What is bacterial urethritis in women and urethroprostatitis in men. Bacterial urethritis in men - signs and treatment methods

Inflammatory process in the mucous membrane urethra caused by exposure to pathogenic microorganisms. This different types bacteria that provoke inflammation of the urethra, as a result of which bacterial urethritis is diagnosed. There are several types of urethritis: nonspecific and specific form. The disease occurs in women and men, although representatives of the fair sex suffer from it more often.

Types of disease and pathogens

Nonspecific urethritis is caused by the following bacteria:

• streptococcus;
• staphylococcus;
• enterococcus.

These microorganisms are constantly present on skin person, but to arise pathological process, additional factors are needed.

The specific form is caused by the reproduction of other pathogens:

• chlamydia;
• gonococci.

Infection occurs during sex. “Carriage” of bacteria is very dangerous, that is, a condition when a person himself is not sick, but is a carrier of the pathogen.

In addition, primary and secondary urethritis are distinguished. Primary develops in completely healthy people, without concomitant diseases. This is precisely the reason for going to the doctor.

The secondary form is a consequence of other inflammatory processes and develops against their background. In this case, urethritis is not treated because it is not diagnosed, since its symptoms coincide with the manifestations of the underlying disease.

Both types of urethritis have acute form(appears after 2–3 days) or chronic (signs are observed after 3–4 weeks).

Provoking factors

Causes causing the disease:

• urethral injuries caused by a foreign body;
• advancement of stones in the urethra with urolithiasis;
• urethral stenosis (congenital, acquired);
• chronic inflammation of the pelvic organs.

But main reason the reason why the disease occurs is a decrease protective properties the body, that is, weakening of the immune system. This happens due to the following reasons:

• hypothermia;
• stress;
• dehydration;
• therapy with hormonal drugs.

Initially, the lesion has a specific type of course. It weakens the human immune system and provides soil for the growth of opportunistic microorganisms. Nonspecific bacterial urethritis develops.

Symptoms in men and women

Urethritis in women and men appears some time after infection. Incubation period depends on the type pathogenic microorganism, presence of concomitant diseases, condition immune system patient and ranges from 3–7 days to a month.

General symptoms of the disease:

• discomfort when urinating;
• pain when going to the toilet;
• hyperemia around the urethral outlet;
• unusual discharge from the urethra.

Bacterial urethritis in men has acute clinical picture- this is due to the fact that the length of the urethra is longer and narrower than the female one.

Therefore, when an infection occurs, the process proceeds rapidly, especially in the mornings the patient notes a large number of discharge from the urethra and severe pain when urinating.

Bacterial urethritis in women manifests itself less acutely, but has the same clinical picture. This depends on the constitutional structure of the female genital organs. Their urethra is short and wide, so damage to it can go unnoticed, and acute process the course will change to chronic. Women experience pain when urinating, pain and burning, and itching of the skin.

Abundant ones appear curdled discharge from the urethra, having a strong unpleasant odor. Later these symptoms are joined nagging pain, localized in the lower abdomen. If treatment is not started in time, the disease affects other organs. urinary system and causes the development of complications.

Bacterial urethritis causes only local inflammation and is therefore not accompanied high temperature, weakness, dizziness.

Diagnostic tests

For determining accurate diagnosis you need to undergo appropriate laboratory tests, since a visual examination by a doctor alone is not enough. The main diagnostic method is a urine test using the “two-glass sample” method, which makes it possible to determine the amount and confirm the presence of inflammatory process.

Culture of contents and discharge from the urethra is also informative. Sowing microorganisms will determine their type and resistance to antibiotics. Patients are prescribed a referral for the following tests:

• general urinalysis;
• general blood test;
• blood biochemistry.

This will help identify the presence or absence of other diseases and prescribe effective treatment. Based on the results of the tests, it will be clear which microorganisms caused the disease and will be prescribed accordingly. necessary groups medicines.

Therapeutic measures

Treatment of bacterial urethritis is carried out with antibiotics. To make the therapy more effective, a combination of several groups of drugs is practiced simultaneously. But for the treatment to give positive results, be sure to look at the results laboratory research regarding the resistance of a particular type of bacteria to a group of antibiotics.

When affected by chlamydia - macrolides (azithromycin), tetracycline drugs. If the cause of the disease is gonococcus, macrolides (azitrox), cephalosporins (cefadox), fluoroquinolones (ciprofloxacin). For infection with Trichomonas - trichopolum, metronidazole, tinidazole. In particular advanced cases the use of monural is indicated.

