How the female genitourinary system works - structural diagram. Structure and functions of the urethra in men and women
The urethra (urethra) is an organ of the urinary system. It is a tube-like channel through which urine is removed from the Bladder out.
The internal opening of the urethra is located in the wall of the bladder. The urinary tract is directed through the urogenital diaphragm. At the end of it, in the vestibule of the vagina, there is an external opening. The latter is round in shape, and next to it there are hard roller-shaped edges. Clearance urethra unequal in diameter along its entire length. The outer opening is relatively narrow, while the inner one is wider and looks funnel-shaped.
Women's urethra is smaller in length compared to men's (up to 4 centimeters), but much larger in width - up to 1.5 cm. The posterior surface of the urethra is fused with the vaginal wall and is located strictly parallel to it. The urethra is surrounded by connective tissue. It is particularly dense in lower sections. The walls of the urethra consist of mucous membrane and muscle tissue.
The urethral mucosa is covered in several layers prismatic epithelium. In some cases, this epithelium is flat, in others it is high.
The membrane is a series of longitudinal folds, and the transverse section of the urethra resembles a star in shape. The largest fold of the canal is called the ridge and is located on its posterior wall, from the bladder to the outlet.
Along the entire urethra there are periurethral glands that produce mucus. There are lacunae on the mucosa, and in the lower regions of the urethra there are the mouths of the gland ducts.
The muscles of the urethra include external, internal, circular and longitudinal layers, as well as smooth muscles with elastic fibers. Connective tissue canal is supplied with veins.
The urethra in women is equipped with a pair of sphincters, external and internal. The purpose of these valves is to keep urine from flowing freely.
The external sphincter is a paired muscle attached to the vagina. Internal - represents a stronger muscle in the bladder area.
Microflora of the urethra
Healthy microflora adult woman consists of epidermal and saprophytic staphylococci and lactobacilli. Maximum level bifidobacteria - 10%, peptostreptococci - 5%. The collection of these microorganisms is called Doderlein flora.
The composition and norms of the specific content of microorganisms in the microflora depend on the woman’s age.
Methods for studying microflora
Smear
The purpose of taking a smear is to detect and study the microflora to identify the microorganisms that caused the disease.
A smear is prescribed in the following cases:
- risk of urinary tract infection;
- pain in the canal area;
- inflammatory process;
- pregnancy.
An indication for taking a smear is also a preventive gynecological or urological examination.
Rules for preparing for a smear:
- within a week, stop taking medications and, first of all, antibiotics;
- do not drink alcohol for at least 24 hours;
- abstain from sexual contacts within 12 hours;
- Do not empty your bladder for an hour before the smear;
- do not douche;
- do not use vaginal medications.
Scraping
3 hours before scraping you need to stop urinating. If there are copious discharge, the external opening of the urethra is wiped with gauze soaked in saline solution.
When performing a scraping, the probe is inserted into the urethra a couple of centimeters and held inside for about 5 seconds. In this case, the tool is rotated around its axis. Assembled biological material transferred to a test tube.
Pathologies
- infection with viruses and bacteria, including mycoplasmas, chlamydia, trichomonas, gonococci, mycotic and mixed infections;
- trauma to the mucous membrane (usually as a result of catheterization);
- metabolic disorder;
- influence of allergens;
- stagnant processes.
- discharge from the canal;
- discomfort, pain, stinging, itching.
- Urethral prolapse. Prolapse of urethral tissue usually occurs in old age and may be accompanied by vaginal prolapse. The cause of the pathology is muscle damage pelvic floor and perineum due to heavy physical labor, protracted labor, delivery, prolonged cough, constipation. If the prolapse is different severe loss walls, circular excision of tissue is used.
- chronic inflammatory process resulting from infection;
- hormonal imbalance;
- inflammatory process in the intestines.
- associated with defects in the formation of the urinary organs;
- appearing due to blockage of skin glands.
- pain syndrome, ;
- pain during sexual intercourse;
- urinary incontinence;
- bleeding.
- inspection and palpation;
- smear cytology;
- histology;
- cystography, cystoscopy.
- Myomas, fibromas, angiomas are benign hormonal-dependent neoplasms. Consist of muscle and connective tissue. Treatment is only surgical.
