompanied by various unpleasant sensations.

General practitioner Elena Vasilyevna Malysheva and cardiologist German Shaevich Gandelman will talk about the features and symptoms of the disease:

The cause of activation of the inflammatory process, according to doctors, is mainly genital infections. The first manifestation of the disease is weakness of the body. A man can feel it just a few hours after the pathogen enters the body. There are also non-infectious causes of the disease (injuries, allergic reactions, poor nutrition or personal hygiene, etc.), but they are quite rare.

It is very important to begin treating inflammation at the initial stage of its development, since urethritis can lead to the development of pathologies of the genitourinary system and reproductive dysfunction.

Causes

The main reasons that cause the development of urethritis in men, doctors include:

1. Diseases that can be transmitted as a result of sexual intercourse without a condom (herpes, HPV, gonococci, Trichomonas, etc.). Basically, inflammation in the urethra becomes just a sign of such infections.
2. Metabolic disorders (especially in the pelvic area).
3. Impact on the body of various toxic substances.

1. Stagnant processes occurring in the pelvic area. This leads to the development of congestive urethritis. The occurrence of stagnation of venous blood is preceded by constipation, hemorrhoids, and the practice of interrupted sexual intercourse.
2. Allergies that can be caused by food, personal care products, or taking certain medications.
3. A large amount of sour and salty foods with a lot of spices in the diet, which can irritate the mucous membranes.

The following factors can provoke the inflammatory process:

• Hypothermia of the body.
• Promiscuous sex life.
• Stress.

• Physical or psycho-emotional fatigue.
• Eating disorder.
• Damage to the walls of the urethra as a result of mechanical impact (medical procedures, etc.).

Classification of urethritis

According to the primacy of the development of inflammation, the disease is:

1. Primary – the infection develops directly in the urethra.
2. Secondary – other organs become the source of infection. Along with the bloodstream, pathogenic microorganisms are able to penetrate the urethra.

Table 1. Classification of urethritis by type of pathogen

Urethritis and cystitis

These two diseases very often accompany each other, so patients often confuse them, mistaking one for the other. But it turns out they have significant differences.

Firstly, this is the place where the inflammatory process occurs. With urethritis, the mucous membrane of the urethra becomes inflamed, and during cystitis, the walls of the bladder are affected.

There are also differences between urethritis and cystitis in the symptoms of the diseases. With cystitis, the urine has an unpleasant odor and becomes cloudy. In contrast, men with urethritis do not experience general weakness of the body.

Symptoms

The very first signs of urethritis in a man can occur at different times: after a few hours (with an allergic type of disease), after 3-21 days (if the cause is pathogenic microorganisms, depending on the type of pathogen), after several months (viral urethritis) or even several years (tuberculous urethritis).

Dermatovenerologist and urologist Sergei Gennadievich Lenkin tells more about the causes and symptoms of the trichomonas form of the disease:

Characteristic manifestations of the disease are:

• Painful urination.
• Discharge from the urethra (the nature of which is associated with the type of pathogen).
• Burning sensation and itching of the penis.

When the pathology becomes chronic, symptoms may disappear completely, with the exception of slight discomfort in the groin area.

Table 2. Symptoms of urethritis, based on the type of disease

Complications

If any signs of inflammation of the urethra appear, it is important for a man to undergo a full course of treatment. If urethritis is left unattended, the disease can lead to serious consequences. This means that the inflammatory process can spread to the testicles, scrotum and prostate gland.

One of the complications of the disease is prostatitis.

The main complications of urethritis in men include: funiculitis. Long-term lack of treatment often leads to disruption of the reproductive system.

Diagnostics

Having noticed any symptoms of urethritis, a man should definitely visit a doctor who will prescribe the necessary examination and be able to make an accurate diagnosis. It is on the basis of diagnostic data that treatment for urethritis will be prescribed.

During the examination, the urologist will palpate the urethra for thickening and tenderness, and check the inguinal lymph nodes. In addition, he will examine the discharge and determine if there is swelling.

To make an accurate diagnosis, a man will have to undergo some examinations and tests:

1. A smear that is taken on the walls of the urethra.
2. Urine and blood analysis.
3. Culture to detect sensitivity to antibiotics.

1. Urethroscopy.
2. PCR (analysis makes it possible to identify a specific pathogen, which is especially important for treatment).
3. Screening for syphilis and HIV.

Treatment

Before prescribing certain drugs for the treatment of urethritis in men, the doctor will draw the patient’s attention to the fact that sex must be completely avoided for the entire period of therapy. This applies not only to classic sexual intercourse, but also to oral sex and even masturbation. If the development of the disease is caused by an infection that can be sexually transmitted, then the man’s partner is also subject to mandatory treatment.

