Urethritis in men and women: causes, types, symptoms, treatment. Traumatic and mechanical urethritis

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

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

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

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

Infectious specific and nonspecific type

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

Specific infectious urethritis is precisely defined in cases where infections provoke inflammation of the urethra. Most often, infections are acquired through sexual intercourse. This is inflammatory urethritis.

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

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

Specific urethritis can also be classified as a broad group.

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

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

Another common form of this disease genitourinary system- This . The cause of this disease is the affected opportunistic microflora.

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

Non-infectious urethritis

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

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

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

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

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

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

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

Chronic and viral type

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

Therefore, if you value your health and you think that you have a weakened immune system, then avoid visiting such places. He recommends treating candidal urethritis with ointments, as they act on the fungus locally, which is most effective. You also need to improve your immunity by using appropriate medications and vitamins.

Another one genitourinary infection, which is the basis for the development of urethritis, is Trichomonas. most often encountered when visiting a urologist. It also occurs due to sexual contact with a carrier. It may not manifest itself for a long time, since the incubation period of this infection is quite long.

Complications from infection with Trichomonas can be caused by alcohol consumption, heavy exercise, as well as systematic overstimulation without discharge. May go to chronic stage. It is characterized by bloody discharge in the semen, purulent discharge during urination, pain and itching.

Conclusion

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

Sometimes urethritis does not manifest itself at all long time, and then is detected in the acute or chronic stage. Therefore, be careful about your men's health, regularly visit a urologist, get tested, and remember that your health is only in your hands.

Useful video

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

The human genitourinary system is susceptible to inflammatory processes of an infectious and non-infectious nature. Urethritis is an inflammation affecting the genitourinary canal, which has severe symptoms and requires timely treatment. Classification and types of urethritis help to establish the cause and source of the disease, make a diagnosis and select effective therapeutic methods to treat the patient. Genital area women are more susceptible inflammatory diseases, but men are not immune from urethritis.

Features of inflammation

The urethra is a flexible urinary canal in the form of a hollow tube, which in men consists of the prostatic, membranous and spongy parts of the penis with an external outlet for urine excretion. When pathogenic agents enter the urinary canal, the symptoms of the inflammatory process in men are characterized by intensity and pain. The manifestation of pathological symptoms depends on the source of inflammation and the incubation period of the causative agent of urethritis. The main causes of the inflammatory process:

• Infections of the genital organs during sexual acts without contraception.
• Injuries to the genitals with ruptures of the mucous membrane, hypothermia.
• Urolithiasis, injuring the walls of the urinary canal.
• Decreased immunity, concomitant diseases, fatigue.
• Medical procedures that cause irritation of the mucous membrane.
• Poor nutrition with an abundance of sour, spicy and salty foods.

Urethritis in men can appear after a few days (causative agents of gonorrhea), months ( viral infection) and years (tuberculosis agent). With the allergic nature of the disease, the first signals of inflammation arrive after a few hours and appear clearly. Comprehensive diagnostics allows you to choose the most effective treatment aimed at eliminating both the symptoms and causes of inflammation.

Infectious types of urethritis

The etiology of the disease makes it possible to classify urethritis according to the cause that provoked the disease. The inflammatory process is infectious nature(sexual transmission of infection, with pathogenic bacteria and viral agents) and non-infectious root causes (trauma, blood stasis, allergies). Several types of infectious urethritis are determined by etiology.

Gonorrheal

Accompanied by acute pain when passing urine and the presence of grayish-yellow discharge from the urinary canal. The urine becomes cloudy due to pus, and blood appears in the semen. The causative agent of the disease is gonococcus, the incubation period is from three to seven days, less often - two to three weeks.

Trichomonas

Features of inflammation in acute stage– itching in the area of ​​the head of the penis. Difficulty occurs during urination, and discharge from the urethra becomes grayish-white in color. The incubation period for Trichomonas infection ranges from two weeks to two months.

Chlamydial

It is characterized by scanty watery or mucous discharge from the urinary canal in the morning. Symptoms can be pronounced or the disease is asymptomatic; the period of manifestation is up to three weeks. Chlamydial infection increases the risk chronic prostatitis.

Bacterial

Accompanied by itching in the genitals, slight swelling of the penis, gray or white discharge morning time With unpleasant smell. The incubation period of the agents is not clearly defined - from a week to two months. Pathogens: streptococci, staphylococci, E. coli.

Mycotic (candida)

Abundant curdled discharge

The mucous membranes of the penis are affected by a fungus. Mostly the disease proceeds covertly and enters the active phase with a significant decrease in immunity against the background of concomitant diseases. The causative agent is a fungus of the genus Candida, main symptom– copious curdled discharge.

Viral

The disease is caused by a simple herpes virus, which reproduces within 14 hours and is sexually transmitted. Symptoms: mucous discharge, tingling when urinating, painful sensations, enlarged inguinal lymph nodes and increased base body temperature.

Mycoplasma

Inflammatory processes are provoked by opportunistic microorganisms. The disease is accompanied by slight mucous discharge and a slight burning sensation of the urethra. The infection is accompanied by infection with Trichomonas and gonococci.

Ureaplasma

The disease is characterized by a long incubation period - one month. The causative agents of the disease are sexually transmitted ureaplasma. Symptoms: scanty discharge from the urinary canal, itching and burning, cloudy urine.