Inflammation of the mucous membrane of the urethra is called urethritis. Most often the disease occurs in acute form and is accompanied by colpitis and endocervicitis. Causes of the disease:
Manifestations:
Therapy for the disease consists of infusions of drugs into the urethra and orally chemotherapy drugs and antibiotics.
Polyps belong to benign tumors occurring on the urethral mucosa. They represent an enlarged area of connective fibers. The neoplasm is soft on palpation and grows rapidly in size. Eventually, the polyps close the internal lumen of the canal. Causes of pathology:
IN initial stage The disease develops asymptomatically, but after a while discomfort appears. Polyps are detected using a urethroscope. During diagnostic measures A bacterial culture of a smear from the urethra and a smear for microflora are carried out. Treatment consists of surgical removal neoplasms.
One of the types of polyps is the caruncle. Its size is from 3 to 5 millimeters. The neoplasm may have a stalk or be without it. The color of the polyp is scarlet. Trauma leads to bleeding, since the tumor contains many capillaries. At the beginning of their development, caruncles are soft, but as a person ages they become harder.
Typically, such polyps are detected in older women. Caruncles are rarely multiple and are located near the external opening of the urethra. The main symptoms of caruncles are bleeding and urinary incontinence. They are often accompanied by inflammatory processes in the bladder and urethra. Treatment of caruncles is carried out surgically and using electrocoagulation.
A manifestation of the papilloma virus is condylomas. The virus is transmitted through sexual contact. The period of latent infection in the body can be any. Externally, condylomas are similar in shape to cauliflower.
Having appeared for the first time, these formations can then spontaneously disappear. Degeneration of endourethral condylomas into malignant tumors- an extremely rare occurrence. Although this condition is more common in men, it can also affect women.
Treatment of condylomas is carried out with cryotherapy and the drug Podophyllin. Moreover, it is not possible to remove the virus itself from the body. Prevention of relapse of the disease consists of strengthening the immune system, a healthy lifestyle, and consuming sufficient amounts of vitamins and minerals.
Cysts are glands filled with fluid. Cysts are located near the outer part of the canal and look like bulging anterior vaginal walls. Cysts are divided into 2 types:
Most often, the pathology occurs when weak immunity as a result of inflammation or injury.
The cyst is characterized by difficulty urinating. Bulges appear near the external opening of the urethra. If suppuration occurs in the cyst, the patient experiences pain and her temperature rises. Treatment of the cyst is surgical under local anesthesia.
Cancer of the urethra is a rare disease. However, this type of tumor is found approximately 10 times more often in women than in men. The location of the tumor in the canal can be anywhere, but most often it occurs near the external opening - between the urethra and the vulva. Manifestations of the disease:
Diagnostics is carried out using the following methods:
Main methods of treatment - surgery and irradiation.
Thermal burns are most often characterized by a small area, rapid scarring and usually heal without therapeutic procedures. Chemical burns cause inflammation and death of mucosal tissue.
The main symptom of a chemical burn is pain when the drug is administered. Whenever the specified symptom you need to determine the temperature of the product introduced into the urethra. You also need to make sure that the exact drug that is prescribed is injected into the urethra.
At chemical burn It is recommended to wash the urethra with a liquid that softens the effect of the irritant. For example, if acid comes into contact with the mucous membrane, you need to rinse with a solution baking soda. The alkali should be neutralized with a solution citric acid or vinegar. After washing, the canal is treated with synthomycin ointment. The patient is recommended drinking plenty of fluids. For severe burns, drainage is installed.
Prevention of urethral diseases consists of observing the rules of personal hygiene and abstaining from eating foods that irritate the mucous membranes. During sexual intercourse, the use of condoms is recommended. If pain, cutting sensations, discharge or other symptoms described above occur, you should consult a doctor to find out the cause and, if necessary, treatment.
IN female body, the reproductive and urinary systems are closely interconnected into one, called the genitourinary system.
The structure of the female genitourinary system is quite complex, and is based on the performance of both reproductive and urinary functions. We will talk about the anatomy of this system in detail later in the article.
What does it look like and what does it consist of?
Urinary system in women (see photo close-up) not much different from men's, but there are still some differences.
The urinary system includes:
- kidneys (which filter many harmful substances and those involved in their removal from the body);
- renal pelvis(urine pre-accumulates in them before entering the ureter);
- (special tubules connecting the kidneys to bladder);
- (the organ that directly contains urine);
- urethra (urethra).
