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The first symptoms and treatments for urethritis in men

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Urethritis - inflammation of the urethra (urethra) is common in men. Almost any infection, penetrating the genitourinary system, first enters the urethra, and then spreads to the internal male genital organs, prostate, seminal vesicles, testicles, bladder and kidneys.

Moreover, the causative agent of urethritis can be both sexually transmitted infections and bacteria, which are normally present in small quantities in the human body.

On our site we will tell you in detail what is urethritis in men, its symptoms and treatment. We describe the difference between the treatment of inflammation of the urethra at home and in the clinic.

Urethritis causes and first signs in men

The cause of urethritis is most often various microorganisms: bacteria, fungi, viruses, protozoa that penetrate the mucous membrane of the urethra, destroy it, causing inflammation.

If we talk about sexually transmitted diseases, everything is very clear and understandable, but for non-specific urethritis caused by infections not related to STDs, it is not enough just to get microorganisms into the canal. Predisposing factors play a role in creating favorable conditions for the reproduction of the pathogen.

Causes of urethritis in men

  1. Sexually transmitted infections: gonorrhea, trichomoniasis, herpes, chlamydia, mycoplasmosis, ureaplasmosis, gardnerellosis, candidiasis. These pathogens can cause inflammation of the urethra of varying severity from an acute purulent process, as in a gonococcal infection, to sluggish, subtle urethritis with mycoplasma or ureaplasma.
  2. bacteria - that is, those that live normally in the body and exhibit their pathogenic properties with a decrease in local or general immunity, with injuries, hypothermia, radiation, dysbacteriosis. These include streptococci, staphylococci, Proteus, Klebsiella, very often E. coli and Enterococcus, which live in the intestines.
    These bacteria can enter the urethra both from the skin of the glans penis and during sexual contact if microflora are disturbed in the woman’s vagina and these microbes or mushrooms such as candida predominate.
    Also often we observe urethritis caused by intestinal bacteria after anal sex and streptococcal inflammation after oral contact.
  3. There are urethritis with urolithiasis, when there is an injury to the mucous membrane of the urethra with sand and stones. In this case, not only the trauma itself takes place, but also the accession of the bacterial flora, which further supports the inflammatory process.
  4. Injuries to the urethra during medical procedures (urethroscopy and cystoscopy), with very active sex.
  5. Urethral burns with thermal and chemicals (including vaginal contraceptive suppositories).
  6. Medicinal urethritis occurs during treatment with drugs that, when excreted in the urine, have an irritating or damaging effect on the mucous membrane of the channel (tumor chemotherapy and a number of other drugs).
  7. Allergic reactions can also affect the urethra. This is how allergic urethritis develops.

When establishing a diagnosis, a urologist or venereologist must take into account the possible combination of factors that caused urethritis so that therapy is effective, and not just prescribe an antibiotic for any type of disease.

It is important for a man to present the first signs of urethritis and the main symptoms of this disease in order to consult a doctor in time, without waiting for the disease to become chronic or cause prostatitis.

How to recognize the disease?

The duration of the incubation period, during which the symptoms of urethritis in men are not yet visualized, can range from several hours to three weeks. It all depends on the pathogen of the inflammatory process.

The most pronounced symptoms of the inflammatory process of the urethra include:

  • discomfort during urination,
  • itching and pain - as the disease progresses,
  • muddy color of urine
  • frequent, sometimes false, urge to the toilet,
  • various kinds of discharge with urine,
  • discomfort during intercourse,
  • increased sensitivity and redness of the head of the penis.

Deterioration of the general condition of the body, as a rule, is not observed. Against the background of discharge, which is characterized by an unpleasant odor. Crusts may form on the head of the penis. A harbinger of the development of the disease can be pulling pains in the lower abdomen, but in the future they do not accompany the inflammatory process.
The development of pathology into a chronic form significantly distorts the etiology of urethritis. Acute signs of urethritis in men subside, there remains only a feeling of discomfort and itching in the urethra. Only during the period of exacerbation do they make themselves felt in a more intense degree.

Causes of urethritis in men

Urethritis can appear due to a number of reasons. In addition to the genital tract of infection, the reproduction of pathogenic parasites can begin under certain circumstances:

  • sexually transmitted infections are the most common cause of urethritis in men who have an active sex life. If sexual intercourse is performed without the use of barrier contraception, then the probability of penetration of the pathogen into the urethra is very high,
  • urolithiasis - is much more often found in men than in women. Such a disease causes traumatic urethritis, for the reason that calculi, moving along the genitourinary tract, actively injure the mucous membrane and lead to the attachment of pathogenic microorganisms,
  • any trauma to the penis and severe physical exertion can cause the development of urethritis,
  • hypothermia is one of the most important provocateurs of exacerbations of chronic diseases (including extrapulmonary tuberculosis, viruses, infections), since in this case the protective functions of the body are significantly reduced,
  • a general decrease in immunity - smoking, alcohol abuse, overwork, lack of sleep, malnutrition leads to a natural depletion of the body's defenses,
  • medical manipulations (catheterization of the bladder, smear) - carry a risk of injury to the mucous membrane of the urethra, also urethritis can develop if the necessary disinfection measures are not followed,
  • nutrition - an abundance of acidic, spicy, salty foods leads to irritation of the mucous membranes, which contributes to the attachment of infection. Lack of fluid causes rare urination, respectively, there is no natural washing of the genitourinary tract from harmful microorganisms that can accidentally enter the urethra.

Thus, the following causes of urethritis in men are distinguished:

  1. The defeat of the human urethra by pathogenic bacteria that penetrate the urethra. Most often, prolonged use of a urinary catheter leads to this condition. This type of urethritis is called bacterial.
  2. The defeat of the urethra with chlamydial infection and other sexually transmitted diseases usually leads to chronic urethritis.
  3. Gonorrheal form of urethritis occurs when it is affected by gonococcus. A very high risk of contracting this infection through unprotected sexual contact with the carrier of the disease. You can catch gonococcus less often through household items that you need to use individually (underwear, towels, washcloths, etc.).
  4. The defeat of the urethra with fungi (candidiasis) leads to a long inflammatory process. These fungi themselves are not so dangerous, but their complications can cause a lot of problems to a person. This form of urethritis in men is called candidiasis.