It is also important to follow a certain diet. During this period, spices, marinades, fatty, salty and spicy foods should be completely excluded from their diet. Drinking alcohol is prohibited. To speed up the recovery process, you need to maintain a drinking regime during treatment. In this case, you need to drink at least 2 liters of clean water without gas every day.

Antibacterial therapy

The treatment regimen for urethritis is always based on the use of antibiotics, without which it is impossible to cure the disease. The name of the drug and its dosage should be determined by the doctor based on the test results. Each of the possible pathogens has its own sensitivity to antibacterial drugs, so general antibiotics for urethritis are not suitable for treatment. The doctor may prescribe:

• The gonococcal type of disease responds well to treatment with Azithromycin or Ceftriaxone.
• Metronidazole or Trinidazole have a better effect on the Trichomonas species.
• “Monural” for urethritis is considered most effective if the disease is of an infectious type or a purulent form of the pathology is diagnosed.

Azithromycin is a semi-synthetic antibiotic used for infectious and inflammatory diseases. Price in pharmacies from 32 rubles

Antiseptics

To reduce pain, men are prescribed antiseptic drugs. These can be either medications in the form of tablets or local remedies, such as Furacilin, Chlorhexidine or Miramistin.

Candles and ointments

Local medications, which are used in combination with antibacterial therapy, help speed up the treatment process. Acyclovir ointment, which is prescribed for the treatment of viral urethritis, has a good antiviral effect.

Rectal suppositories are comparable in effectiveness to injections. Therefore, the course of treatment is often supplemented with suppositories “Heksikon”, “Cifran”, “Indomethacin” or “Metronidazole”.

Immunomodulators

To restore the body's defenses, the urologist will prescribe immunomodulators to the patient. They are always included in the main course of treatment, since a decrease in immunity is considered one of the main reasons for the development of the disease. They must be taken in addition to antibacterial drugs to support the immune system. The most effective treatments for treatment include: “Myelopid” or “Timalin”.

An interesting report by Tatyana Germanovna Fedoskova, Doctor of Medical Sciences, on the topic “Immunomodulators in clinical practice: role in anti-infective therapy and prevention”:

Vitamin therapy

During the treatment of urethritis, it is important for a man to eliminate the deficiency of vitamins and microelements. Therefore, the doctor may prescribe medications (multivitamin preparations with a high content of vitamins A, C, D and E (“Pikovit”, “Bio-max”, etc.). A balanced diet and enriching the diet with fresh fruits help to replenish the supply of vitamins in the body and vegetables.

Folk remedies

It is important to understand that it is impossible to completely cure the disease with folk remedies. However, using them along with drug treatment helps to avoid relapse and speed up recovery. For this, decoctions and infusions of medicinal herbs can be used, which can be prepared at home:

1. An infusion made from blackcurrant leaves. This product has an antiseptic effect and helps enrich the body with vitamins. To prepare it, 3 tablespoons of dried leaves are poured into 250 ml of boiling water and left until completely cooled. After this, the infusion is filtered and taken 15 minutes before meals three times a day.
2. Oak bark decoction. This remedy eliminates the pain and burning sensation that appears during urination. To prepare it, take 1 tablespoon of raw material, add 250 ml of boiling water and keep it in a water bath for about 20 minutes. After cooling, the broth is filtered and taken 1 tablespoon before each meal. The decoction can also be used for sitz baths.
3. Cornflower infusion. To prepare the infusion, add 250 ml of boiling water to 1 teaspoon of dried flowers and leave for at least 1 hour. After this, the product is filtered and taken three times a day before meals, 2 tablespoons. The medicine helps relieve inflammation and normalize microflora.

Watch a video about treating the disease with folk remedies:

Additional treatments

Along with drug therapy, physiotherapy is prescribed for the treatment of chronic urethritis. According to patient reviews, magnetic therapy, electrophoresis, laser therapy, and UHF have a good effect. During the period of exacerbation, they are contraindicated.

Urethritis in children

Inflammation of the urethra can affect not only adults. Urethritis in children is no less common. Both infectious and non-infectious factors can lead to its appearance. Infectious diseases include the entry of bacteria, viruses, gonococci, trichomonas, mycoplasma, and ureaplasma into the area of ​​the urethra. Among non-infectious factors, trauma (passage of stones through the urethra or medical procedures), allergic reactions and congestive processes in the pelvic area predominate. In addition, narrowing of the urethra can lead to its appearance.