The kidneys, in both men and women, have the same shape and structure, and their size is about 10 cm. Located in the lumbar region and surrounded by a dense layer of fat and muscle tissue. This allows them to stay in one place without falling or rising.
The bladder in women is oblong, oval shape, and for men - round. Volume of this important body can reach 300 ml. From it, urine flows directly into the urethra. And here, too, there are significant differences in the structure of the female and male body.
In women, urethral length cannot exceed 3-4 cm, while in men, this figure is 15-18 cm or more. Moreover, in women the urethra functions only as a channel for the removal of urine, but in men it also has a fertilizing function (delivery of semen to the uterus).
In the urethra of any person there are special valves (sphincters) that prevent the spontaneous outflow of urine from the body. They are external and internal, and it is the internal valve that allows us to independently control the process of urination.
As for the female reproductive system, it includes the external genitalia and reproductive (internal) organs. The external organs are usually called the labia majora, clitoris, labia minora and the opening leading to the vagina.
In young girls and girls, this hole is tightly closed with a special film (hymen).
The reproductive system includes:
- vagina (a hollow tube, about 10 cm long, connecting the labia to the uterus);
- uterus ( main body woman in which she bears a child);
- fallopian (uterine) tubes, through which the sperm moves;
- (glands that produce hormones and egg maturation).
The urethra is very close to the vagina, therefore all these organs, due to their location, are called a single genitourinary system.
How does urination occur in women?
Urine is formed directly in the kidneys, which take an active part in cleansing the blood of harmful substances. During this cleansing process, urine is formed (at least 2 liters per day). As it forms, it first enters the renal pelvis, and then through the ureters into the bladder.
Due to the structure and shape of this organ, a woman can endure the urge to urinate for quite a long time. When the bladder is filled to capacity, urine is released from the urethra.
Unfortunately, the length and location female urethra contribute to the penetration of all kinds of infections into the body and the development of inflammatory processes. While, thanks to the length of the urinary canal, they are protected from this.
What diseases are the female genitourinary system susceptible to?
As already noted, the majority similar diseases provoked by infections. Moreover, the close location of the urinary and genital organs causes not only urological problems and ailments, but also gynecological.
There are several other causes of genitourinary diseases:
- fungal infections;
- viruses and bacteria;
- gastrointestinal diseases;
- hypothermia;
- endocrine disorders;
- stress.
Most often, women suffer from the following diseases:
In addition, women are often exposed to infection venereal diseases and STIs (sexually transmitted infections). The most common of them:
- mycoplasmosis;
- HPV (papilloma virus);
- syphilis;
- ureaplasmosis;
- gonorrhea;
- chlamydia.
Ureaplasmosis, like mycoplasmosis, are transmitted only sexually, affecting the urethra, vagina and uterus. They are characterized by itching, pain, and mucus discharge.
Chlamydia- this is very dangerous infection, difficult to treat and affecting absolutely the entire genitourinary system. Accompanied by weakness, fever, purulent discharge.
HPV in women it proceeds without brightness pronounced signs And pain. The main symptom is the presence of papilloma formations in the vaginal area. It is not easy to cure; it causes a huge number of complications.
Syphilis and gonorrhea also dangerous and extremely unpleasant ailments that require immediate attention inpatient treatment. And if you can diagnose gonorrhea in yourself in the first days after infection, according to the characteristic painful urination and secretions, then syphilis is much more difficult to detect.
Prevention of her diseases
It is much easier to prevent any disease than to try to get rid of it.
Just a few simple rules reduce risk genitourinary lesions to a minimum. Adviсe on prevention:
- avoid hypothermia;
- Wear underwear only from natural fabrics, comfortable and not restricting movement;
- observe all necessary hygiene procedures daily;
- avoid promiscuous sex or regularly use a condom;
- lead a healthy and full image life, engage in moderate physical activity;
- stay longer fresh air, strengthen immune system, take additional vitamin supplements.
It is important to remember that the female genitourinary area is a complex, interconnected system. Any disease can lead to sad consequences : from chronic lesions internal organs, to infertility or oncology. That's why it's so important to comply preventive actions to prevent their development.
How is the female reproductive system- watch the video:
Few people know what the female urethra is. The urethra is the urethra, the last link in the system for removing urine from the body. It has its own structural features:
- small length (about 3–5 cm);
- wide diameter at the moment of stretching;
- narrowed areas;
- one enlargement near the bladder;
- secreting glands.