Antibiotics are used for a course of up to 10 days. Along with them, probiotics are prescribed to preserve the intestinal microflora (Linex).

In addition to antimicrobial therapy, vitamins and immunostimulants are indicated to increase the body's protective properties. Along with the use of medications internally, external ones are prescribed antiseptics that help relieve inflammation (miramistin, protargol). The urethra is washed with furatsilin solution.

Antihistamines and painkillers are prescribed according to indications. If the course of the disease is not acute, then physiotherapeutic procedures (UHF, electrophoresis) are prescribed. During the period of treatment, the patient must abstain from sexual intercourse and adhere to proper nutrition and comply drinking regime(drink up to 3 liters clean water per day).

Nutrition during therapy involves eating non-spicy foods with minimal use of seasonings. During this period, you should not drink alcohol, sweets or flour products.

It should be remembered that you cannot treat urethritis on your own, since it is unknown which microbe caused the inflammation. There will be no benefit from such treatment. If symptoms of urethritis appear, you need to visit a doctor, get tested and undergo appropriate treatment. All recommendations regarding treatment are given by a urologist (men), gynecologist (women).

Possible complications

At untimely treatment the disease becomes chronic and affects not only the urethra, but also other pelvic organs. Pathologies develop:

• prostatitis;
• cystitis;
• orchitis.

Urethritis can cause narrowing of the urethra, causing infectious lesion kidney The most serious complication in women is the development of infertility.

Disease prevention

Preventing the disease is not difficult. You just need to follow some tips:

• maintain personal hygiene;
• have a permanent sexual partner;
• wear underwear made from natural fabrics;
• drink more fluids;
• Do not use skin irritating hygiene products.

It is necessary to promptly identify and treat chronic foci of inflammation and disease urinary tract, increase immunity. It is important to treat colds, undergoing a full course of therapy, and not taking medications only until the symptoms disappear. You should not overcool and expose your body to stress. Following these recommendations will help avoid the recurrence of bacterial urethritis.

Inflammation of the mucous membrane of the urethra is called bacterial urethritis. According to statistics, it is diagnosed equally in both men and women. Pathogenic microorganisms can come from outside or wander throughout the body. The causative agent can be: staphylococcus, enterobacteria, coli and others. To avoid complications, you should start treatment when the first signs appear.

Causes of the disease

Bacterial urethritis occurs due to penetration into the epithelial layer pathogens which contribute to the development of the inflammatory process. The development of the disease is provoked by the following pathogens:

• streptococci;
• staphylococci;
• chlamydia;
• enterococcus;
• coli;
• Trichomonas.

Infection often occurs when unprotected sex, but in some cases a person does not even suspect that he was a carrier of mycobacteria. IN normal conditions opportunistic microorganisms exist on the surface of organs genitourinary system, and their activation is facilitated by:

• mechanical damage to the mucous membrane of the urinary canal, for example, after use;
• at urolithiasis small particles move along the urethra and injure it;
• narrowing of the urinary canal, this may be congenital pathology or purchased;
• long-term inflammatory processes of the genitourinary system, this leads to the addition of secondary infections, as well as stagnation of urine;
• dental caries;
• poor nutrition;
• excessive consumption of alcoholic beverages.

Bacterial urethritis in women often occurs in menopause When immune resistance decreases, the vaginal microflora changes, which contributes to the rapid spread of pathogenic bacteria.

Characteristic symptoms of urethritis

If the infection strikes and neighboring organs, then the person may feel an increase in temperature.

If discomfort appears the next day after intercourse, then most likely the reason is different. Symptoms may not appear together, or in some cases they may not appear at all. If the infection has affected neighboring organs, the body temperature rises and bloody issues when urinating. arise frequent urge to the toilet even at night. The incubation period lasts from 5 days to a month, after this period the first symptoms of the disease begin to appear:

• pain at the moment of bowel movement Bladder and after completion;
• severe itching and burning that occurs in the external genital area;
• swelling of the glans penis is accompanied by pain when pressed, which causes discomfort during sex;
• mucous discharge with specific unpleasant smell, in most cases yellow or green in color, pus may appear;
• blood-filled vessels near the outer edge of the urethra.

Methods for diagnosing bacterial urethritis

To get started adequate treatment, the doctor must collect necessary information. For this purpose, laboratory and hardware diagnostic methods are used. In addition, in women the gynecologist examines the genital organs and mucous membranes, in men initial examination carried out by a urologist. The patient's complaints and medical history are taken into account. Scroll necessary examinations:

For full examination The patient is prescribed urethrography.