Symptoms in children are always related to gender. Boys are more likely to experience a burning sensation during urination, itching of the genital organ, discharge (white or mixed with mucus) and the presence of traces of blood in the urine. In girls, the disease manifests itself as an increased urge to urinate and pain in the lower abdomen.

Normal indicators of bacteriological analysis of urine

For diagnosis, bacterioscopic and bacteriological analyzes of urine and urethral discharge are used. If the doctor suspects a chronic form of the disease, the child will undergo urethroscopy.

Treatment depends on the form of the disease. In the case of the acute phase of urethritis, antibiotics are used that are suitable for a specific age group. If a chronic form is diagnosed, in addition to the use of antibiotics, the patient is prescribed drugs to maintain immunity and the introduction of drugs into the urethra.

After completion of treatment, the child must undergo a re-examination. Along with drug treatment, the child needs a special diet (excluding smoked, spicy and salty foods) and a drinking regime.

If left untreated at the initial stage of the disease, urethritis in a child can become chronic, when it becomes much more difficult to cure.

Prevention

It is easier to avoid any disease, including urethritis, than to deal with its consequences. To do this, it is important for a man to follow certain preventive rules:

• Strictly observe the rules of personal hygiene.
• Wear underwear made from natural materials.
• Avoid using other people's personal items (towels, linen, etc.). Thus, you can become infected with various infections and fungi.
• Avoid promiscuous sex. Have a permanent partner. In case of contact with a casual partner, it is important to use barrier methods of contraception (condom).
• Regularly (at least 2 times a year) a man needs to undergo a preventive examination by a urologist. This must be done even if nothing bothers him, because many infections can not manifest themselves in any way, but at the same time cause irreparable harm to the man’s body.
• Conduct timely treatment of any genital infections and diseases caused by fungi. This is due to the fact that they can cause complications in the urethra, causing the development of urethritis.
• Avoid hypothermia, especially the genital area.

• Protect the genitals from possible injury.
• Avoid excessive physical and psycho-emotional fatigue.
• Provide yourself with proper nutrition, with sufficient vitamins and microelements in foods.
• Observe the drinking regime and drink at least 2 liters of clean water without gas during the day.
• Get rid of bad habits or reduce them to a minimum.
• Avoid delaying urination and completely empty your bladder at the first urge.
• Temper the body and use vitamins to support the immune system.

Every year, a large number of men are faced with a diagnosis such as urethritis. A number of reasons can lead to an inflammatory process in the urethra. The most common of them are infections that can be sexually transmitted. In addition, there are allergic and traumatic urethritis, which are not associated with the entry of pathogenic microorganisms into the urethra.

Regardless of what caused the inflammatory process, the disease requires mandatory treatment, which can only be prescribed by a doctor after a comprehensive diagnosis and identification of the causative agent. All medical recommendations must be strictly followed by the patient. This is due to the fact that urethritis is difficult to treat and if you do not complete the therapeutic course, a relapse is possible, urethritis becomes chronic or complications develop.

Before we talk about the broad classification of urethritis, it is necessary to talk about what this disease is.

Urethritis is an inflammatory process that occurs in the urethra, the so-called urethra, which is how the disease got its name.

Some types of it can be caused by exposure to viruses, while other types of urethritis can be caused by a banal failure to comply with hygiene rules. They provoke the development of urethritis diseases.

However, depending on the reasons for acquiring the disease, the specifics of its course, as well as many other factors, it is possible to make a classification that will be most effective in selecting treatment. Let's talk about the classifications of urethritis.

Infectious specific and nonspecific type

Many men do not take care of their health for many years. Promiscuity, lack of hygiene, hard work, stressful situations, all this negatively affects the body and leads to various infections.

Specific infectious urethritis is precisely defined in cases where infections provoke inflammation of the urethra.

Most often, infections are acquired through sexual intercourse. This is inflammatory urethritis.

But often, a weakened body, lack of immunity, and other reasons can also contribute to the development of this type of disease. The most common infections with specific urethritis are herpes, ureaplasmosis, trichomonas, gonococcus.

Chlamydia and mycoplasma are slightly less common. Very often, specific urethritis is also called gonococcal. Treatment of such a disease should begin first of all with getting rid of the infection.

Specific urethritis can also be classified as a broad group.

This disease is noteworthy in that it can actually be caused by viruses that are not gonococci.

It is somewhat less common than the categories described above, however, the occurrence of such a disease can lead to even a banal ARVI. Therefore, male representatives need to closely monitor their health and not even catch a common cold.

Another common form of such a disease of the genitourinary system is. The cause of this disease is the affected opportunistic microflora. REFERENCE!