Gardnerella

The disease occurs as a result of infection with Gardnerella during unprotected sexual contact with a partner suffering from bacterial vaginitis. Symptoms and clinical picture are not clearly expressed. The disease is characterized by spontaneous attenuation. The incubation period lasts from weeks to months.

Sexually transmitted urethritis is classified as specific diseases. If inflammatory process occurs as a result bacterial infection, determine nonspecific bacterial urethritis. In addition, non-sexually transmitted male inflammation can enter the urinary canal area from other organs. Examples of pathology are tuberculosis and diphtheria urethritis.

Classification of non-infectious urethritis

According to etiology, urethritis caused by non-infectious causes is distinguished. These include allergic (irritation of the urinary canal), traumatic (medical intervention, ruptures and tears of the urethra) and congestive urethritis, which manifests itself with venous stagnation in the pelvic organs. The symptoms and clinical picture of non-infectious urethritis vary.

The cause of the disease is allergies

Allergic urethritis is an inflammation of the urinary canal caused by external stimuli with high sensitivity of the male body to various allergens. The immune response leads to a complex reaction of the body to irritants, therefore, along with the symptoms of classic allergies, signs of an inflammatory process in the male genitourinary canal are observed. The sources of allergic urethritis are:

• Food products consumed as food.
• Medicines and medicines.
• Personal hygiene and skin care products.
• Underwear material, condoms.
• Spermicides and antiseptic compounds.
• Mycosis and candidiasis accompanying urethritis.
• Heavy allergic conditions and stress.

Allergy sufferers at the time of exacerbation of sensitivity to certain irritants are poorly protected from negative impact allergens. This may be manifested by impaired visual acuity, gastrointestinal disorders, respiratory tract problems respiratory tract(cough, runny nose, sneezing). The usual symptoms of allergies may be accompanied by dysfunction of the genitourinary system - inflammation of the urethra or allergic urethritis.

Signs of allergic urethritis include swelling, unbearable itching and burning of the urethra, glassy sticky grayish-white discharge, difficulty urinating, false urges sudden pain in the bladder area, if cystitis is associated with inflammation. The main difference between allergies and other causes of the inflammatory process is swelling of the mucous membrane of the urinary canal with penetration of the disease into the submucosal layers.

When taking new medications and introducing new foods into the diet, allergy sufferers need to pay attention to signs such as bladder fullness and itching in the genital area. Severe inflammatory edema can lead to narrowing of the lumen of the urinary canal and the need for dilation of the penis surgically.

Treatment of allergic urethritis is fundamentally different from the treatment of infectious inflammatory diseases of the urinary canal. The main directions of treatment are eliminating the cause allergic reaction, taking antihistamines and glucocorticoid hormones.

Trauma as a cause of urethritis

Inflammation of the urinary canal, which does not involve an infectious pathogen, is classified as traumatic urethritis. Damage to the walls of the urethra as a result of traumatic factors leads to the development nonspecific disease. The course of the disease can be mild or complicated - it all depends on the degree of damage to the mucous membrane of the urinary canal and surrounding tissues. The causes of the disease are mechanical (impact, bruise), thermal (burn) and chemical (taking drugs) effects on the genital area with disruption of the urethral mucosa and microtrauma. Any injury that affects the walls and mucous membrane of the urethra can provoke an inflammatory process:

• A blow to the penis as a result of a fall, injury to the genitals due to physical contact, for example, a blow to the groin.
• Fracture pelvic bones with ruptures and tears of the tissues of the urethra.
• Masturbation with insertion into the urethra foreign object. Irritation of erogenous zones can cause tissue rupture.
• Medical manipulations - insertion of a catheter into bladder, cystoscopy, bougienage of the urethra when the canal is narrowed.
• Receiving a gunshot or knife wound, as well as an animal bite.
• Excretion in urine residual funds chemicals irritating the urethral mucosa.
• Violation mineral metabolism, accompanied by the passage of urinary calculi (stones) through the canal.
• Rinsing the penis with hot solutions or performing medical procedures using instruments that have not cooled down after sterilization.
• When diagnosing traumatic urethritis pronounced sign– cloudiness of urine submitted for laboratory testing. There may be bloody discharge in the fluid. Depending on the location of the damage, traumatic urethritis can affect the anterior or posterior section urinary canal.

Symptoms of the disease depend on the nature of the injury - tingling, pain, hematoma, burning, itching, tissue rupture. Treatment of traumatic urethritis is aimed at protecting the mucous membrane with antimicrobial drugs; if necessary, surgical therapy is recommended.

Causes of congestive urethritis

Congestive urethritis is a non-infectious disease. The inflammatory process of the urinary canal occurs as a result of stagnation of venous blood in the pelvic organs. The risk group includes men who predominantly lead a sedentary and inactive lifestyle. Interrupted sexual intercourse during an active sexual life can provoke congestive urethritis, chronic constipation, penile injuries and excessive expansion of hemorrhoidal veins. There are no classic symptoms of congestive urethritis. The main symptoms of the disease are considered to be general dysfunction of sexual function.

Torpid inflammation

Manifestations of the disease are practically not expressed, the disease is asymptomatic. It is characterized by minor itching, which does not cause any particular inconvenience to the patient. The urethral sponges may stick together and general minor discomfort may be felt.

Chronic urethritis

If the disease lasts more than two months, doctors diagnose chronic urethritis. The degree of disease activity is high, moderate and weakly active. Danger chronic inflammation is possible complications– the formation of prostatitis of the prostate gland, the formation of seminal vesicles, the development of funiculitis on the vas deferens, orchitis and epididymitis of the testicles, as well as narrowing of the urinary canal, which disrupts the normal outflow of urine.