• General analysis urine. An accessible type of analysis that shows quantitative and qualitative changes in the body.
• Bacteriological culture of secretions. Allows you to identify the cause of development.
• Bakpasev smear from the urinary canal. Helps you choose suitable group antibiotics.
• Urethroscopy. A device with optics helps to study the walls and cavity of the bladder, but acute course disease is not used.
• PCR. Allows you to identify a number of pathogens.
• Urethrography. The urethra, filled with a specific substance, is X-rayed.

Treatment of the disease with modern methods

Treatment of bacterial urethritis is comprehensive; after the pathogen has been identified, appropriate medications are prescribed. Anti-inflammatory drugs are an integral part of treatment local action: “Protargol”, “Dioxidin”, “Miramistin”, “Collargol”. Preparations based on silver nitrate are used more often; they effectively remove unpleasant symptoms and promote the regeneration of affected tissues.

Bacterial nonspecific urethritis is treated antibacterial agents broad action:

For treatment, the doctor may prescribe Cefazolin.

• Macrolides: Erythromycin, Azithromycin, Clarithromycin.
• Cepholosporins: Ceftriaxone, Cefazolin;
• Tetracyclines: “Doxycycline”, “Tetracycline”;
• Fluoroquinolones: Pefloxacin, Abaktal;
• Sulfonamides: “Sulfazol”, “Urosulfan”.

Most commonly prescribed medications wide range lesions:

• In case of trichomania, Trichopolum and Metrogyl will effectively overcome the disease.
• For gonorrhea, groups of cephalosporins, fluoroquinols and macrolins are suitable.
• For chlamydia, macrolides and tetracyclines will help.
• If the disease is at the development stage, then “Monural” will help, which acts during the first day and will help eliminate staphylococcus in the urethra.

So that the treatment brings positive result and does not develop into a chronic form, it is important to complete the course of antibiotics; on average, the course of treatment is 7-10 days. After which the favorable microflora should be restored with the help of Linex and Lactovit. Besides, vitamin complexes will raise local immunity. You can add physiotherapy to the list: electrophoresis or UHF. During the treatment period, you should abstain from sexual intercourse, healthy image life and adjust your diet.

Bacterial urethritis is frequent illness and occurs in both men and women. The danger of the pathology is that the inflammatory process can spread to neighboring organs, affecting the bladder, prostate, etc.

Forms of the disease

Pathology leads to inflammation of the urethra. Bacteria enter upward path. The disease is divided into 2 types: specific and. The first form is characterized by the fact that the causative agents of the inflammatory process are pathogens that are transmitted primarily through sexual contact. These include gonococci, trichomonas, chlamydia, mycoplasma, etc.

The emergence of nonspecific is due to the penetration of conditionally pathogenic microflora, which includes streptococci, staphylococci, fungi, etc. The disease is divided into primary and secondary species, which is caused by the penetration of bacteria: the primary inflammatory process occurs due to the entry of bacteria during sexual contact, and the secondary one develops when pathogens penetrate from infectious foci- prostate, bladder, etc.

The nature of the course determines the presence of acute and chronic types diseases:

1. The first is characterized by vivid symptoms and develops quickly.
2. Chronic form can last a long time with periods of remissions and relapses.

Causes of infection

Causes of bacterial urethritis:

Symptoms in men

Bacterial urethritis in men has the following symptoms:

Most men additionally feel discomfort in the penis area, which intensifies during movement.

Manifestation of the disease in women

Bacterial has the following symptoms:

In women with bacterial urethritis, the cervical canal. The infection can spread to other organs - the uterus and ovaries.

Diagnostics

Diagnosis of urethritis consists of the following examination methods:

1. Blood and urine analysis. These methods help determine the presence of an inflammatory process, which is accompanied by an increase in normal ESR indicators and change leukocyte formula with urethritis. A urine test in this case is more informative. A three-glass sample is often used. The first portion, if bacteria are present, contains increased amount leukocytes.
2. Examination of discharge from the urethra. The pathogen is determined using culture and PCR diagnostics. The results of bacterioscopic examination allow us to judge the presence of pathogens of the inflammatory process.
3. Ultrasound. Ultrasound diagnostics helps determine the spread of the disease to nearby organs. At the same time, the mucous membrane of the urethra thickens. If the bacterial process spreads to the bladder, then echo signs of cystitis occur.