To give examples, most often infection and urethritis are nearby, being provoked by staphylococcus, streptococcus, fungal diseases, and E. coli.

If you understand what the causes of infectious urethritis are, it is quite easy to understand that in this case you need to be especially careful. Due to the fact that such a disease is more difficult to get, therefore, it is more difficult to treat. Therefore, carefully study the reasons why it may appear, and also get acquainted with the main types. This is non-purulent urethritis

Non-infectious urethritis can be caused by an accident. It is classified as traumatic urethritis. With mechanical impact on the male genitourinary system, a defect can occur, which, one way or another, will affect the urethra. Traumatic urethritis is a consequence of a blow or other physical impact. Treatment of traumatic urethritis in men is absolutely necessary.

Another type of non-infectious urethritis is. Inherent in those who are prone to allergic reactions to various food, chemical, and drug allergens.

Sometimes it can be diagnosed in patients suffering from stomach disorders due to impaired metabolism or diabetes.

Urethritis, which is caused by gonorrhea, has a name and its incubation period is about two weeks.

It manifests itself as cutting pain, a burning sensation that is present when urinating, as well as purulent discharge from the urethra. It can become chronic if not treated promptly. Chronic gonorrheal urethritis can occur without symptoms for years, then turning into infertility.

In this video about infectious and non-infectious types of diseases and their treatment:

Chronic and viral type

Such inflammation of the urethra is provoked by the presence of fungal diseases, which you can catch in such places.

Therefore, if you value your health and you think that you have a weakened immune system, then avoid visiting such places. He recommends treating candidal urethritis with ointments, as they act on the fungus locally, which is most effective.

You also need to improve your immunity by using appropriate medications and vitamins.

Complications from infection with Trichomonas can be caused by alcohol consumption, heavy exercise, as well as systematic overstimulation without discharge.

May go into a chronic stage. It is characterized by bloody discharge in the semen, purulent discharge during urination, pain and itching.

Conclusion

All of the above types of urethritis can often occur in representatives of the stronger sex. Somewhere the reason for this is a banal lack of compliance with hygiene rules, somewhere it is a consequence of infection as a result of the negligence of a sexual partner, and somewhere it is the result of an incorrect lifestyle.

Sometimes urethritis does not manifest itself in any way for a long time, and then is detected in the acute or chronic stage.

Therefore, be attentive to your men's health, regularly visit a urologist, get tested, and remember that your health is only in your hands.

Useful video

What causes this or that type of urethritis, and what can be used in a particular case:

There are many causes of urethritis in men, the symptoms and treatment of which depend on the etiology of the disease. Urological pathology can be provoked by various circumstances and reduced immunity. The disease can occur with severe symptoms or without any sensations at all.

Collapse

Urethritis is an inflammation of the mucous membrane of the urethra - the channel that removes urine. The cause of the pathology may be infectious diseases, hormonal imbalances, exposure to mechanical factors and weakened immunity.

The cause of infectious urethritis is unprotected sex with infected sexual partners. The causative agents of the disease are gonorrhea, chlamydia, trichomonas, gardnerella, etc.

Sometimes inflammation occurs as a result of pathogenic microflora caused by various cocs entering the genitourinary system due to improper hygiene.

Urolithiasis can injure the urethra as stones pass, causing inflammation. Some medical procedures, such as the use of a catheter, can damage the mucous membrane and cause inflammation.

Men suffering from hormonal disorders, with a high concentration of oxalic acid in the urine, are periodically subject to irritation of the urethra. When emptying, the acidic environment acts on the mucous membrane, causing a burning sensation.

• promiscuous sex life without proper protection;
• prolonged exposure to low temperatures;
• urinary retention;
• infectious diseases;
• mechanical damage to the canal;
• allergic reactions;
• dehydration of the body;
• hygienic uncleanliness;
• alcohol addiction and abuse of spicy foods.

A difficult situation arises when bacterial flora is associated with non-infectious urethritis.

Symptoms of urethritis in men appear within a week. The non-infectious form appears much earlier. Painful sensations and a burning sensation cause great discomfort to a person.

Signs of urethritis in men are as follows:

• pain during bowel movements;
• blood in urine;
• frequent urge to go to the toilet;
• itching in the urethra.

The main symptoms may include watery and purulent discharge, inflammation, sticking of the urethra and discomfort during sexual intercourse. In rare cases, the temperature rises.

After some time, the symptoms subside. If treatment is not started in time, the pathology can become chronic, the recovery from which will take a longer time.

Chronic urethritis in men is similar to its acute form, but is less painful. Unfavorable factors and decreased immunity provoke relapses, which recur periodically.