With chronic urethritis, the patient is often unaware of the development of the inflammatory process, since the disease is asymptomatic or mild. The main reason for the development of the chronic form of the disease is incorrect treatment of acute urethritis, elimination of symptoms, and not the causes of urinary canal disease.

Localization of the source of inflammation

Inflammation of the urethra is concentrated in the anterior, posterior region or covers the entire urinary canal - spreads completely. On this basis, urethritis is classified into anterior, posterior and total. The long urinary canal of a man serves not only to remove urine, but also to transport sperm. The disease, localized in any part of the urethra, is painful. What complications can the inflammatory process lead to:

• Total urethritis is symptomatically similar to acute prostatitis, since it affects the entire urethra at the same time. After one to two weeks, the symptoms disappear, but the disease remains. Under favorable conditions for the pathogenic agents, a relapse occurs with the spread of inflammation throughout the entire genitourinary system - the testicles and seminal canals are affected. Violated sexual function men and, as a result, a decrease in potency.
• With the anterior type of urethritis (inflammation is localized in the hanging part of the urinary canal), there is a risk of serious pathologies of the male genital organs. Untimely treatment leads to the formation of cystitis, orchitis, prostatitis or epididymitis. Acute inflammation the anterior part of the urinary canal is additionally characterized by swelling and adhesion of the urethral sponges, but the general condition of the patient remains satisfactory.
• When the disease is localized in the posterior part of the urethra, in addition to inflammatory processes in the testicles, seminal ducts and prostate gland, a narrowing of the urinary canal may occur, making it difficult to remove urine - severe complication, called a stricture. The fluid stagnates, infection gets into it and urine flows back into the kidneys, complicated by pyelonephritis and renal failure.

Acute urethritis is easier to treat than chronic inflammatory disease in neglected form. When the disease is localized in the posterior part, the patient experiences a deterioration in general health, weakness and malaise. In forty percent of cases, advanced total urethritis leads to the development of funiculitis - inflammation spermatic cord with a disappointing diagnosis male infertility.

Variants of infection penetration

According to the method of penetration of the pathogen into the genitourinary canal, urethritis is classified into primary and secondary. This only applies to bacterial nonspecific inflammation infectious type. A disease that immediately appears on the urethral mucosa is primary urethritis. If pathogens enter the genitourinary canal from other organs (adjacent or distant), secondary urethritis is diagnosed. Manifestations of primary bacterial inflammation:

• Pathogens: staphylococci, streptococci, Escherichia coli.
• Factors: hypothermia, decreased immunity, hypovitaminosis.
• Reasons: unprotected sexual intercourse, anal sex.
• Symptoms – burning, itching, redness, profuse purulent discharge.
• The incubation period has no clear boundaries.
• A characteristic feature is acute pain when urinating.
• Diagnostics - tank culture for the presence of gonococci is required.
• Acute condition – characterized by pain.
• Chronic condition - occurs with mild symptoms.
• Possible complications are colliculitis (inflammation of the seminal tubercle).
• The main treatment is taking antibacterial drugs.

Primary urethritis of the bacterial type has a similar clinical picture to gonorrheal inflammation. To put accurate diagnosis differential diagnosis is required - bacteriological laboratory testing will exclude gonococci as agents of the inflammatory process and focus therapy on eliminating the bacterial infection.

Secondary urethritis occurs when inflammatory pathogens enter the urinary canal through the lymphogenous or hematogenous route. The source of infection is located in neighboring organs (pelvis, bladder, prostate, seminal vesicles) or is concentrated in distant internal organs with concomitant diseases - sore throat, pneumonia. The main differences between secondary bacterial urethritis:

• The course of the inflammatory process is long-term, latent.
• Symptoms – mild pain.
• The presence of discharge is scanty, mucopurulent.
• Infectious agents are pathogenic bacteria.
• Additional signs are fever, weakness.
• The condition of the urinary opening is hyperemia, stickiness.
• Clinical picture – symptoms of chronic urethritis prevail.
• Feature – resistance (addiction) to antibiotics.

To cure bacterial inflammation of the urinary canal, it is necessary to reliably diagnose the causative agent of the disease and the route of penetration of the agent into the urethra. If the disease is secondary, it is necessary to eliminate the infectious focus in neighboring or distant organs.

Urethritis takes up a significant part urological diseases. The age group of patients who may develop inflammation of the urinary canal varies from 20 to 50 years.

To avoid unpleasant complications, men should follow the rules intimate hygiene, refuse promiscuous sexual intercourse, give preference to protected sexual intercourse. Any signal about possible inflammation of the urethra should be taken seriously so as not to develop the disease into a chronic form, which is difficult to cure.

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Urethritis is an inflammatory process that is located in the urethra. This disease is very common, and the pathology develops regardless of the age and gender of the patient. In order to clearly understand what urethritis is in a man, what are the symptoms and methods of treating this pathology, it is necessary to clearly understand the anatomy of the male urethra.

Anatomical features and structure of the male urethra

The outlet of the bladder is the beginning of the urinary canal, which in medical and scientific circles is commonly called the urethra. This is a small-diameter reproductive tube, which has a length of 16 to 24 centimeters. It is worth noting that the female urethra is only 4 centimeters long. It is these comparative characteristics that are the main reason for the differences in the manifestations of urethritis in representatives of different sexes; accordingly, if in women urethritis can pass without visible pathological symptoms, then in men the disease has very intense symptoms and can manifest itself soon after direct infection and the development of the inflammatory process .