Candidiasis can be caused by taking antibiotics, lowering immunity, drinking alcohol, malnutrition, or direct infection of a person from a pediatric fungus.

In addition, the following factors and diseases are distinguished, in which a man at times increases the risk of getting urethritis:

  1. The effect of various genital infections. In this condition, the disease easily penetrates the urethra of a person and causes severe inflammation. Also, cases of the transition of urethritis along with a sexual infection to a chronic course are quite common. Those men who often change sexual partners and practice unprotected intimate relationships are most at risk of catching such infections.
  2. An acute form of urolithiasis, which affects men more often than women. In this state, a person develops an acute traumatic form of urethritis, because the stones and "sand" that come out irritate and literally scratch the urethra.
  3. Earlier injuries of the penis can cause acute urethritis, which will be accompanied by circulatory discharge during urination.
  4. Severe hypothermia of the body can lead to acute and chronic inflammation of the urethra. Also, it is hypothermia that very often causes an exacerbation of existing sluggish chronic pathologies.
  5. Improper diet (especially frequent consumption of salty, sweet, spicy and sour foods) irritates the mucous membranes, making them more susceptible to infections. In addition, smoking and alcohol abuse reduces the body's defenses, which makes a man even more vulnerable to urethritis.
  6. Inadequate observance of intimate hygiene leads to the spread of pathogens in the genitals and a strong inflammatory process.
  7. Drinking an insufficient amount of fluid provokes rare urination, due to which the urethra cannot independently wash out all the pathogens that enter it.

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Pathogens that cause infectious urethritis

Depending on the type of microorganisms that enter the urethra and cause the inflammatory process, urethritis is divided into specific and non-specific.

Nonspecific urethritis is a classic suppurative inflammation. Its symptoms are independent of the type of microorganism with which it is caused.

Microorganisms that cause non-specific infectious urethritis:

  • staphylococci,
  • streptococci,
  • E. coli
  • less often - others

A specific infection in the urethra, usually cause microorganisms that cause sexually transmitted infections.

Types of specific infectious urethritis:

  • gonorrheal
  • Trichomonas
  • candida
  • mycoplasmal
  • chlamydial.

Viral Infectious Urethritis It is caused, as a rule, by herpes viruses.

Ways of infection with infectious urethritis

Infection with urethritis can occur through sexual or hematogenous routes.

Genital tract It is realized during sexual contact with a sick person. So most often there is an infection with specific infections.

Hematogenous and lymphogenous pathways realized with the spread of infection with blood or lymph flow from other foci of chronic inflammation in the body. For example, from inflamed tonsils or carious teeth.

Classification of urethritis

The clinical picture and treatment methods depend on the type of infectious agent that caused the inflammation, stage of neglect and intensity of the disease, the presence of concomitant diseases and provoking factors. That is why the appointment of an effective and adequate treatment depends on the nature of the pathology.

Classification of urethritis by etiological indicators

Non-infectious urethritisInfectious urethritis Noncommunicable diseases include:

  • congestive urethritis - may appear due to venous stasis in the pelvis,
  • traumatic urethritis - appears against the background of ruptures and tears of the urethra, as well as after surgical interventions (catheterization, cystoscopy),
  • allergic urethritis - develops due to exposure to allergens.
Each type of infectious urethritis has its own specific type of pathogen, and only with mixed urethritis, inflammation can occur against the background of the action of two or more pathogenic organisms:

  • tuberculous
  • mixed,
  • gardnerellosis,
  • chlamydial
  • ureaplasmic
  • mycotic,
  • bacterial,
  • Trichomonas
  • viral,
  • mycoplasmal
  • Trichomonas.
Classification according to severity of symptomsClassification by the course of the diseaseChronic urethritis is divided into periods without exacerbations and the acute stage:

  • urethritis is weakly active,
  • moderate degree of disease activity (urethritis),
  • a high degree of activity of inflammation of the urinary canal.
Fresh urethritis is divided into:

  • torpid
  • subacute
  • acute.
Classification by disease specificityClassification by the onset of the disease
  • specific - these are sexually transmitted infections (chlamydia, trichomoniasis, gonorrhea) and tuberculosis,
  • non-specific - the causative agent of the infection are microorganisms that are constantly present in the body, but are suppressed by a healthy immune system.
  • primary - the disease occurs as an isolated pathology,
  • secondary - develops due to the presence of other diseases in the body.

In most cases, the causative agent of urethritis is chlamydia and gonococcus, while in about 50% of cases it is not possible to detect these infectious agents in the study of the material.

Forms of the disease

Depending on the cause, urethritis in men is divided into infectious and non-infectious, and infectious, in turn, into gonococcal and non-gonococcal.

Non-neococcal urethritis is divided into types depending on the pathogen:

  • bacterial (caused by opportunistic microflora),
  • chlamydial
  • Trichomonas
  • mycotic (candida, fungal),
  • viral,
  • tuberculous
  • ureaplasma
  • mycoplasmal
  • gardnerellosis,
  • mixed.

Non-infectious urethritis in men is of the following types:

  • allergic,
  • traumatic,
  • congestive (congestive).

By the duration of the course of the disease, fresh (acute, subacute and torpid) and chronic urethritis are isolated.

Depending on the localization of the pathological process:

  • front urethritis - in the front of the urethra, i.e. located closer to the outlet on the glans penis,
  • posterior - in the posterior urethra, i.e. localized closer to the bladder.

Stages of the disease

Fresh (acute) urethritis proceeds in three stages:

  1. The incubation period is the time from the moment of infection to the onset of the disease, lasting from 1-2 days to 2 weeks.
  2. The period of severe symptoms.
  3. The period of convalescence - complete recovery under favorable conditions (treatment) or chronicity of the process, i.e., the transition of the disease into a chronic form in an unfavorable way.

In the clinical picture of chronic urethritis, three alternating periods are also distinguished:

  1. Exacerbation (symptoms are pronounced).
  2. Remission (asymptomatic, however, the inflammatory process is not allowed, it continues in an implicit form).
  3. Unstable remission (scant clinical manifestations).