Sometimes the disease occurs without pronounced sensations. Urethritis is discovered accidentally during examinations related to other diseases.

Acute urethritis can cause various pathologies, such as prostatitis, inflammation of the seminal vesicles, testicular pathology, balanitis, and narrowing of the urethra.

Timely treatment and subsequent prevention will save the strong half of humanity from unwanted consequences.

Treatment with medications is prescribed depending on the etiology of the disease and based on the diagnostic data obtained. The doctor conducts a visual examination of the patient, prescribes laboratory tests for urine, blood, and smear tests. In some cases, ultrasound examination and urethroscopy are performed to exclude pathologies of internal organs.

The patient usually undergoes outpatient treatment. Only in case of serious complications is hospitalization prescribed.

How to treat urethritis in men, basic principles:

• the use of medications aimed at the cause of the development of infectious urethritis;
• prescription of anti-inflammatory drugs;
• taking immunomodulatory drugs;
• a course of physiotherapy for chronic disease;
• diet;
• abstinence from sexual activity;
• temporary limitation of excessive physical activity.

Medicines are selected individually for each specific case. The type of antibiotics depends on the causative agent of the disease.

Acute urethritis of gonorrheal origin is treated with antibiotics from the cephalosporin group. The doctor may also prescribe medications of the tetracycline series - Erythromycin, Tetraolean, Kanamycin. Purulent urethritis complicated by other infections is treated comprehensively with the use of Azithromycin.

For diseases caused by fungal microorganisms, antifungal drugs are prescribed: Hexicon, Vilprafen, Fluconazole, Levorin, Diflucan, Medoflucon and other drugs.

In men, treatment of urethritis with chlamydia requires special attention. Incorrectly selected drugs can lead to infertility and inflammatory diseases of neighboring organs. To combat pathology, Azithromycin and drugs of the tetracycline group are prescribed.

If viral urethritis occurs in men, treatment is combined with antiviral drugs (Acyclovir, Ribamidil, Famciclovir, Gerpevir). With this form of pathology, the use of antibiotics is ineffective; antiseptic therapy is prescribed in combination.

Acute urethritis associated with trichomonas inflammation is treated with drugs based on Metronidazole. In this case, treatment with antiseptics is contraindicated; they can eliminate the symptoms, but not cure the cause of the disease.

Inflammation of the urethra in men of a nonspecific nature is treated with broad-spectrum antibiotics.

The pathology is treated comprehensively; in addition to the drugs listed above, several types of drugs are used at once.

Methylene blue and Chlorhexidine, Furacilin are prescribed as antiseptics, which are used to lubricate the head and entrance to the urethra. Such procedures are designed to suppress the growth of fungi. Hydrocortisone is injected directly into the penis.

Local medications are used to promote the healing process. These include ointments and suppositories. Rectal medications for the treatment of urethritis in men are equivalent to injections. Doctors often prescribe Acyclovir, Hexicon, Tsifran.

Without immunomodulators, urethritis in men cannot be treated; drugs are mandatory in drug therapy. Timalin and Myelopid are prescribed.

In addition to basic methods, physiotherapy is used for effective treatment. These procedures are prescribed for chronic forms of the disease. Acute urethritis in men is not treated with these methods due to possible complications from inflammatory conditions.

In chronic cases, electrophoresis, ultrasound and laser therapy are used. Such methods require constant supervision by a specialist.

Folk remedies and prevention

In complex therapy, you can use some traditional medicine that helps increase immunity, fights inflammatory processes and has some diuretic effect. Alternative medicine proven over the years will tell you how to treat urethritis in men:

1. Cranberry juice prevents urolithiasis and copes well with inflammatory processes.
2. Black currant has general strengthening properties, has a beneficial effect on the body, and has a weak diuretic effect. The leaves of the plant are poured with boiling water and taken 0.5 cups 3 times a day.
3. A decoction of parsley seeds will help strengthen the body, have an antiseptic and anti-inflammatory effect, and cause a diuretic effect.

Very often, older men suffer from prostatitis, which developed against the background of urethritis. Without treatment, the disease can damage the scrotum and testicles, make a man infertile and cause kidney disease.

Prevention consists of following basic rules:

• careful care of the genitals;
• You cannot use other people’s towels and underwear;
• avoid sexual contact with dubious partners without protection;
• promptly treat sexually transmitted infections;
• avoid hypothermia;
• proper nutrition and sufficient fluid intake;
• vitamins to strengthen the immune system.

If urethritis in men is detected in time, the symptoms and treatment will be less painful and effective.