The urethra is located in front of the vagina and passes through the muscles located in the pelvic floor. The muscle corset at the exit from the urethra is slightly weakened.
The urethra performs the following functions:
- removal of accumulated urine from the bladder;
- muscle toning to create a reservoir;
- erogenous zone.
Many people think that this is a simple pipe and do not take it seriously. This is an erroneous opinion, since diseases of the urethra in women can lead to a disorder of the reflex functioning system, which can have a significant negative impact on intimate life.
Why does urethral disease occur?
Urethritis is divided into 2 main types:
- non-infectious origin;
- caused by infectious agents.
Diseases of non-infectious origin occur:
- at mechanical damage integrity of the mucous membrane with stones, the movement of which is characterized by urolithiasis;
- injury from a cystoscope, catheter, etc.;
- allergies;
- malignant tumors;
- diseases of the genital organs;
- venous stagnation in the pelvic organs.
Diseases infectious nature arise as a result of pathogens entering the body through sexual contact:
- gonococci;
- chlamydia;
- mycoplasmas;
- herpes viruses.
Factors contributing to the development of urethritis
It is clear that the disease develops for certain reasons and in connection with certain pathogens, but there are a number of factors contributing to the development of this disease:
- severe cold in the body;
- injuries of the reproductive system;
- constant stress and suffering from serious illnesses;
- poor nutrition;
- bad habits, especially alcohol abuse;
- lack of vitamins;
- chronic form of disease respiratory tract, organs of the reproductive system and oral cavity;
- diseases of the urinary system;
- period of pregnancy or menopause;
- neglect of hygiene rules.
Routes of infection
There are 3 ways by which infectious pathogens enter the urethra:
- contact, which occurs during the body’s transportation of urine from the kidney, where the epicenter of the infection is located, to the bladder;
- sexual – in progress intimacy with a sick partner;
- hematogenous – the infection comes from inflammatory foci chronic diseases through blood circulation.
Urethritis is classified according to the nature of its distribution:
- primary – develops if infectious bacterium enters the area of the urethra;
- secondary - pathogenic microbes enter during the blood circulation from the pelvic organs, intestines or other location of the chronic focus.
Main symptoms of the disease
Signs of the development of the disease can be very diverse. The clinical picture of the disease is represented by acute and chronic forms.
The acute form appears when it goes away incubation period from the moment of entry of the pathogen.
The following sensations arise:
- the appearance of sharp pain at the time of urination;
- the occurrence of burning and itching at the exit of the urethra;
- the appearance of discharge with a mucous or purulent structure;
- bad smell.
In case of allergies, in parallel with the above symptoms, the following are observed:
- difficulty breathing associated with nasal congestion;
- rash on the skin;
- lacrimation;
- the appearance of shortness of breath.
Upon examination, the urologist may detect a low degree of swelling of the mucous membrane, redness of all tissues that surround the urethra.
Diagnosis
In order to diagnose the disease, it is necessary to conduct a urine test. This is done using the three-glass test method. Morning urine is collected in turn into 3 sterile containers. It is important to remember that the presence of a disease such as urethritis is determined by 1 portion of urine.
Typically, the following result is achieved:
- The first portion of urine has a cloudy structure. In it a large number of leukocytes, since there is an inflammatory process in the cavity of the urethra.
- The second portion contains much fewer leukocytes.
- In the third portion they are completely absent.
The material obtained from the urethra for research is analyzed by bacterial culture, and the degree of sensitivity of the flora to antibiotics is also determined. If difficult case, then experts use polymerase chain reaction(PCR). With its help, you can determine the type of pathogen by DNA, even with hidden current diseases. For analysis, a tissue sample is taken from the wall of the urinary canal using a probe. This is a very difficult procedure, since the female urethra is very small. This method necessary in order to detect herpetic or chlamydial urethritis.
To perform ureteroscopy, local anesthesia is used.
Often, specialists will prescribe antibiotics a week before the procedure to prevent further spread of the infection.
With help ultrasound examination You can determine cystitis and identify disease in the pelvic organs.
