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Infectious urethritis in women treatment

Urethritis in women: symptoms and treatment

Urethritis in women refers to diseases that are much more common than reported cases. The reasons are associated with mild symptoms of inflammation of the urethra and a rare isolated course of the disease. Much more often, the disease is observed simultaneously with cystitis, pyelonephritis - "under cover" of other lesions of the urinary and reproductive systems.

This feature worsens the prognosis of a cure, because such a course of urethritis is the root cause of ascending infection. And attempts to treat it on their own without medical help and examination only aggravate the form of inflammation, contribute to chronicity.

What is this disease?

Urethritis is an inflammatory process that affects the walls of the urethra, that is, the urethra. In women, the disease occurs with almost the same frequency as in men, but due to the erasure of symptoms, women in many cases do not go to the doctor, and it remains unrecognized. And this is unfavorable, since the lack of timely and adequate treatment contributes to the chronicity of the inflammatory process, creates the preconditions for the development of an ascending urinary tract infection.

Reasons for the development of urethritis

Inflammation of the urethra most often has an infectious origin. The causative agents of the disease can be staphylococci and streptococci, Klebsiella, Escherichia coli and Proteus. All these microorganisms live in the genital tract of every woman, but normally they do not lead to the development of the disease.

The occurrence of urethritis can be triggered by the following factors:

• decreased immunity;
• injuries;
• hypothermia;
• stress;
• exacerbation of other urinary and reproductive diseases.

The cause of urethritis in women can also be chlamydia, ureaplasma and mycoplasma. These microorganisms are very insidious and often lead to the formation of chronic pathology. Chlamydial and mycoplasmal urethritis is quite difficult to treat, and not always doctors manage to avoid the development of complications with this infection. It is chlamydia and mycoplasma that are one of the most common causes of infertility in women of reproductive age.

Non-infectious urethritis in women occurs as a result of trauma to the urinary tract, and also as a manifestation of an allergic reaction. In most cases, this pathology activates its own opportunistic flora. Secondary inflammation develops, the signs are no different from the manifestations of infectious urethritis.

Classification

Urethritis is classified into groups of infectious and non-infectious diseases. The causative agents of urethritis of the infectious group can be bacteria, chlamydia, mycoplasmas, Trichomonas, gonococci, viruses, ureaplasmas, gardnerella and others. In turn, bacterial pathogens of urethritis are divided into specific and (chlamydia, gardnerella, etc.) and non-specific (E. coli, staphylococci, streptococci).

The main symptoms of urethritis in women (see photo) include:

• redness (hyperemia) of the vulva and external opening of the urethra;
• burning and pain at the time of urination - unlike cystitis, pain with urethritis persists throughout the emptying of the bladder;
• itching of the vulva and vagina, which increases just before the onset of menstruation;
• purulent discharge from the external opening of the urethra - their color can vary from whitish to rich yellow and greenish (depending on the pathogen).

In chronic urethritis, the main complaint of a person is the appearance of pain in the lower abdomen, in the suprapubic region - its intensity is very slight, and it is rarely paid due attention to, which makes it difficult to diagnose the disease in a timely manner.

Symptoms of specific urethritis

A more vivid clinical picture will be when affected by specific agents:

The specialist will decide how to treat urethritis in a particular woman after determining the causative agent of the infection. Self-medication is unacceptable.

Chronic urethritis

The chronic form of the disease in remission is asymptomatic, but with relapses it has the following symptoms: there is a frequency of urge to urinate and a slight separation of urine at the same time, discomfort in the intimate area. Other manifestations characteristic of the acute form of the disease are absent.

In the case when the inflammation of the urethra occurs together with cystitis or thrush (colpitis), the symptoms may include both discharge and soreness of the female genital organs. Urethritis and cystitis are very similar ailments in terms of symptoms, so they can only be recognized with the help of a diagnosis. The patient must be shown to a specialist.