An important part of diagnosing the disease is interviewing the patient, which helps determine the presence of characteristic features. In men, the urologist notes inflammation of the glans penis, and in women, the gynecologist examines the vagina and cervix. In the presence of pathogenic microflora, areas of hyperemia are present.

Consequences

The consequences of bacterial urethritis are dangerous for the reproductive and urinary systems. As a result of the spread of pathogenic microflora in women, adhesions may form in fallopian tubes. Chronic course inflammation leads to prostate diseases in men.

Treatment of urethritis

Treatment of urethritis bacterial etiology carried out using a whole range of means. To eliminate the cause of the disease, broad-spectrum antiprotozoal drugs are used. Treatment tactics depend on the type of pathogenic microflora.

Instillation of the urethra with solutions of silver nitrate and collargol is effective. Additionally, it is important to correct the immune system. For these purposes, drugs containing interferon are prescribed. During therapy it is necessary to abstain from sexual intercourse. It is important that treatment is carried out simultaneously for both partners, otherwise there is a risk of re-infection.

If the cause of bacterial urethritis is gonococcus, then antibiotics from the group of fluoroquinolones and cephalosporins are indicated. Additionally recommended drinking plenty of fluids, which promotes the rapid elimination of pathogenic microflora.

If a solid infiltrate is present, then cauterization with silver nitrate is indicated by introducing it through the urethroscope. In this case, a highly concentrated solution is used. Treatment of bacterial urethritis, caused by Trichomonas, is carried out with the use of Metronidazole, Tinidazole and other antiprotozoal drugs. During therapy, it is important to exclude spicy and salty foods from the diet, which can increase the intensity of symptoms. Alcohol is prohibited during treatment.

Instillation of 1% concentration of triomonacid into the urethra for at least 15 minutes is effective. For chlamydial urethritis, treatment is carried out with antibiotics and glucocorticoids (Hydrocortisone, Dexamethasone, etc.).

In the presence of candidiasis infection, it is important in therapy to use antifungal drugs. Men are often prescribed medications for oral administration, and women are prescribed tablets and tablets, which help to quickly get rid of acute symptoms.

During the inflammatory process, Miramistin is often used to wash the urethra.

Bacterial etiology can be used as an auxiliary method. Bee products have a good immunostimulating effect. Honey and propolis can be used for medicinal purposes. Additionally used dead bee. It is better to take honey on an empty stomach, dissolving it in the mouth. A water infusion of propolis should be consumed an hour before meals. Treat urethritis folk remedies needed within a month.

Additionally, you can use herbs that increase the body's defenses and help you recover faster. These include St. John's wort, mint, oregano, lemon balm, etc. Diuretic herbs help rapid elimination bacterial flora, enhancing the effect of antibiotics. For urethritis, you can use knotweed, bearberry, rose hips and other plant components.

Bacterial urethritis in men is a pathological process that develops in the urethra. The disease tends to affect other pelvic organs and provoke various complications. To combat urethritis, the use of effective antibiotics and other agents capable of destroying nonspecific bacteria that penetrate the urethral flora.

What is bacterial urethritis

Bacterial urethritis is usually understood as an inflammatory process in the urethra that develops after the penetration of pathogenic microorganisms into it.

The disease may be:

• primary, in which infection occurs from the outside;
• secondary, developing against the background of the presence of other foci of inflammation in the body (most often in the prostate or bladder).

Bacterial urethritis is diagnosed several times more often in representatives of the stronger sex than in women. The disease is characterized by a severe course, which is associated with anatomical structure the male urethra, reaching a length of 22 cm, and forming bends along its path. Due to this feature, the infection lingers longer in the urethra, and when edema appears, the risk of blocking the internal lumen and urination problems increases.

Urethritis can occur in acute and chronic forms. In the first case, the disease is characterized by a rapid course and severe symptoms. The chronic form is a long-term condition, with erased symptoms and frequent relapses.

Causes of occurrence in men

One of the reasons for the occurrence of pathology is the activation of pathogenic microflora in the human body, which includes:

1. Staphylococcus.
2. Streptococci.
3. E. coli.

This happens when there is favorable conditions– hypothermia, weakened immunity, presence in the body chronic infections, alcohol or heavy food abuse.

Urethritis is contagious, as it is often caused by various microbes that enter the human body during unprotected sexual intercourse. Such microorganisms include chlamydia, trichomonas, and gonococci.