There is also a radiopaque examination using voiding cystourethrography. The introduction of a contrast agent into the cavity of the bladder makes it possible to take photographs. Using these images, you can detect poor patency, neoplasms, adhesions and similar defects. Women must undergo examination by a gynecologist. This is necessary to exclude diseases inflammatory in nature cervix, genitals.
Treatment used
Despite the fact that it brings a woman very uncomfortable and painful sensations, there is no need for treatment in a hospital setting. Disease light form is treated on an outpatient basis.
Initially, you should undergo an examination prescribed by a specialist. During the examination, you can determine the cause of the disease, the type of pathogen, and select the most suitable, effective anti-inflammatory drug. When infection occurs through sexual contact, not only the woman, but also her sexual partner should be treated.
- it is important to avoid intimacy until complete recovery;
- limit physical activity as much as possible;
- prevent hypothermia of the feet;
- eat right, or rather: exclude salty, spicy, smoked foods and, of course, alcoholic drinks from the diet;
- regulate the amount of fluid consumed: throughout the day you need to drink about two liters of water in the absence of diseases associated with fluid retention in the body;
- Eat fermented milk and more fruits and vegetables every day.
Concerning drug treatment, then doctors prescribe the use of a wide variety of drugs that have an anti-inflammatory effect, prescribe injections, tablets, vaginal suppositories, douching, etc.
The antibiotic must be taken for 5 to 10 days. The exact dosage is determined by the doctor, taking into account the degree inflammatory process, body weight, age of the patient.
Under no circumstances should you self-medicate. It is especially contraindicated to use antibiotics longer than prescribed, since microorganisms develop resistance to the drug, and then the medicine does not have the desired effect.
Treatment tactics are determined by the type of pathogen:
- for a disease caused by a fungus, antifungal drugs are prescribed;
- if the disease appears due to mycoplasmas, use drugs of the imidazole group.
To enhance the effect medicines, experts recommend using them in the form of suppositories. Due to the fact that the suppositories are injected directly into the area of inflammation, their composition is completely absorbed by the pelvic vessels. Thus, there is an anti-inflammatory effect on nearby organs.
In addition to potassium permanganate, you can use a decoction of herbs that have an anti-inflammatory effect. Douching with antiseptic agents is recommended.
Treatment of urethritis with traditional methods
Traditional methods are not as effective as they should be. That is why experts insist on medicinal form therapy. Despite this, there are some herbs that complement the action of drugs, and such complex treatment allows you to succeed. For this purpose, herbs and plants that have diuretic, antimicrobial, and antispasmodic effects are used.
The following should be consumed when eating:
- lingonberry, carrot or cranberry juice, free of sugar and preservatives;
- from fresh herbs - parsley, as well as beets;
- decoction of parsley, linden, cornflowers, black currants.
Ways to prevent the disease
It will take a lot of time and effort. It is also important to say that this disease brings very unpleasant painful sensations. To avoid this, you need to take preventive measures. In the process of prevention, all possible sources of pathogen entry into the body are completely eliminated. Thus:
- It is important to pay attention to the health of your sexual partner and avoid unprotected sexual contact.
- It is necessary to strictly observe all the rules of personal hygiene, constantly wash yourself using light disinfectants.
- You should not use hygiene products containing alcohol, soap, or components that cause severe irritation of the urethra.
- Eliminate from the diet all foods that lead to irritation of the urinary organs. These products include smoked meats, spicy and salty dishes.
- You should dress warmly (according to the weather) to prevent hypothermia of the body, especially the legs. It is necessary to wear clothes that do not restrict the waist and abdomen, as this leads to slow blood circulation in the pelvic area.
- All emerging diseases should be treated with the utmost seriousness and treated promptly to prevent them from becoming chronic.
Despite the fact that a disease such as urethritis is not considered a fatal disease, it can greatly affect a woman’s health, seriously compromising it. Constant discomfort associated with itching and painful sensations, causes severe irritability, insomnia, negatively affects ability to work. It is better to do everything in a timely manner to prevent the disease than to experience all the negativity of urethritis and treat it for a long time. When the first signs of the disease appear, you should seek help from a specialist as soon as possible.
Urethra (urethra)- this is part urinary system women and the urinary and reproductive systems of men.
In men, the 20 cm long urethra is located both in the pelvis and inside the penis, and opens into an external opening on the glans. Anatomically, the following sections of the male urethra are distinguished:
(1) external opening;
(2) scaphoid fossa;
(3) penile;
(4) bulbous;
(5) membranous;
(6) prostatic (proximal and distal areas).