The male urinary canal consists of the following sections:

prostatic department. This is part of the urethra, which is located in the prostate gland and is about 4 centimeters long. The prostatic section is also called prostate;

membranous section. Also called membranous. Its length is 2 centimeters. The beginning of the section is located behind the prostate gland and ends at the base of the penis. This space of the male urethra is the narrowest;

spongy section, or spongy. It is the longest section of the urinary canal and is located inside the shaft of the penis. Compared to the membranous and prostatic, the spongy section is characterized by mobility. This section of the urethra ends with an outlet called the meatus.

Classification of urethritis

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

Classification of urethritis according to etiological indicators
Non-infectious urethritis	Infectious urethritis
To diseases non-infectious nature relate: congestive urethritis - may appear due to venous stagnation 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 can inflammation occur against the background of the action of two or more pathogenic organisms: tuberculous; mixed; gardnerella; chlamydial; ureaplasmic; mycotic; bacterial; trichomonas; viral; mycoplasma; Trichomonas.
Classification according to severity of symptoms	Classification according to the characteristics of the disease
Chronic urethritis is divided into periods without exacerbations and the acute stage: low-active urethritis; moderate degree of disease activity (urethritis); high degree of inflammation of the urinary canal.	Fresh urethritis is divided into: torpid; subacute;
Classification by disease specificity	Classification according to the characteristics of the onset of the disease
specific – these are sexually transmitted infections (chlamydia, trichomoniasis, gonorrhea) and tuberculosis; nonspecific - the causative agent of the infection is 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 agents of urethritis are chlamydia and gonococci, while in approximately 50% of cases these infectious agents cannot be detected when examining the material.

Symptoms of urethritis

After direct infection of the body, symptoms of urethritis appear after some time, and the time period from the moment of infection to the first signs of pathology directly depends on the incubation period of the pathogen. For allergic urethritis - a few hours, for tuberculosis - several years, for viral - several months, for candidiasis and trichomoniasis - two to three weeks, for chlamydial - 7-14 days, for gonorrheal - 3-7 days.

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

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

The process of urination is also disrupted, which initial stage quite often accompanied by cloudy urine, pain, and at the same time the number of daily urges to urinate increases. The end of this process may be accompanied by sharp pain and sometimes with blood.

If the disease has become chronic, then the symptoms of the disease may disappear altogether, there will be no discharge, and the patient may only be bothered by mild itching and discomfort in the urethral area. More bright severe symptoms observed only during periods of exacerbation of the disease.

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

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

Non-infectious urethritis
Traumatic urethritis	Symptoms depend on the nature of the injury - burning and pain when urinating.
Allergic urethritis	Also pain and burning, however, a feature is the presence of allergic edema.
Congestive urethritis	Classic symptoms are often completely absent. It manifests itself in different types of sexual dysfunction.
Infectious urethritis
Tuberculous urethritis	In most cases, it occurs against the background of renal tuberculosis or genital tuberculosis. Mycotic tuberculosis bacteria penetrate into the urethra through urine flow. Has few symptoms (sweating, increased fatigue, low-grade fever).
Gardnerella urethritis	The incubation period ranges from one week to several months. In most cases, it is present as a component of mixed urethritis.
Chlamydial urethritis	There are no stinging or burning sensations, slight discharge. In most cases it occurs chronically.
Ureaplasma urethritis	Most often accompanied by trichomoniasis or gonorrheal urethritis. The incubation period is about 1 month. There is green or white discharge, burning and itching when urinating. Symptoms worsen due to sexual intercourse or alcohol intake.
Mycotic urethritis	The incubation period is about 20 days, there is burning and itching. The discharge is watery or mucous, sometimes pale pink in color.
Bacterial urethritis	Purulent discharge. The symptoms are erased. The incubation period can last several months.
Trichomonas urethritis	It is characterized by constant itching in the area of ​​the head of the penis, also characterized by the presence of grayish-white discharge and difficulty urinating.
Viral urethritis	The course of the pathology is sluggish, the symptoms are mild. May be accompanied by conjunctivitis or joint inflammation
Mycoplasma urethritis	Quite rarely occurs in isolation. In most cases it is combined with gonorrheal or trichomonas urethritis.
Gonorrheal urethritis	Gray-yellow discharge from the urethra, acute pain at the time of urination. The pus contained in the urine gives it a cloudy color. Blood impurities appear in semen and urine.

Treatment of urethritis in men

The choice of treatment for urethritis, like any other disease, is made based on diagnostic data. First of all, laboratory test results are used. A general blood and urine test, urethroscopy data, examination of urethral smears, and bacteriological urine culture are taken into account.

Treatment procedures can be carried out on an outpatient basis; during treatment it is important to be systematic and accurate in following medical instructions; hospitalization is not necessary. If the reception antimicrobials is interrupted, carried out irregularly, or the patient drinks alcohol during therapy, the disease threatens to become chronic.

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

The selection of medications 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 a sensitivity test. It is thanks to this research that the most effective treatment can be selected.