Diagnostics and tests

It does not matter what kind of chronic or recurrent urethritis a woman has, the first method of diagnosing the disease is to see a doctor and pass laboratory tests, which include:

• Bacteriological culture of urine, which allows you to determine which drugs will be most effective in each case;
• general urinalysis, which detects the number of leukocytes - this is the fastest method for determining inflammation in the urethra;
• a three-glass urine sample, which makes it possible to determine the localization of the inflammatory process for the implementation of differential diagnosis between pyelonephritis, cystitis and urethritis;
• analysis of discharge from the urethra in case mucus or pus is secreted from the urethra;
• Smears from the urethra to detect the concentration of leukocytes and sensitivity to antibiotics;
• ureteroscopy is a study with the introduction of medical equipment directly into the urethra to examine its mucous membrane.

Additional studies if necessary: ultrasound, voiding cystourethrography (X-ray), urethrocystoscopy (examination of the bladder).

Complications of urethritis

It is clear that the most undesirable complication of urethritis is its transition to the last stage, when no treatment can calm the pain and other unpleasant symptoms. In addition, the inflammation process can spread, including to the bladder, provoking cystitis, which happens very often. In more serious cases, the disease spreads to the kidneys and pyelonephritis develops.

Launched chronic urethritis can cause deformation of the urethra and subsequently its narrowing. Fortunately, such cases rarely occur.

Treatment of acute urethritis

The general treatment regimen for urethritis in women includes:

The main and most effective method of treating urethritis in women and men is antibiotic therapy (with the exception of diseases with viral and fungal etiology). The choice of antibiotic is very important for the effectiveness and usefulness of treatment - the identified causative agent of urethritis must be highly sensitive to the selected drug.

The treatment regimen depends on the type of urethritis that a woman has:

Urethritis in women - symptoms and treatment of acute and chronic type, drugs

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What is it? Urethritis is an acute or chronic inflammatory process that develops in the structure of the urethra. It is characterized by an inflammatory lesion of the mucous epithelium lining the inner walls of the urethra. Both men and women are affected with the same frequency.

Only urethritis in more than half of the female population can be asymptomatic for a long time. It was this factor that helped to win the "palm" in terms of incidence in men.

Urethritis does not pose a particular danger to a woman's life - but, as an excellent contributing factor, it poses a great threat of inflammatory damage and the development of complications in other organs of the urination system. Although the manifestation of an inflammatory reaction in the urethritis itself, pathological conditions of these organs are often preceded.

Early detection of the disease is very important - a neglected disease contributes to the upward movement of the infection and the development of dangerous complicated processes that are difficult to stop. With urethritis, cystitis in women is the most harmless of the complications of the disease.

Causes of urethritis in women

Urethritis in women, photo 1

The leading factor in the development of inflammatory reactions in the mucous epithelium of the urethra are infections and irritations, which is why the disease is classified as a non-infectious and infectious pathology, which in turn is divided into specific and non-specific.

The causes of non-infectious urethritis are due to:

• A hypersensitivity reaction of the body, in which the immune system, upon encountering an irritant, infects the cells of the tissues of its own body. Simply put, it's an allergy.
• An irritating factor resulting from trauma to the urethra due to: diagnostic examinations, therapeutic manipulations, emerging small stones, allergic and gynecological diseases, tumor processes, venous vascular stasis, first sexual intimacy.
• Anatomical structural disorders in the organs of urination.

The main genesis of infectious specific inflammations in the urethra is infections and microorganisms that contribute to the manifestation of venereal diseases (STDs and STIs). The causative agents are:

• Vaginal trichomonas;
• Mycoplasma and ureaplasma bacteria;
• Specific gonococcal and other infections.

Infection of the urethral canal is caused by two ways of infection - sexual (unprotected sex) and hematogenous - through the introduction of an infectious agent into the blood from infected foci in the body (stomatitis, caries, purulent tonsillitis, tuberculosis, or purulent sinusitis).

The cause of nonspecific infectious urethritis is uncontrolled processes of intensive growth and reproduction of pathogenic and opportunistic bacteria (rod-shaped, fungal and coccal representatives), provoked by the failure of a weakened immune system due to:

• Hypothermia (general hypothermia);
• Deficiency of vitamins and nutrients in the body;
• Various diseases transferred on the eve of infection;
• Stress and psycho-emotional overload;
• Serious hormonal overload (pregnancy condition).