Figure taken from www.urologyhealth.org
The prostatic urethra passes through the prostate and is divided into proximal and distal parts at the level spermatic tubercle. In the proximal part of the prostatic urethra, the excretory ducts of the prostatic glands open at the orifices along the posterolateral surfaces. On the sides of the seminal tubercle are the mouths of the right and left ejaculatory ducts, through which sperm enters the lumen of the urethra from the seminal vesicles and vas deferens. In the distal part of the prostatic part and in the membranous part of the urethra there are elements of the urethral sphincter. Starting from the bulbar region, the urethra passes inside corpus spongiosum penis. The bulbar region is located inside the bulb of the corpus spongiosum. In membranous and bulbar regions the urethra bends anteriorly upward. In the penile region, the urethra is located medially along the ventral surface of the penis downwards from cavernous bodies. The capitate part of the urethra is located inside the head of the penis. Inner surface The male and female urethra are covered with mucous membrane (transitional epithelium, with the exception of a short area near the external opening, where there is flat non-keratinizing epithelium).
The main functions of the urethra in a man
- carrying urine out of the bladder;
- carrying sperm out during ejaculation (ejaculation);
- participation in the mechanism of urinary continence.
The most common diseases of the urethra
- Urethritis (inflammation of the urethra) often due to sexually transmitted infections (gonococci, chlamydia, ureoplasma, etc.);
- (narrowing of the lumen) of the urethra in its various parts (due to formation: congenital, traumatic and inflammatory origin);
- Anomalies of urethral development: the most common is hypospadias (the location of the external opening of the urethra on the ventral surface of the penis is more proximal than the apex of the glans).
Urethra (Urethra) - What is it?
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Urethra ( urethra)
- This is an organ in the form of a tube through which the contents of the bladder are evacuated from the body.
Structure and functions of the urethra
The walls of the canal inside are covered with a mucous membrane, followed by a muscular layer and a layer of connective fibers; the organ has the shape of a tube.Representatives of different sexes have different canal structures.
Urethra in men
– length up to 22 cm, diameter up to 8 mm.
Divided into three departments: prostatic, membranous And spongy.
Around the prostatic section there is a body of the prostate with a special protrusion that prevents sperm from being thrown into the bladder. The exits of the vas deferens and prostate ducts are also located here.
The membranous section is very narrow and is located at the level of the muscular diaphragm of the pelvis.
The spongy section, up to 15 cm long, passes through the body of the penis.
Urethra in women
up to 4 cm long, up to 1.5 cm in diameter. The posterior surface of the urethra is connected to the vaginal wall. Along the entire length of the canal there are periurethral glands that produce mucus, the amount of which increases with excitement.
To hold urine, the canal is closed by two sphincters: internal And external.
Channel Function:
- Urine excretion
- In men, excretion of seminal fluid.
Sphincters
The external urethral sphincter is a paired muscle that compresses certain part channel. These muscles in women are attached to the vagina ( and squeeze it), in men they connect to the prostate.The internal sphincter is the sphincter of the bladder, which is a more powerful muscular wall at the exit of the urethra.
Microflora in women
The microflora norm varies depending on age. In an adult healthy woman The vast majority of microorganisms are lactobacilli, as well as saprophytic staphylococci and epidermal staphylococci; the presence of up to 10% of bifidumbacteria, as well as up to 5% of peptostreptococci, is possible. This combination of microorganisms is called microflora of Doderlein.Microflora in men
In men, the microflora of the urethra remains unchanged throughout life. Within a few hours after birth, epidermal staphylococcus is detected in the urethra of boys, saprophytic staphylococcus. In this case, microorganisms inhabit only the first 5 outer centimeters of the canal. Further, it is almost sterile. The reaction in the channel is neutral alkaline.Smear
Indications:- Possibility of urinary tract infection
- Discharge from the urethra
- Unpleasant sensations in the canal area
- Inflammation of the urinary system
Goals:
- Detect the composition and quality of microflora, identify pathogens.
- 7 days before the test, do not take any medications, especially antibiotics.
- Do not drink alcohol for a day,
- Do not copulate for 12 hours,
- Do not urinate 60 minutes before the test,
- Women do not use 24 hours before vaginal preparations, do not douche.