Treatment of bacterial, gonorrheal urethritis

Antibiotics of the cephalosporin group demonstrate excellent results in the treatment of gonorrheal urethritis. In addition to them, kanamycins, oletethrins, erythromycins, and 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 short courses. In some cases, if gonorrheal urethritis is complicated by other infections, simultaneous use of several antibacterial drugs is practiced. In such cases, it is best to use the complex “Gentamicin” and “Azithromycin” (“Ecomed”, “Hemomycin”, “Azitrox”, “Azicide”, “Z-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 treatment is an individual selection of drugs. Quite often, men who suffer from gonorrheal urethritis ask friends to “prick” and use antibiotics uncontrollably and without consulting a doctor. Such self-medication is unacceptable, since long-term use of strong anti-inflammatory drugs without a clear treatment plan and control of cure 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 be completely sure that the body has freed itself from gonococcus and is completely cured, it is necessary to take control smears three times. Only after receiving negative test results can the patient be considered completely healthy.

Gardnerella, ureaplasma and mycoplasma urethritis

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

For any specific urethritis, it is necessary to carry out simultaneous therapy for both sexual partners.

Trichomonas urethritis

If a man is diagnosed with Trichomonas urethritis, when selecting medications, they turn to Metrogil, Trichopolum and Metronidazole. If urethritis is chronic, antibiotic therapy is added to treatment. In case of inadequate treatment, infertility may develop.

Candidal urethritis

Treatment of candidal urethritis in men requires a completely different approach. The main drugs to combat this pathology are antimycotic drugs, such as Pimafucin, Nystatin, Clotrimazole, Fluconazole. Important has a qualitatively selected treatment for the underlying disease, which is the cause of candidal urethritis.

Chlamydia urethritis

The only antibiotic that actively fights the causative agent of this infection is azithromycin. If you choose the wrong drug for chalmydia urethritis, serious complications can occur - inflammatory diseases, epididymitis, Reiter's syndrome, infertility. If the patient has an individual intolerance to azithromycin, the following alternatives are used: doxycycline, levofloxacin, erythromycin, ofloxacin, clarithromycin. Immunostimulating drugs and vitamins should also be used in combination.

Viral urethritis

Treatment is carried out using antiviral drugs. The sooner treatment is started, the faster the recovery will occur. Among antiviral drugs, preference is given to: “Gerpevir”, “Famciclovir”, “Riboverine”, “Acyclovir”. It is not advisable to use antibiotics for this form of pathology, since they are not able to fight viruses.

Nonspecific chronic urethritis

Treatment of nonspecific chronic male urethritis is not as fast as for infectious ones. The chronic course of the disease is often aggravated associated pathologies, and signs of the disease are mild or may be absent altogether. Therefore, therapy for chronic urethritis should begin with taking immunostimulants. Only this approach makes it possible to activate the body’s defenses to fight infection. After receiving the result in individually antibiotic therapy is selected. Main feature Treatment of nonspecific forms of urethritis is the absence of the need to treat the sexual partner.

Non-infectious urethritis

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

Antibiotics may be prescribed for:

installation of the drug through catheter administration into the urethra;

intravenous infusions in 0.2% of cases of acute urethritis;

intramuscular injections in 18%;

oral administration in 81%;

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		Gonococcal urethritis				Mixed urethritis
"Ornidazole"		"Doxycycline"				"Josamycin"
"Josamycin"		"Ciprofloxacin"				"Ceftriaxone"
"Azithromycin"		"Metronidazole"				"Ornidazole"
"Doxycycline"		"Azithromycin"				"Secnidazole"
"Metronidazole"		"Ceftriaxone"				"Fluconazole"
						"Doxycycline"
						"Azithromycin"
Non-gonococcal urethritis, which is caused by atypical agents				Urethritis of unknown etiology
"Clarithromycin"				"Clarithromycin"
"Secnidazole"				"Ciprofloxacin"
"Josamycin"				"Tinidazole"
"Metronidazole"				"Nimorazole"
"Doxycycline"				"Josamycin"
"Ofloxacin"				"Secnidazole"
"Fluconazole"				"Fluconazole"
"Azithromycin"				"Ceftriaxone"
				"Doxycycline"
				"Metronidazole"
				"Azithromycin"

Additional treatments

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

Local procedures involve the injection of medications directly into the opening of the urethra. Urethral installations are performed using the drug hydrocortisone, Dioxidin and Mirimistin. Local treatment gives good result, subject to complex use with other drugs.

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

Causes of urethritis in men

sexually transmitted infections are the most common cause of urethritis in men who are sexually active. If sexual intercourse is performed without the use of means barrier contraception, then the probability of pathogen penetration into the urethra is very high;

urolithiasis - found much more often in men than in women. This disease causes traumatic urethritis, for the reason that stones, moving along the genitourinary tract, actively injure the mucous membrane and lead to the attachment of pathogenic microorganisms;

any injury to the penis and severe physical exercise may 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, poor nutrition leads to a natural depletion of the body's defenses;

medical manipulations (bladder catheterization, smear) - carry the risk of injury to the mucous membrane of the urethra, and urethritis can develop if the necessary disinfection measures are not followed;

nutrition - an abundance of sour, spicy, salty foods leads to irritation of the mucous membranes, which contributes to the addition of infection. Lack of fluid causes rare urination; therefore, natural rinsing of the genitourinary tract does not occur. harmful microorganisms which may accidentally enter the urethra.