Symptoms of Urethritis

After direct infection of the body, the symptoms of urethritis appear after some time, while the time interval from the moment of infection to the first signs of pathology directly depends on the incubation period of the pathogen. In case of allergic urethritis it takes several hours, in case of tuberculosis - several years, in case of viral - several months, in case of candidiasis and trichomoniasis - two to three weeks, in case of chlamydial - 7-14 days, in case of gonorrhea - 3-7 days.

The most typical symptoms of male urethritis are:

  • the presence of characteristic discharge that appears from the urethra,
  • burning, itching, and pain when urinating.

Other symptoms characteristic of STDs, such as general weakness and hyperemia, are not observed with urethritis.

However, the nature of the discharge may be different and depends on the type of pathogen that caused the urethritis. In most cases, green or white discharge with an unpleasant odor appears, against the background of which yellow crusts can form on the penis. The discharge is most noticeable in the morning.

In addition, redness and adhesion of the external opening of the urethra may be present along with the discharge. Pain in the lower abdomen can occur regardless of the type of urethritis, but even they are not a constant symptom of pathology.

The urination process is also disturbed, which in the initial stage is often accompanied by turbid urine, soreness, along with this, the number of daily urge to urinate increases. The end of this process can be accompanied by sharp pains and sometimes blood impurities.

Complaints made by the patient

Symptoms of urethritis do not occur immediately after infection. First, the incubation period passes, the duration of which can be from several minutes to two months in the case of nonspecific urethritis. Specific infections have a shorter time frame.

In almost 50% of cases, acute urethritis is asymptomatic. The patient makes no complaints. Most often, this picture occurs in women. Infection with an asymptomatic disease is quite capable of being sexually transmitted and leading to complications characteristic of urethritis.

Urethritis in men is characterized by a shorter incubation period, a more rapid onset and more severe symptoms.

In general, the differences between the symptoms of acute specific and nonspecific urethritis are not pronounced.

Common signs of acute urethritis:

  • itching and other unpleasant sensations during urination,
  • pains in the pubic area - periodic, aching,
  • in men - violation of urination, difficulty in the outflow of urine, up to an acute delay,
  • purulent discharge from the urethra,
  • blood impurities in the urine - hematuria,
  • the external opening of the urethra is glued in the morning.

With such complaints, as a rule, the patient visits a urologist. But most often they are not all present at the same time. Some of them are very pronounced, while others are completely absent. The course of acute urethritis can vary greatly.

Despite the fact that acute urethritis is an inflammatory disease, it is not accompanied by a violation of the general condition of the patient. Body temperature almost never rises.

Upon transition to a chronic form, the symptoms of the disease subside or completely disappear. In the future, they can occur periodically, that is, the disease constantly goes through stages exacerbations and remission (temporary well-being).

If the disease has become chronic, then the symptoms of the disease may disappear altogether, there is no discharge, and the patient may be disturbed only by mild itching and discomfort in the urethra. More pronounced symptoms are observed only during periods of exacerbation of the disease.

Purulent discharge

With bacterial urethritis, purulent discharge is observed, with trichomoniasis - whitish, with gonorrhea urethritis - gray-yellow or greenish. Also, the discharge may be insignificant or completely absent, however, the man will be disturbed by blood in semen or urine, burning and itching at the time of urination, swelling of the penis, pain at the time of intercourse.

The table shows the most characteristic symptoms of urethritis for its various types.

Traumatic urethritisSymptoms depend on the nature of the injury - it is burning and pain when urinating. Allergic urethritisAlso, pain and burning, however, a feature is the presence of allergic edema. Congestive urethritisClassical symptoms are often completely absent. It manifests itself in different types of sexual dysfunction.

Tuberculous urethritisIn most cases, it occurs against the background of kidney tuberculosis or genital tuberculosis. The penetration of mycotic tuberculosis bacteria into the urethra with urine flow occurs. It is not very symptomatic (sweating, fatigue, subfebrile condition). Gardnerellosis urethritisThe incubation period is from one week to several months. In most cases, present as a component of mixed urethritis. Chlamydial urethritisCramps and burning are absent, slight discharge. In most cases, it proceeds according to the chronic type. Ureaplasma urethritisMost often accompanies trichomoniasis or gonorrhea urethritis. The incubation period is about 1 month. There are green or white discharge, there is a burning sensation and itching when urinating. Exacerbation of symptoms occurs against the background of sexual intercourse or alcohol. Mycotic urethritisThe incubation period is about 20 days, there is a burning sensation and itching. The discharge is watery or mucous, sometimes pale pink. Bacterial urethritisPurulent discharge. Symptoms erased. The incubation period can last several months. Trichomonas urethritisIt is characterized by constant itching in the area of ​​the head of the penis, the presence of grayish-white secretions and difficulty urinating is also characteristic.

Viral urethritisThe course of the pathology is sluggish, the symptoms are mild. May be supplemented by conjunctivitis or joint inflammation. Mycoplasma urethritisQuite rarely occurs apart. In most cases, combined with gonorrheal or trichomonas urethritis. Gonorrhea urethritisGray-yellow discharge from the urethra, acute pain at the time of urination. The pus contained in the urine gives it a cloudy color. Impurities of blood appear in semen and urine.

Urethral anatomy

The urethra is located in the urethra of men (features of the anatomy are in the photo). It looks like a hollow tube 16-24 cm long. The male urethra is divided into three parts:

  1. The prostatic is in the prostate. The length of this section of the urethra is approximately 4 cm. Otherwise, the department is called the prostate.
  2. Membranous (membranous) - 2 cm long. The department is located behind the prostate, the second border is at the base of the penis. This is the narrowest part of the urethra.
  3. The spongy (spongy) is inside the penis. This is the longest department. Unlike others, it is the most mobile, ends with a meatus (hole).

Inflammation of the urethra is more common in men. This is due to the features of the anatomical structure. The causative agents of urethritis are usually gonorrhea and chlamydia, which enter the genitourinary system. The division into anterior and posterior inflammation is characteristic only for the male half. The channel itself has two sections. Posterior urethritis occurs above the membranous portion. The anterior is located near the bladder.

Disease classification

When symptoms appear, treatment of urethritis in men is made taking into account the etiology, intensity, stage of pathology.