Scraping
Collection of scrapings from men
The scraping procedure is painless and is carried out using a special probe.
Before the procedure, the head of the penis is treated with saline solution. If there is no discharge, massage the urethra, after which the head of the penis is released, a probe is inserted into the canal to a depth of 4 cm, it rotates around its own axis and thus collects cells of the mucous membrane for examination. The biomaterial is placed in a test tube with saline solution.
Collection of scrapings from women
Before scraping, you should not urinate for 3 hours. If there is a lot of discharge, the urethral outlet is wiped with gauze and saline solution. The probe is inserted into the canal to a depth of 2 cm, and is rotated along its own axis for 5 seconds. The biomaterial is transferred into a test tube, washing the walls of the probe with saline solution.
Polyp
This is a benign neoplasm that forms on the mucous membrane of the urinary canal. The neoplasm is an enlarged area of connective fibers, soft to the touch, quickly increasing in size and blocking the internal lumen of the urethra.Causes:
- Chronic inflammatory processes caused by infection
- Hormonal imbalances
- Intestinal inflammation.
It is detected using a urethroscope, and a bacterial culture of a smear from the urethra and a smear for microflora are prescribed.
Therapy:
Surgical removal of the polyp.
Inflammation of the urethra (Urethral infection)
Urethritis is an inflammatory process of the urethral mucosa. The disease very often develops in both sexes.Causes:
- Infections ( viruses, bacteria, chlamydia, mycoplasma, gonococci, trichomonas, mycotic infections, as well as mixed),
- Mucosal injury ( more often after catheterization),
- Metabolic disorder
- Allergic reaction,
- Stagnant processes
- Diseases of the urethra.
- Discharge from the urethra,
- Pain, stinging or difficulty urinating,
- In men, the urethral sponges stick together.
Inspection, study of microflora.
Treatment:
- Medication ( antibiotics)
Cyst
Cysts of the urethra are of two types: cysts that develop when the formation of the urinary organs is disrupted, as well as those that arise when the skin glands located around the outlet of the urethra are blocked. The disease is more common in people with reduced immunity, in the presence of an inflammatory process, and sometimes after injury. The size of the cyst can reach 4 cm.
Symptoms:
- Urinary excretion is complicated Bulges appear around the external exit of the canal.
Diagnostics:
Most often discovered during a gynecological examination.
Treatment: surgical removal.
Stricture (narrowing)
Narrowing is a complication in the treatment of prostate tumors. In particular severe cases the lumen is completely blocked.Stricture incidence:
- After radical prostatectomy – 7.2%,
- After radical radiation therapy – 3.2%,
- After brachytherapy – 1.3%.
- Mild pain during urine output
- Urine flows in a thin stream without pressure
- Unpleasant sensations during urine output
- With each urine excretion, the amount of urine decreases
- Before the flow of urine you need to strain, wait
- After the main urine comes out, it leaks out for some time
- The stream is not solid
- There may be blood in the urine
- Pain in the lower abdomen
- Discharge from the urethra.
- Urethroscopy
- Contrast urethrography
- Uroflowmetry.
- Bougienage
- Urethrotomy
- Urethroplasty
- Use of bioresorptive stents.
After the operation, it is recommended to drink more in small quantities so that urination occurs as often as possible and does not allow the walls of the urethra to grow together. Do not remove the catheter from the canal prematurely. Treat inflammation of the excretory organs in a timely manner.
Urethral condylomas (endourethral)
Condylomas are a manifestation of the human papillomavirus. The virus is transmitted sexually. The latent period of infection in the body is unlimited. The shape of condylomas is similar to heads of cauliflower, located at an elevation relative to the surface of the mucous membrane.
After appearing for the first time, condylomas may disappear on their own after some time. Degeneration of condylomas into malignancy registered in isolated cases.
Representatives of the stronger sex are more susceptible to this disease. If the volume of condylomas is large, a man may experience urinary complications.
Treatment:
Elimination of condylomas using cryotherapy methods, as well as drugs podophyllin. It should be borne in mind that the virus itself is not removed from the body.
To prevent relapses, you should strengthen your immune system, lead a healthy lifestyle, and take vitamins.
Cancer
This is not a very common disease. Women are 10 times more likely to get this type of cancer than men.Tumor localization:
It can be located in any part of the canal, but is more often found at the external outlet between the vulva and urethra. In men, the tumor can be located in any part of the canal.