Prevention of complications of urethritis

Statistics say that every second man on the planet after 50 years has prostatitis. Do not think that prostatitis can directly cause urethritis. However, quite often the occurrence of prostatitis occurs against the background of active infectious diseases genitourinary system. Urethritis can cause the development of Reiter's syndrome, infertility, sexual dysfunction, colliculitis, balanoposthitis, orchitis, vesiculitis. In order to minimize the risk of complications of urethritis, a man should:

avoid excessive and intense physical activity;

do not get carried away with salty, spicy, fatty foods, alcohol;

empty the bladder at the first urge to urinate, try to “tolerate” less;

avoid hypothermia;

promptly treat any chronic pathologies;

lead a decent sex life, observe the rules of intimate hygiene.

Despite the fact that the most common cause of urethritis is an infection that is transmitted from one sexual partner to another during unprotected sexual intercourse, in certain cases the disease can also occur in people who maintain sexual hygiene, as well as complete absence sexual activity. In this case, we are talking about traumatic urethritis - inflammation of the urethra that occurs as a result of mechanical damage to the urethral canal.

In the vast majority of cases, the occurrence of mechanical urethritis is associated with certain types of medical procedures. Typically this is diagnostic methods, implying mechanical penetration into urethra for the purpose of taking biological material for research. Despite the fact that doctors carry out mechanical penetration as carefully as possible, traumatic situations cannot always be avoided. In some cases, it is after this kind of event that traumatic urethritis occurs - inflammation of the urethra resulting from damage to the mucous membrane.

IN medical practice cases have been recorded when mechanical urethritis turns out to be a consequence of another non-infectious type of inflammation - allergic inflammation of the urethra. This is due to the fact that when allergic reactions occur, swelling of the mucous and submucosal layers of the organs of the genitourinary system is possible. Sometimes this swelling is so severe that it blocks the urethral outlet, resulting in the need for bougienage. And it is precisely the result of such events that can become traumatic injury urethra.

When approaching the issue of treating this kind of inflammation in men and women, the doctor must take into account that any injury to the mucous membrane is a decrease in its protective forces, therefore, if the therapy is not sufficiently effective, the addition of any sexually transmitted infection cannot be ruled out. Therefore, expecting that a mechanical or traumatic type of inflammation will go away on its own, without taking any measures, is dangerous, first of all, for the patient himself, especially if he is sexually active. You should also not treat any type of this disease independently, especially until its nature and degree of neglect is known.

Gardnerella urethritis
In men who had unprotected sex with women infected with bacterial vaginitis, gardnerella can often be detected during microbiological analysis....

Urethritis refers to an inflammatory process occurring in the urethra. Representatives of both sexes and people of any age are susceptible to pathology. The classification and types of urethritis are determined depending on the causes of the disease, the nature of its course and other factors. It is recommended to treat this disease from the moment when the first signs of an inflammatory process in the urinary system appear. Otherwise, urethritis in men and women becomes chronic.

Causes of urethritis and its classification

The source of urethritis is often sexually transmitted pathologies or injuries to the urinary system. Under this symptom, the disease is classified into:

Infectious;

Non-infectious.

It has been established that untreated urethritis leads to reproductive dysfunction. Therefore, if the following symptoms appear, it is recommended to seek help from a doctor:

The presence of unpleasant sensations during urination;

The appearance of itching and cutting pain;

Frequent urge to go to the toilet, which is not always accompanied by urination;

Cloudiness of urine and the appearance of various impurities in it;

Impaired sensitivity of the genital organ;

Male libido decreases.

Depending on the factor that provoked the development of the inflammatory process in the organs of the reproductive system, urethritis is divided into:

Traumatic;

Allergic;

Congestive.

Each of these types of disease is non-infectious in nature. Infectious urethritis is classified into:

Gardnerella;

Bacterial;

Gonorrheal;

Ureaplasma;

Mycotic;

Viral;

Chlamydial;

Mycoplasma;

Tuberculous;

Trichomonas.

The names of each type of disease indicate the reasons that provoked the development of the inflammatory process. All of the above pathologies are characterized by their own symptoms. In this case, the main manifestations of the disease coincide with the general clinical picture characteristic of urethritis.

Classification of urethritis according to the nature of its course

Depending on the stage of progression, urethritis has the following forms:

1. Acute urethritis.

Symptoms in the acute form of the pathology appear with high intensity. The patient notes the presence severe pain and burning sensations that occur when urinating. Along with urine, copious discharge appears. The tip of the genital organ turns red and swells. In some cases, an increase in temperature and the appearance from the urethra are diagnosed. small clots blood.

2. Subacute.

If the acute form of the pathology is not treated, it gradually becomes chronic, acquiring a subacute type. The latter is characterized by a gradual decrease in the intensity of clinical manifestations. In particular, swelling, volume of discharge and pain are reduced, and urine acquires a natural color and transparency.

3. Chronic urethritis.

Symptoms of the chronic form of urethritis appear during exacerbation of the disease. This occurs under the influence of provoking factors: general hypothermia body, frequent alcohol consumption, etc. The danger of the chronic form is that it can lead to narrowing of the urethra. This fact is indicated by a decrease in the amount of urine released, and the stream itself becomes thinner. Treatment of a chronic form of pathology lasts for several years.

Total urethritis is also distinguished. A feature of this form of the disease is that the entire length of the urethra is affected. Symptoms of total urethritis are in many ways phenomena characteristic of prostatitis.

Traumatic type of urethritis

Traumatic urethritis develops under the influence external factors. The appearance of an inflammatory process in the urethra can be provoked by:

Birth injuries;

Errors made during medical procedures;

Urolithiasis disease.