InfectiousNon-infectious
Caused by various pathogens, divided into:

  • tuberculous
  • chlamydial
  • mycoplasmal
  • gardnerellosis,
  • viral,
  • bacterial,
  • gonorrheal
  • Trichomonas
  • mycotic,
  • ureaplasmic.

Mixed urethritis appears due to infection by several pathogens at once.

  1. Allergic urethritis appears due to exposure to irritants.
  2. Congestion occurs due to stagnation of venous blood in the pelvic area.
  3. Traumatic due to physical damage to the urinary tract. May appear after surgery.

Urethritis is divided into primary, appearing as a separate disease, and secondary - developing against the background of other pathologies. The course can be acute, subacute and torpid. Chronic disease occurs with different intensities - high, moderate or weakly active.

Nonspecific urethritis is caused by microorganisms that constantly live in the body, staphylococci. At the same time, the immune system is not able to cope with pathogens on its own. Specific is caused by gonorrhea, chlamydia, etc., appears with tuberculosis.

Desquamative urethritis develops against a background of chronic degenerative processes. This leads to a narrowing of the channel and the formation of pus inside. Interstitial inflammation of the urethra occurs due to hypothermia. This type of pathology is accompanied by fever, it is very difficult to tolerate.

Causes of the disease

The main causes of urethritis are pathogenic microflora and bacterial pathogens:

  1. Gonorrhea is caused by the appearance of gonococci. Infection occurs mainly during intercourse. In a domestic way, the infection is transmitted less frequently.
  2. Trichomonas appears two weeks after infection with bacteria. In many men, the disease proceeds in a latent form. With improper treatment, trichomonas prostatitis appears.
  3. Bacterial occurs due to pathogenic microflora. It can be activated against the background of a weakened immune system, unprotected sexual intercourse, or when using catheters.
  4. Viral is caused by chlamydia. It provokes a dysbiosis of microflora.
  5. Urethral candidiasis is rare. The cause of the disease is yeast. It is activated after prolonged use of antibiotics, weakening of the body, inflammation.

Chronic urethritis is formed against a background of weakened immunity, the spread of inflammation beyond the urinary tract. The acute form also goes into this phase if the disease has not been completely cured. Other causes of urethritis:

  • kidney pathology
  • malnutrition
  • injuries
  • genital infections
  • maceration
  • hypothermia
  • insufficient hygiene
  • the introduction of various medical instruments into the urinary canal, the expansion of the urethra,
  • violation of blood microcirculation in the pelvis,
  • allergic reactions.

Non-infectious urethritis can occur due to metabolic disorders, oncology. The disease appears after long riding, cycling or riding a motorcycle. The occurrence of nonspecific urethritis is due to the multiplication in the microflora of streptococci, E. coli in the urethra.

Causes of bacterial urethritis:

  • urogenital system defects (may be acquired or congenital)
  • body intoxication,
  • excessive drinking
  • caries,
  • urinary stenosis,
  • chronic inflammation
  • allergy,
  • increased levels of uric (and other) acids,
  • excessive consumption of marinades, fatty and spicy (as well as too salty and acidic) foods.

Cardiovascular diseases, emotional overstrain, and high physical exertion can provoke inflammation.

The first signs of urethritis

  • Pain, pain, burning, itching, discomfort in the urethra, often aggravated by urination. The severity of these symptoms is different and depends largely on the pathogen and the degree of damage to the urethra. Sometimes the manifestations are so insignificant that they occur only in the morning or during the emptying of the bladder.
  • Discharge from the urethra: purulent, mucous, turbid, bloody, thin, thick, plentiful, scarce. In general, any discharge from the channel is no longer the norm, but an occasion to contact a urologist.
  • Spots on underwear.
  • Adhesion of the lips of the urethra.
  • Turbid urine with impurities.
  • Redness of the lips of the urethra.

These signs need to be addressed to a man in order to understand that he is ill. With a healthy urethra, there can be no such signs and never does.

Even if there was no accidental sexual intercourse, symptoms of urethritis caused by non-venereal microflora may appear. This is also an occasion to take care of your health.

Many men do not seek help at the first sign of urethritis, hoping that it will pass by itself. Indeed, the symptoms sometimes disappear or become less pronounced over time. But pathogenic bacteria at this time spread to the posterior urethra, to the prostate, the epididymis. And then chronic prostatitis, vesiculitis or epididymitis, which will continue throughout life with periodic exacerbations, has already to be treated.

Urethritis is of two main types: specific, caused by an infection, sexually transmitted infection or mycobacterium tuberculosis, and non-specific urethritis caused by microflora.

For a specific urethritis, a clear incubation period is characteristic, that is, the time elapsed from the moment of infection to the onset of signs of urethritis.

With non-specific urethritis, it is difficult to isolate the incubation period, because the pathogen could be in the body for a long time without causing problems. Here predisposing factors come to the first place: hypothermia, traumatization, decreased immunity, and diabetes.

Symptoms of urethritis in men with STD infection depend directly on the pathogen. For example, with gonorrhea, the discharge is abundant purulent, pain in the canal is severe, the disease begins abruptly and acutely in the classic version. With chlamydia, the discharge will be liquid, cloudy, not abundant, the sensation is more likely to be itchy than pain or pain.

Without treatment, the severity of symptoms gradually wanes, the disease becomes chronic.

Signs of chronic urethritis are almost the same as in acute, only they do not always appear, but mainly during exacerbations. Outside of the acute period, a man may be bothered by mild discomfort, tingling, itching in the penis, mucous membrane from the urethra, slight redness and swelling of the urethra sponges.

Herpetic urethritis is characterized by periodic exacerbations, it begins acutely with pain in the canal, mucous secretions, sometimes with an admixture of blood. Even after a quality treatment, relapse is still possible.

Diagnosis of urethritis in men is not very difficult. , we focus on the clinical picture, complaints, symptoms,, conduct laboratory tests to confirm the diagnosis.