There are factors contributing to the development of the disease :

• damage to the urethral walls during medical procedures (catheterization, cystoscopy);
• regular stress;
• lack of personal hygiene;
• untimely and poor-quality treatment of male diseases (prostatitis, hydrocele);
• excessive physical activity.

The most severe case of urethritis is caused by Staphylococcus aureus.

This type of bacteria is different high degree resistance to antibiotics, which often requires long-term treatment.

Symptoms and manifestations of urethritis

On 4-7 days after infection, manifestations are observed initial symptoms acute urethritis:

1. Itching in the external genital area.
2. Burning, pain, discomfort in the urethra.
3. Increased sensitivity of the genital organ.
4. Redness of the external opening of the urethra, sticking of its lips.
5. Swelling of the head of the penis.
6. Traces of blood in urine and semen.
7. Pain during sexual intercourse.
8. Frequent urge to urinate.
9. Increased body temperature.
10. General weakness, drowsiness.

A characteristic sign of developing bacterial urethritis is the presence of unpleasant-smelling discharge in the morning. They may have white or grey colour, be purulent or mucous. Most men feel discomfort in the penis area, which increases during movements.

The chronic form of the disease is accompanied by itching and burning when urinating, a feeling incomplete emptying bladder, the appearance of scanty white-yellow discharge from the urethra. During erection or ejaculation, the patient experiences discomfort, worsening the quality of sexual life.

Bacterial urethritis can be asymptomatic, thereby complicating timely diagnosis. In this case, it is possible to identify the pathological process only as a result of laboratory tests.

Diagnostics: what to examine, how to prepare

If urethritis is suspected, the following diagnostic measures are required:

• conversation between the doctor and the patient to collect anamnesis;
• examination of the patient’s external genitalia;
• blood and urine tests;
• taking a smear from the urethra for culture and PCR;
• Ultrasound of the pelvic organs.

Blood is donated on an empty stomach, which means refusing any food 6-8 hours before the procedure. Before visiting medical institution It is necessary to carry out a thorough toilet of the perineum, genitals and anal area. To do this you should use warm water with soap.

You should stop taking any medications 7 days before the examination. 2 days before the collection of biomaterial, you need to abstain from sexual intercourse. During the 2 hours preceding the procedure, it is forbidden to urinate.

Repeated diagnosis is carried out in case of relapses that develop after treatment. This often happens 1.5-3 months after completion drug therapy, and is observed in 10% of men.

After taking a smear from the urethra, pain and discomfort during urination often develop, which goes away on its own after 2-3 days.

If such sensations intensify or unusual discharge appears, you should consult a specialist.

Drugs: treatment regimen

The treatment regimen for bacterial urethritis in men is selected by a specialist after a thorough diagnosis. The goal of therapy is to eliminate the infection and restore the walls of the urethra.

Patients are prescribed the following types medicines:

1. Antibiotics from the group of macrolides, cephalosporins, penicillins.
2. Immunomodulators.
3. Enzyme-containing drugs.
4. Multivitamin complexes.

Additionally, instillations are carried out to eliminate pathogenic flora and restore the mucous membrane of the urethra antiseptic solutions(miramistin, chlorhexidine).

The treatment regimen for male urethritis is selected individually. The following treatment option is common.

At all stages of treatment, alcohol abstinence, sexual abstinence, frequent change underwear, daily hygiene procedures.

Complications and consequences

Untimely treatment of bacterial urethritis in male patients can provoke complications in the form of:

• vesiculitis - an inflammatory process affecting the seminal vesicles;
• epididymitis, leading to inflammation of the epididymis;
• balanoposthitis - lesions of the glans penis and foreskin;
• cystitis - inflammation in the bladder;
• bartholinitis, in which the pathology spreads to the Bartholin glands;
• deferentitis - an inflammatory process in the vas deferens;
• phimosis, which causes narrowing of the foreskin ring;
• Prostatitis is a common pathology of the prostate gland among men.

In some cases, against the background of bacterial urethritis, lymphangitis of the penis or inguinal lymphadenitis, leading to inflammation of the lymph nodes concentrated in these areas of the body.

The most severe consequences of incorrect or late treatment there is a narrowing of the urethra, as well as its complete adhesion.

Prevention of bacterial urethritis

Prevention of bacterial urethritis consists of measures such as:

1. Avoiding hypothermia.
2. Timely treatment of infectious and inflammatory diseases.
3. Emptying the bladder at the first urge.
4. Eating healthy and giving up bad habits.
5. Careful personal hygiene.
6. Stable sex life with a reliable partner.