With the mechanical type of pathology, there is a high probability of the addition of bacterial microflora, since the inflammatory process weakens local immunity. IN similar cases they also say the course of secondary urethritis.

Symptoms for this form of the disease practically do not differ from the manifestations characteristic of other types of the pathology under consideration. Men are quicker to notice that they have problems related to the functioning of the urinary system. The course of the disease is indicated by:

Itching and burning sensation that occurs during urination;

Sharp pain that is localized in the urethra;

Presence of blood clots in the urine.

The characteristic discharge with mechanical urethritis appears only if an infection occurs. This symptom is accompanied by an unpleasant odor. The discharge itself has a creamy consistency.

Due to the fact that it is women who seek help later, mechanical urethritis often causes complications in them in the form of cystitis (occurs in 80% of cases) and pyelonephritis.

Treatment of traumatic urethritis does not imply similar therapy for the patient’s sexual partner. This is due to the fact that the inflammatory process in this form of pathology develops against the background of mechanical damage to the mucous membrane of the urethra.

In the treatment of a traumatic type of illness, the following are used:

Anti-inflammatory drugs, the action of which is aimed at eliminating foci of inflammation and suppressing general symptoms;

Antibacterial drugs, if pathogenic microflora is detected;

Uroseptics, which are injected directly into the urethra;

Immunomodulators to restore immune defense.

IN difficult cases treatment of mechanical urethritis requires surgical intervention. Surgeries are mainly prescribed for urolithiasis that has caused damage to the mucous membrane of the urethra.

Allergic urethritis

Allergic urethritis develops when there is hypersensitivity body to the effects of a certain substance. In each case, the disease occurs under the influence of individual factors. The following can lead to allergies:

Consumption of certain foods (vegetables, fruits, nuts, etc.);

Medications;

Cosmetics and personal hygiene items;

Clothing that comes into direct contact with the genitals.

In men, allergic urethritis often develops when in contact with:

Condoms;

Antiseptics;

Spermicides.

Also, mycosis, candidiasis or insect bites can lead to the development of an inflammatory process in the urethra.

The allergic type of urethritis follows the same scenario as other types of pathology. Patients experience:

Itching and burning in the urethra;

Redness and swelling of the genital organ;

Presence of bleeding, etc.

A characteristic feature of this form of pathology is that its course is accompanied by the appearance common symptoms characteristic of an allergic reaction. In such cases, patients encounter the following:

Redness of the mucous membrane of the eyes caused by inflammation;

Itching on the skin;

Frequent sneezing;

Increased tear production;

Nasal congestion;

Anaphylactic shock;

Quincke's edema.

IN in rare cases the allergic form of urethritis occurs in isolation. That is, the patient does not exhibit other symptoms characteristic of an allergic reaction. Recognize this type pathology can be determined by the discharge from the urethra: it has a glassy grayish-white tint.

Select allergic form The disease is important because the use of antibiotics during its treatment aggravates the patient's condition. Often, successful restoration of the body with this type of pathology can be achieved by eliminating the influence causative factor. Also used during treatment:

Antihistamines, which are mainly used by injection;

Glucocorticoids prescribed for severe pathology, as well as in the absence visible results when treated with antihistamines;

Bougienage of the urethra, which is carried out in conditions of its severe narrowing caused by edema.

The allergic form of the pathology is often complicated by cystitis. Treatment of the disease is supplemented by adjusting the daily diet.

Congestive urethritis

Congestive urethritis develops as a result of congestive processes in the pelvic organs, when the flow of blood through the venous vessels. The causes of the disease include the following factors:

Intense masturbation;

Prolonged or interrupted sexual intercourse;

Prolonged erection;

Chronic constipation;

Hemorrhoids and more.

These factors provoke stagnation of venous blood. When this process becomes prolonged, the posterior part of the urethra receives a large number of round cell elements penetrating from blood vessels. In addition to the urethra, in such cases the prostate gland is affected, and therefore its contractile functions are disrupted. As a result, foci of inflammation form in both the urethra and the prostate.

With congestive urethritis, the symptoms are less pronounced. A small amount of discharge appears from the urethra. Basically, this type of disease is characterized by dysfunction of the reproductive system, as indicated by:

Weakening of erection;

Decreased libido;

Fast ejaculation;

Pain that occurs during sexual intercourse.

Due to the fact that with congestive urethritis the inflammatory process often occurs in the prostate gland, the patient simultaneously experiences the following symptomatic phenomena:

Pain localized in the perineum;

Urinary problems;

Frequent urge to go to the toilet, worse at night;

Local increase in temperature.

In the treatment of congestive urethritis, the leading role is played by measures aimed at restoring venous blood flow in the pelvic area. This can be achieved by identifying and eliminating the causes of stagnation. The patient is prescribed:

Active lifestyle;

Therapy against hemorrhoids;

Medicines to relieve constipation;

Antibiotics and other drugs that restore the functions of the prostate gland.

The patient must adjust his diet.

Gardnerella type of urethritis

Gardnerella urethritis develops against the background of infection of the female reproductive system with an anaerobic gram-negative bacillus known as gardnerella. The disease occurs due to:

Sexual contact with a stick carrier;

Stress;

Irregular meals;

Presence of chronic diseases;

Long-term use of various medications.