Urethritis tests

  • Microscopy of a smear from the urethra: we determine the signs of inflammation, white blood cells, mucus, the amount of microflora. You can identify a number of STIs: gonorrhea, Trichomonas, gardnerella, candida. In our clinic, a smear is done within 30 minutes. It costs 900 rubles.
  • PCR diagnosis of sexually transmitted diseases. A scraping is also taken from the channel in which the laboratory detects the DNA of pathogens of sexually transmitted diseases. Such an analysis is done 1 day. It costs 300 rubles. for 1 infection or 1700 rubles. for the complex of basic STIs.
  • Sowing from the urethra to the flora with the determination of its sensitivity to antibiotics and, in some cases, to bacteriophages.The analysis is performed within 5-7 days. It costs from 1600 rubles., Depending on its volume.
  • A general urine test helps to identify the inflammatory process, salts, sand, which could provoke trauma and inflammation of the urethra.
  • To diagnose allergic urethritis, a blood test is performed clinically and for general immunoglobulin E.

Based on the clinical picture, the doctor may add studies of the prostate gland, blood, urethroscopy.

Based on the survey, a diagnosis of acute or chronic urethritis, specific or non-specific, of one nature or another, is established. Therapy is prescribed depending on this and can be started on the first day of the patient’s treatment or after all the tests are ready.

Most common symptoms

Gonococcal (gonorrheal)Sharp and severe pain during emptying, turbid urine with gray-yellow pus from the urethra. Blood clots are visible in sperm and urine.
Ureaplasma urethritisIt proceeds with trichomoniasis and gonorrhea urethritis. From the member appears mucus of a white-green hue. There is burning sensation, pain and itching in the urethra, the symptoms are aggravated after drinking alcohol.
TuberculousThe temperature rises, severe sweating, fatigue.
MycoplasmalIt occurs along with trichomonas and gonorrhea, has corresponding symptoms.
ChlamydialBurning in the urinary tract, small discharge. More often, it is completely asymptomatic.
MycoticLiquid discharge from the urethra, white or pinkish. The mucous membrane is covered with a curd coating.
GardnerellaIt has no distinctive features. The symptomatology is the same with which form of urethritis is mixed.
TrichomonasThe head of the penis constantly itches, emptying is difficult, gray discharge appears.
ViralGeneral symptoms, mild. Conjunctivitis appears, joints hurt, discomfort in the urethra is felt.
BacterialWith blurry general symptoms. Pus from the urethra with an unpleasant odor appears; it turns yellow as it dries.

Congestive urethritis is accompanied by impaired reproductive system. General symptoms rarely appear. Symptoms depend on the nature of the damage. Most often, during emptying, burning and pain occurs. Features of the allergic type of the disease include edema. Additionally, itching appears.

Treatment of acute urethritis

Acute urethritis is treated well and quickly, if a pathogen is identified, drugs to which it is sensitive are identified, and the most effective treatment regimen is appointed that can destroy the cause of the disease, remove inflammation, and not leave the prerequisites for the development of chronic urethritis.

Typically, an antibiotic is sufficient to treat this type of urethritis if it is caused by bacteria, an antimycotic if it is fungal in nature, and an antiprotozoal drug if it is caused by protozoa. Herpetic urethritis is treated with antiviral drugs.

The choice of drug dosage, route of administration, course duration depends on a number of factors, but usually does not exceed 10-14 days.

For STDs, the instructions determine the drugs of choice and the duration of treatment. In the treatment of non-specific acute urethritis, the doctor focuses mainly on the effect of it and the results of intermediate analyzes of a smear from the urethra.

In the treatment of acute urethritis, the choice is usually for injectable drugs that have better bioavailability and immediately create maximum antibiotic concentrations in the affected tissue. But such treatment is possible only in the clinic under the supervision of a doctor. For home schemes, alternative tablets are prescribed, which do not always have the necessary effectiveness. Although in some cases it is necessary to combine injections with tablets.

Depending on the pathogen identified, cephalosporins, fluoroquinolones, macrolides, tetracyclines, aminoglycosides, imidazoles and antifungal drugs can be prescribed.

How to treat acute urethritis if it is caused simultaneously by venereal and non-venereal bacteria in combination with protozoa or fungi?

This is actually not a rare situation when several pathogens of urethritis are detected at once. In this case, the selection of drugs is not easy. But for an experienced doctor is not an insurmountable obstacle.

First of all, we determine the presence of protozoa, which, being large cells, can contain bacteria of other microorganisms inside themselves. First, start therapy against them. It is mainly used metrogil intravenously in a drop combination with tablet forms if necessary. The dosage is selected by the doctor.

Next, we attach an antibiotic that acts on a sexual infection, if it is detected. Ideally, the drug is also prescribed taking into account the existing sensitivity of the identified non-specific flora.

Such treatment has established itself as the most effective option for getting rid of acute mixed urethritis and helps to avoid its chronic form.

Diagnosis of the disease

The treatment of urethritis in men is carried out by a urologist. Before drawing up a treatment regimen, the type of disease, the cause, is clarified. If the infection occurred through sexual contact, consultation with a dermatovenerologist is necessary. Before making a diagnosis, a general smear is taken from the urethra. Feeling and visual inspection of the scrotum and penis. Diagnostics includes analyzes:

  • urine
  • Nechiporenko analysis,
  • blood
  • bacterial urine culture,
  • 3 cup sample.

Urethroscopy, PCR, ELISA is done. Urethral ultrasound is prescribed. The presence of a bacterial species may be indicated by an increased level of leukocytes, the presence of protein in the urine.

Treatment with folk remedies

Treatment of urethritis at home only with alternative methods will not give an effect. A necessary basis is drug therapy. Urethritis is an inflammation of the urinary tract. To eliminate it, infusions of herbs are made - celandine, St. John's wort, knotweed, bearberry, coriander and others. A decoction of currant leaves is useful. Cornflower flowers are brewed, grated fresh wheatgrass root.

To relieve swelling and redness of the penis, the organ is washed with infusion of chamomile or marigold compresses are made. Herbs are antiseptics, help eliminate itching and burning in the head of the penis. For the same purposes, compresses from oak bark are used.

In the acute form of urethritis, the symptoms are pronounced, hirudotherapy is used to eliminate it. Leeches are applied to the lower back. Eight procedures are enough to normalize urination.

Treatment with folk remedies offers a separate therapy regimen for primary urethritis and its initial stage. The head of the penis is rubbed on the first day with its own urine, on the second - with a weak solution of potassium permanganate.