Symptoms in women:
- Pain and burning during urine output
- Pain during intercourse
- Urinary incontinence
- Some not very obvious difficulties during copulation, as well as urination.
Diagnostics:
- Inspection and palpation
- Smear cytology
- Histology
- Cystoscopy and cystography, prostatography.
- Surgical
- Irradiation.
caruncle
A caruncle is one of the types of polyps measuring from 3 to 5 mm. A caruncle can develop with or without a pedicle. The polyp is scarlet in color and bleeds when traumatized, as it contains quite a lot of capillaries. “Young” caruncles are soft, but the older the formation, the harder its surface.This formation is more often found in older women; caruncles are rarely multiple and usually form near the external urethral outlet.
Symptoms:
- Urinary incontinence
- Blood discharge.
Treatment:
- Surgical
- Electrocoagulation.
Burn
Thermal burns usually do not cover a large area, scar quickly, and usually go away without special treatment.Chemical burns can cause inflammation and death of mucosal tissue.
Burn symptoms:
- Pain during administration of a medicinal substance.
If this symptom is observed, you should immediately check the temperature of the fluid being poured into the urethra, and whether it is actually pouring medicinal substance or an error has occurred.
If the burn is chemical, you should rinse the canal with a liquid that neutralizes the effect of the first ( for example, if an acid was introduced, it should be washed with a solution of baking soda, and if an alkali was introduced, with a solution of citric acid or vinegar).
After rinsing, it should be inserted into the canal synthomycin ointment. The patient is advised to drink a lot.
Further therapy is carried out as for inflammation of the urethra. If the burn is severe, drainage should be installed.
Bougienage
This is very old way treatment of stricture disease of the urethra, which was used in ancient times. The name of the method comes from the French " bouge", which means " kernel».Methodology:
The procedure involves expanding the lumen of the canal using a special rod. The procedure requires special skill, since there is a possibility of damage to the walls and rupture of the urethra. The method is rarely used today, since in practice it is almost impossible to perform the procedure without additional trauma.
More modern look bougienage - using a special catheter equipped with an increasing segment. This segment is placed at the site of the stricture and inflated with water. The segment increases in volume, leading to the spreading of scars and strictures. This method is more gentle, but also not very effective.
Urethral catheterizations carried out from time to time also belong to one of the types of bougienage. This method is by far the most common in medicine. But it is used only in combination with other methods of treating urethral strictures.
Massage
This is one of the treatment methods chronic urethritis in men. The massage is performed with a special instrument ( let's wake up). Before the massage, the canal is irrigated with a solution mercury oxycyanide to prevent infection. The same solution is pumped into the bladder.The procedure is performed with the patient lying on his back. Doctor right hand inserts the bougie and, holding it with your left hand, carefully moves the bougie from the root to the exit. The duration of the procedure is from 30 to 60 seconds. Frequency of procedures: once a day or two days.
After the procedure, the urethra is irrigated with a solution of mercuric oxycyanide.
Gap
This injury is more typical for representatives of the stronger sex. A rupture occurs when the penis is fractured or the perineum is bruised. The rupture can be complete or partial. With a complete rupture, urine is not evacuated from the body, but spreads throughout the tissues, causing many complications.
Symptoms of closed injury:
- Perineal hematoma
- Blood is released from the urethra between urinations
- Delayed urinary excretion.
Treatment:
For incomplete damage, antibiotics and bed rest are usually sufficient.
If urinary function suffers, catheterization is prescribed to evacuate urine.
If the damage is significant, surgical intervention is prescribed.
Plastic
Indications:- Developmental defects
- Strictures.
Urethroplasty is prescribed if the exit of the canal is at back surface penis, in the scrotum area, and also on the perineum.
More than 50 methods of shaping the urethra for developmental defects have been developed. Most often, tissue from the lower part of the penis is used to form the canal. It is advisable to carry out treatment in childhood.
In some cases, with large strictures ( more than four centimeters) use augmentation urethroplasty. Such operations are quite complex and are sometimes performed in two stages. During the operation, the diameter of the canal is increased due to the engraftment of an additional section of tissue.
Usually the required piece of mucous membrane is taken from inside patient's cheeks. Such a flap of tissue takes root very quickly in a new place.