The carrier of Gardnerella is always a woman. In the presence of strong immunity, pathogenic microflora is not activated. However, gardnerella never develops in isolation. Gardnerella urethritis is always accompanied by the addition of bacterial microflora of various etiologies. In this regard, patients with this form of the disease often develop other pathologies of the genitourinary system.

Gardnerella urethritis is indicated by:

Discharge from the urethra with specific smell and yellow or green tint;

Irritation foreskin, which causes redness and swelling;

Unpleasant sensations that occur during sexual intercourse

If untreated, gardnerella spreads up the urethra, penetrating the bladder, kidneys and prostate gland. The activity of the rod provokes the development of foci of inflammation in these organs.

In the treatment of gardnerella urethritis it is important A complex approach when both sexual partners are treated. If, for example, the bacillus was diagnosed in a woman, then during intimacy and it is recommended to use condoms throughout the recovery period. Also, to achieve a successful result you must:

Avoid alcohol and spicy foods;

Sleep at least 7-8 hours a day;

Avoid stressful situations.

In the absence of obvious symptoms, the following are used in the treatment of the disease:

Procedures for washing the urethra;

Multivitamins;

Phytotherapy.

These procedures are supplemented by the oral use of antianaerobic drugs (Metronidazole, Clindamycin) if the patient experiences discomfort in the urethra.

Bacterial urethritis

Bacterial urethritis develops due to infection of the urethra by pathogenic microflora. The most common pathogens of the disease include:

Escherichia coli;

Streptococci;

Staphylococcus;

Enterococci.

This group of urethritis also includes:

Chlamydial;

Ureaplasma;

Gonococcal;

Mycoplasma;

Trichomonas.

The differences between these diseases lie only in the type of bacterial microflora, the addition of which provoked the development of an inflammatory process in the mucous membrane of the urethra. It is important to note that these microorganisms are always present in small quantities in the urethra. For the development of the inflammatory process, the influence of third-party factors is necessary, which include:

Mechanical damage to the urethra caused by trauma, catheterization, cytoscopy and other manipulations;

The course of urolithiasis;

Stenosis of the urethra, in which its lumen narrows;

Congestion in the pelvic organs.

In the case of primary infection of the human body with bacterial microflora, the first signs of bacterial urethritis appear approximately a week after sexual intercourse. Behind specified period The incubation period of microorganisms ends and they begin to actively develop.

The clinical picture of bacterial urethritis is also characteristic of other types of disease. The pathogen can be identified by the characteristics of the discharge:

White or green purulent mucous membranes – ureaplasma;

Mucus or pus – chlamydia;

Grayish - Trichomonas.

The chlamydial form of urethritis is often asymptomatic. The first signs of pathology become noticeable when the inflammatory process has caused complications.

The clinical picture in men is more pronounced than in women. This difference is explained by the structural features of the urethra. In men, the urethra is longer and narrower, while in women it is the opposite. That is why the latter turn to a specialist mainly when the pathology has become chronic.

In the treatment of bacterial urethritis, antibiotics play a leading role. Antibacterial drugs are selected based on the type of pathogen. If during the diagnosis the type of bacterial microflora was not established, then antibiotics are used wide range actions. The most popular medications are:

Monural;

Azithromycin;

Doxycycline.

Antibacterial therapy is complemented by the use of uroantiseptics.

Viral type of urethritis

Viral urethritis develops when the body is infected with a group of oculogenital viruses. More often, pathological microflora is transmitted sexually. The clinical picture of viral urethritis is mild. The patient experiences the following symptoms:

Pain when urinating;

Joint pain;

Scanty discharge from the urethra;

Redness of the eyes;

Photophobia;

Profuse lacrimation;

Decreased appetite;

Sleep disturbance.

The causative agent of the disease can live in the prostate gland or seminal vesicles for a long time. Against the background of decreased immune defense, pathogenic microflora migrates into the urethra, causing inflammation of its mucous membrane.

In treatment viral urethritis Antibiotics are rarely used due to their low effectiveness. To suppress the pathological process in the urethra, the following are used:

Vitamin C;

Ultraviolet irradiation of blood;

Hydrocortisone and prednisolone;

Antiviral drugs.

Complete recovery of the body takes at least one month.

Fungal urethritis

Fungal or mycotic urethritis is caused by infection of the body with fungi from the genus Candida. Infection occurs against the background of:

Diabetes mellitus;

Disturbances of the endocrine system;

Long-term use of antibiotics.

In women, fungal urethritis is accompanied by vaginal discharge of a cheesy structure. In men, this form of the disease causes a burning sensation that occurs when urinating. The discharge of the latter at the initial stage of development of the pathology (within 2-3 weeks) will be transparent. Later they take the form of long threads of mucus.

Antifungal drugs are used in the treatment of mycotic urethritis. During the entire recovery period, you must stop taking antibiotics.

Gonorrheal type

Gonorrheal urethritis is a venereal pathology caused by infection of the body with gonococcus. Mostly pathogenic microflora is transmitted during sexual intercourse. Also, household items that were previously used by the carrier of the pathogen can become a source of infection with gonococcus.

An exacerbation of symptoms occurs 3-7 days after infection. The clinical picture of gonorrheal urethritis is characterized by:

Copious yellow-gray discharge with a creamy consistency;

Burning and painful sensations problems that occur when urinating;

Increased body temperature;

Headaches;

General weakness.

Within two months after infection, the disease becomes chronic, and clinical phenomena become less intense.

Antibiotics are mainly used in the treatment of gonorrheal urethritis.