Washing is carried out after each emptying. On the third day, the penis is lowered into hot water with an interval of four hours. On the 4th day, a man should take a steam bath in a dry sauna or bath.

This treatment regimen helps eliminate inflammation in a week. The penis can be washed with bergamot oil mixed with vodka and water. This prevents the spread of infection.

Attention! All folk methods are only auxiliary. The main treatment is medication.

Complications of urethritis

Urethral diseases, improper treatment or its absence can lead to balanoposthitis, Reiter's syndrome. With frequent inflammation of the urethra, a narrowing of the urethra occurs. This can trigger a stricture. With advanced urethritis, more serious complications appear. Most often, pathology leads to prostatitis, male infertility, veseculitis, orchitis. Urethral cancer may develop.

Prevention

In most cases, urethritis is caused by various bacteria and is transmitted during intercourse. As a preventive measure, it is necessary to observe personal hygiene, to be choosy in intimate relationships, to use condoms. Proper nutrition is important.

It is necessary to exclude salty, spicy and fatty foods, alcoholic beverages. When urge to the toilet, the bladder must be emptied immediately. Checked annually by a urologist, avoid hypothermia.

Urethritis is a serious disease that can lead to serious complications, including infertility and cancer. It is impossible to self-medicate, since it is necessary to know the cause of the disease, the type of pathogen. Uncontrolled use of antibiotics can lead to a worsening of the condition.

Disease Diagnostic Methods

Urethral swab in men - an effective diagnosis of the disease

At the first sign of urethritis, it is important to consult a urologist. In some cases, when the disease was promoted by a sexual infection, a consultation with a dermatovenerologist is prescribed.

A medical examination is sometimes insufficient to determine the diagnosis, especially if the disease is asymptomatic. The main research methods include urinalysis, which is considered the simplest. If there is an increased level of white blood cells in the urine, this indicates an inflammatory process. Usually the analysis is given in the morning. To do this, take the first portion of the liquid. For examination for bacterial urethritis, a blood test is mandatory.

Additional methods for the study of urethritis of bacterial origin include:

  • Three glass sample
  • Urine analysis according to Nechiporenko
  • Urethroscopy
  • Urine culture
  • Polymerase chain reaction of secretions (PCR)

If in the blood and urine there is an increased indicator of leukocyte cells, there is a protein in the urine (proteinuria), then this may indicate bacterial urethritis.

A mandatory method is a smear from the urethra, it can be bacteriological and microscopic.

To prepare for such a diagnosis, sexual acts, the use of any antibiotics should be excluded the day before the procedure. In addition, you can not urinate about two hours before the smear. An ultrasound examination of the bladder, kidney, prostate and ureter can also be prescribed.

Stages of treatment

Treatment of urethritis in men should be carried out as soon as possible, since this disease does not pass on its own. Even non-infectious urethritis easily passes into a nonspecific form (when opportunistic bacteria are activated).

In the absence of proper therapy, urethritis becomes chronic and unpleasant complications are ensured in the future. Do not rely on knowledge of traditional medicine. A urologist knows how to treat urethritis, whose consultation in case of illness will be indispensable.

Therapy includes several stages.

What is the treatment for non-specific urethritis in which there are no types of STIs?

An antibiotic is prescribed taking into account the results of sowing and eliminate the factors that caused the appearance of inflammation of the urethra. That is, they add urolithiasis therapy, stop the traumatic procedures on the urethra, recommend avoiding hypothermia, and so on.

Sometimes treatment for acute nonspecific urethritis is prescribed by injectable antibiotics until the seeding is ready, if the symptoms are severe. Further, when receiving the data of a bacteriological study, the drug may change, or remains the same. The dosage and duration of the course may also change.

Depending on the type of urethritis after treatment, control tests are carried out after 7-10 days, and with some STIs after 14-21 days.

Acute urethritis, correctly and timely treated, almost always ends with the patient's recovery. If the treatment was prescribed inadequate, incomplete, or the patient was self-medicating, it is possible to develop chronic urethritis in men, which can be treated for a long time, it is difficult and not always possible to completely get rid of this disease.

Chronic urethritis treatment regimen

The main drugs acting on the pathogen are the same as in acute urethritis, and are selected on the basis of laboratory diagnostic data.

But antibiotics alone are not enough to treat chronic urethritis. Bacteria simply do not become so readily available for their action.

Therefore, the treatment regimen for chronic urethritis in men includes the following points:

  1. The antibiotic intramuscularly or intravenously for 10-14 days with a further transition to the tablet form for another 14 days.
  2. Immunostimulating therapy, which contributes to the transition to the acute stage, in which the effectiveness of antibiotics is much higher. Usually, it precedes antibiotic therapy and is then carried out throughout the treatment or in several stages.
  3. Enzyme preparations such as longidase, lidase, chymotrypsin throughout antibiotic therapy help the delivery of drugs to the mucous membrane of the urethra, affected by a chronic inflammatory process.
  4. Local treatment of chronic urethritis is the introduction of drugs directly into the focus. Instillations in the urethra of collargol in glycerol, liniment of cycloferon, antibiotics and metrogil in dimexide are performed. This enhances the immune response in the channel, creates high concentrations of drugs directly in the lesion, which cannot be achieved by any other method of administration, even intravenous.
    In the presence of island-inflammatory phenomena, local treatment is delayed until they subside.
    If chronic urethritis engulfed the posterior urethra, then the drugs are administered by catheter.
    In total, from 7 to 10 instillations can be performed during the treatment.
  5. Physiotherapeutic procedures used in chronic urethritis help to increase blood flow in the urethra, antibiotic delivery there, and restoration of the mucous membrane. Used laser irradiation of the urethra, electrophoresis of antibacterial drugs and enzymes in the posterior urethra from 10 to 15 procedures.

The treatment of chronic urethritis is always complex and is carried out in a medical center, which includes both medicines and various procedures. At home, it is almost impossible to achieve a result.

The constant independent use of various antibiotics leads to the development of multidrug resistance of bacteria to drugs, the growth of scars, infiltrates in the urethra, and the occurrence of chronic prostatitis.

If some types of nonspecific acute urethritis can be cured by taking tablet forms of drugs, then only a urologist should deal with the chronic process in a clinic where there is every opportunity for local, physiotherapeutic treatment of inflammation of the urethra.

The cost of treating chronic urethritis is from 10 thousand rubles.

Instillations in the urethra - 800 rubles.

Physiotherapy from 800 to 1200 rubles. per procedure, depending on type.

Our clinic has developed treatment regimens for all types of acute and chronic urethritis caused by both sexually transmitted infections and a non-specific process.

Even with the advanced course of the disease, a man can be helped in most cases.

But, unfortunately, many are trying to repeatedly be treated with tablet forms of antibiotics at home. As a result, in the crops revealed a complete lack of sensitivity of bacteria to the main drugs. We have to look for backup, expensive drugs to affect the infectious process.

Treatment in the clinic of urethritis is outpatient. The patient comes 1, a maximum of 2 times a day in difficult cases for procedures and takes part of the drugs at home.

After treatment, control tests are given.In case of a chronic disease, it is possible to provoke before taking material.

Treatment of urethritis in men (not children)

The choice of treatment for urethritis, like any other disease, is made on the basis of diagnostic data. First of all, laboratory testimony is used. A general analysis of blood and urine, data of urethroscopy, a study of urethral smears, bacteriological culture of urine are taken into account.

  • Therapeutic procedures can be carried out on an outpatient basis, during treatment it is important to observe systematicity and accuracy in the implementation of medical prescriptions, hospitalization is not required.
  • If the intake of antimicrobials is interrupted, is carried out irregularly or during the period of therapy the patient drinks alcohol, the disease threatens with a transition to a chronic form.

It is quite obvious that the selection of drugs for the medical treatment of male urethritis is carried out by the doctor, and the patient must follow the necessary rules throughout the treatment period: drink plenty of fluids, do not use pickled, smoked foods, spices, spices, give up alcohol, observe personal hygiene rules, exclude sex life.

  • The selection of drugs is carried out purely individually. Any infectious urethritis is treated with antibiotics.
  • The most pronounced effect is achieved when using an antibacterial drug, selected on the basis of the analysis of sensitivity.
  • It is thanks to this study that you can choose the most effective treatment.

Treatment of bacterial, gonorrhea urethritis

The antibiotics of the cephalosporin group demonstrate excellent results in the treatment of gonorrhea urethritis. In addition to them, kanamycins, oletetrins, erythromycins, tetracyclines can be prescribed. In this case, kanamycins must be used with extreme caution, since these drugs are highly toxic. Drugs with prolonged action - bicillin-5 and bicillin-3 should be prescribed in short courses.

In some cases, if gonorrhea urethritis is complicated by other infections, the simultaneous use of several antibacterial drugs is practiced. In such cases, it is best to use the complex of "Gentamicin" and "Azithromycin" ("Ecomed", "Hemomycin", "Azitroks", "Azicide", "Zi-factor", "Sumamed").

In order to prevent the occurrence of candidiasis, due to prolonged antibiotic therapy, Levorin, Fluconazole, Nystatin, Pimafucin and other antimycotic drugs are prescribed. The most important aspect of treatment is the individual selection of drugs.

Quite often, men who suffer from gonorrhea urethritis ask friends to “give injections” and use antibiotics uncontrollably and without consulting a doctor.

  • Such self-medication is unacceptable, since prolonged use of strong anti-inflammatory drugs without a clear treatment regimen and cure control can lead to the transition of urethritis to a chronic form and the development of resistance of the pathogen to drugs.
  • In addition to antibiotics, the patient should take immunostimulating drugs and vitamins.
  • To fully convince that the body has freed itself from gonococcus and is completely cured, it is necessary to pass control smears three times.
  • Only after receiving negative research results can we assume that the patient is completely healthy.

Gardnerellosis, ureaplasma and mycoplasma urethritis

These types of urethritis are treated with antibiotics, lincosamines, fluoroquinolones, macrolides and tetracyclines. The tetracycline group, and specifically doxycycline, is considered the most effective. The macrolide group (clarithromycin) also gives excellent results. Immunostimulants are also prescribed.

For any specific urethritis, simultaneous therapy of both sexual partners is necessary.

Trichomonas urethritis

  • If a man is diagnosed with trichomonas urethritis, when selecting drugs, they turn to metrogil, trichopolum and metronidazole.
  • If the urethritis has a chronic form, antibiotic therapy is added to the treatment.
  • In the case of inadequate treatment, infertility may develop.

Candidiasis urethritis

Treatment of candidal urethritis in a man requires a completely different approach. The main drugs to combat this pathology are antimycotic drugs like Pimafucin, Nystatin, Clotrimazole, and Fluconazole.

Qualitatively selected treatment of the underlying disease is important, which is the cause of candida urethritis.

Chlamydial urethritis

The only antibiotic that actively fights the causative agent of this infection is azithromycin.

  • If the drug is incorrect in case of chlamydial urethritis, serious complications can occur - inflammatory diseases, epididymitis, Reiter's syndrome, infertility.
  • If the patient has an individual intolerance to azithromycin, doxycycline, levofloxacin, erythromycin, ofloxacin, clarithromycin are used as an alternative.
  • Also, immunostimulating drugs and vitamins should be used in the complex.

Viral urethritis

Treatment is with antiviral drugs. The sooner treatment is started, the faster recovery will occur. Among antiviral drugs, preference is given to: “Herpevir”, “Famciclovir”, “Riboverin”, “Acyclovir”.

Using antibiotics with this form of pathology is impractical because they are not able to fight viruses.

Nonspecific chronic

Treatment of non-specific chronic male urethritis is not as fast as with infectious ones. The chronic course of the disease is often aggravated by concomitant pathologies, and the signs of the disease are mild or may be absent altogether.

  • Therefore, treatment of chronic urethritis should begin with the use of immunostimulants.
  • Only this approach allows you to activate the body's defenses to fight infection.
  • After receiving the result, antibiotic therapy is selected individually.
  • The main feature of the treatment of non-specific forms of urethritis is the lack of need for treatment of a sexual partner.

Non-infectious

For allergic urethritis, antihistamines must be used.

If urethritis is caused by stagnation of blood in the pelvic area (congestive), it is necessary to eliminate the cause of this stagnation. With traumatic urethritis, in addition to antimicrobial therapy, surgical intervention may also be required.

Antibiotics can be prescribed for:

  • the installation of the drug through catheter injection into the urethra,
  • intravenous infusion in 0.2% of cases of acute urethritis,
  • intramuscular injection in 18%,
  • oral administration in 81%,
  • the use of only one antibiotic - monotherapy 41%,
  • two - 41%
  • three - 13%
  • four antibiotics - 5% of cases.

The most popular antibiotics for acute male urethritis, which are prescribed by a doctor depending on the type of pathogen

Trichomonas urethritis in combination with atypical agents

Ornidazole6%Doxycycline3%Josamycin6% Josamycin6%Ciprofloxacin4%Ceftriaxone8% "Azithromycin"9%"Metronidazole"10%Ornidazole14% Doxycycline21%"Azithromycin"15%"Secnidazole"15% "Metronidazole"36%Ceftriaxone61%Fluconazole24% Doxycycline25% "Azithromycin"29%

Non-coconut urethritis, which is caused by atypical agents

Urethritis of unknown etiology

Clarithromycin3%Clarithromycin3% "Secnidazole"3%Ciprofloxacin3% Josamycin5%Tinidazole3% "Metronidazole"6%Nimorazol3% Doxycycline12%Josamycin4% Ofloxacin12%"Secnidazole"4% Fluconazole24%Fluconazole9% "Azithromycin"35%Ceftriaxone10% Doxycycline18% "Metronidazole"18% "Azithromycin"24%

Traditional treatment of the disease

Proper and effective treatment of bacterial urethritis can only be prescribed by a doctor.

Treatment of bacterial urethritis is aimed at the destruction of pathogenic microflora. After the diagnosis, with the help of which the presence of a certain type of bacteria is determined, the specialist selects antibacterial drugs. In this case, complex therapy is needed.

Most often prescribed antiseptics - drugs for external use. These are such medicines:

  • Protargol
  • Dioxidine
  • Miramistin
  • Collargol
  • Furatsillin

Silver nitrate based products are excellent. These drugs relieve itching and reduce pain. With their help, urethral rinses, the so-called instillations, are done. Herbal preparations Phytosoline and Kanefron have a good effect.

In addition, ointments are used in the treatment, which help the regeneration of the tissues of the urethra.

Effective in the treatment of urethritis is the use of antibiotics inside. Depending on the specific causative agent of the disease, a specialist may prescribe the following groups of such drugs:

  • Macrolide series of antibiotics: Erythromycin, Azithromycin, Clarithromycin.
  • Cephalosporins: Cephritriaxone, Cefazolin.
  • Tetracycline group: Doxycycline, Tetracycline.
  • Fluoroquinolones: Pefloxacin, Levofloxacin, Abactal, Ofloxacin.
  • Sulfonamides may also be used.

It is better to give preference in this disease to broad-spectrum antibiotics. Usually these are drugs for internal use or medicines in the form of injections:

  • With a disease caused by Trichomonas, Trichopol, Metrogil, Metronidazole, Trichomonacid, Tinidazole are suitable.
  • If gonorrhea provoked urethritis, then it is better to use cephalosporin, macrolide or fluoroquinolone drugs. These are antibiotics such as Azithromycin, Gentamicin, Cefuroxime, Cefotaxime, Azitrox, Summamed, Erythromycin, Oleandromycin, Spiramycin, Cefaclor, Rifampicin.
  • Chlamydia is more effective in macrolides, tetracyclines, and fluoroquinolones. Azithromycin is the most popular in the treatment of urethritis, which is caused by chlamydia.
  • If the disease is not started, then you can try to use Monural, which helps to eliminate the inflammatory process during the day.

Antibiotic therapy course

The course of antibiotic therapy is up to ten days. It is important to remember that when using antibiotics, probiotics should be used that help restore intestinal microflora. These are drugs such as Linex, Lactovit, Bifidumbacterin.

Additional methods of treating the disease ::

  • Antihistamines such as Suprastin or Tavegil are used to relieve swelling of the genital organ and itching.
  • The use of immunostimulants and vitamin-mineral complexes is also recommended. These include Timalin, Duovit, Ribomunil, Gepon. Such funds help increase defenses and restore the urethral mucosa.
  • For the treatment of bacterial urethritis, the following physiotherapeutic procedures may be prescribed: magnetotherapy, electrophoresis, or UHF.

However, these methods are not carried out in the acute course of the disease. To speed up recovery, you must also adhere to a special diet and abstain from sexual activity during treatment. After treatment, a second examination should be taken.

Additional treatments

In addition to the basic course of treatment with antibacterial drugs that suppress the acute symptoms of the disease, other therapeutic methods are also widely used, which relate to local and physiotherapeutic procedures.

Local procedures involve administering drugs directly to the urethral opening. Urethral installations are performed using a hydrocortisone, Dioxidin and Mirimistin preparation. Local treatment gives a good result, provided that it is used in combination with other drugs.

Physiotherapeutic treatment is used exclusively in cases of chronic urethritis, it is strictly contraindicated to use these methods in acute inflammatory processes. Magnetotherapy, laser therapy, UHF, electrophoresis can be prescribed. However, all these methods should be carried out only systematically and only under the supervision of specialists.

Forecast

Men can cure urethritis only if all the recommendations of a specialist are observed.

The correct medication and the passage of all necessary procedures, in most cases, has a successful outcome.

Otherwise, the disease may become chronic (desquamative) in nature.
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Forms of Urethritis

There are various types of urethritis classified for inflammation. The most common is the division into gonococcal and non-gonococcal urethritis. Gonococcal urethritis is caused by the same bacterium that causes gonorrhea, a sexually transmitted disease. This form accounts for 20% of all cases of urethritis. Non-gonococcal urethritis is urethritis caused by other infections that are not gonorrhea. For example, chlamydia is a common cause of non-gonococcal urethritis. If urethritis is not associated with an infectious lesion, but is a consequence of mechanical or chemical damage, it is classified as a traumatic form. In addition, more often in women, mixed forms of urethritis are found. According to the clinical course, acute and chronic, complicated and uncomplicated forms of urethritis are distinguished.

Watch the video: Male Urethral Stricture Disease: Signs, Symptoms and Treatment (February 2020).

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