At the same time, the addition of various infections often translates non-infectious urethritis into the category of infectious pathologies, with manifestations of the corresponding symptoms.

Symptoms of urethritis in a woman, characteristic signs

Female urethritis rarely occurs with the manifestation of clear signs. During the latency period of infection (up to 2 months), no signs are noted, but even after this time, most patients may not have any specific symptoms of urethritis. Despite the different nature of infectious urethritis, the signs of their acute manifestation are identical. Characterized by:

• discomfort and itching symptoms when emptying the bladder;
• periodically recurring aching painful symptoms in the pubic area;
• manifestation of urethral discharge with purulent inclusions;
• appearance of blood impurities in urine;
• feeling of "sticky" urethra in the morning.

At the same time, the manifestation of signs of urethritis is not necessary in the aggregate. The severity of many of them prevails over the rest of the symptoms.

A distinctive feature of the clinical course of infections of this kind is the absence of common signs, such as elevated temperatures and a feeling of weakness.

The manifestation of symptoms of chronic urethritis in a woman is possible only with an exacerbation of the process (for example, after hypothermia). Symptoms of the disease are expressed by a sharp pain in the lower abdomen, pain and pain during urination. Without any medical intervention, (after a couple of weeks) such symptoms subside or disappear altogether.

This gives patients reason to believe that the body has coped with the disease on its own. Meanwhile, the infection continues its successful growth and reproduction in the vaginal glands and Bartholin ducts, contributing to the exacerbation of the disease with any provocative factor (hypothermia, alcohol consumption, frequent sex, etc.).

The signs of various forms of inflammatory lesions of the urethra depend on the specific pathogen, which helps to identify the etiology of the disease and prescribe, based on the symptoms, the treatment of urethritis in a woman - with drugs selected to effectively destroy a specific infectious agent.

1) Signs of gonococcal (gonorrheal) urethritis can appear within a day after contact with the carrier of the infection, or after one and a half, two weeks. The symptomatology is manifested by a sharp pain and the manifestation of unpleasant sensations in the process of prolonged abstinence from the emission of urine. It is possible to identify an infection only if symptoms appear, since in a chronic course, there may be no signs of the disease.

2) In trichomonas urethritis, the latent period lasts up to one and a half weeks, after which itching symptoms appear, burning in the area of the urethral canal and external labia, foamy whitish discharge, frequent and sharply painful urination. But, in a third of patients, the disease may not manifest specific signs. When the process is chronicized, the signs disappear altogether.

3) Symptoms of fungal urethritis (candidiasis) do not appear throughout the entire incubation period (10 to 20 days). Then there are moderate burning pains during the act of urination, unpleasant discomfort and discharge in the form of a white-pink, viscous and thick substrate. In the chronic form of the course, it is almost impossible to determine the form of the disease by the symptoms, since the signs can be very diverse.

4) Urethritis caused by chlamydia appears a month after infection. The signs correspond to the general nature of the disease, with the only difference being that the discharge is purulent.

5) The manifestation of the urogenital tuberculosis form of the disease is characterized by the similarity of signs with the above symptoms of the disease. Sometimes it develops with tuberculous kidney damage with simultaneous damage to the urethral canal and the development of cystitis.Extrapulmonary pathology (lung tissue on x-ray without pathologies) is characterized by signs of prolonged subfebrile condition, weakness and hyperhidrosis.

From all this abundance of forms and similar symptoms, one thing is clear - the treatment of female urethritis should take place after a thorough differentiated diagnosis and an accurate determination of the etiology of the disease.

Treatment of acute urethritis, drugs

Uncomplicated urethritis in women can be successfully treated - comprehensive and phased. With female urethritis, antibiotic therapy is the most effective stage of treatment. Its effectiveness is due to the correct choice of the drug, which is selected purely individually, taking into account the high sensitivity of a certain pathogen to it.

In order not to waste time while the pathogen is being determined, antibiotics with a broad (universal) property are prescribed. Among the most popular:

Tableted medications, drugs for intramuscular or intravenous injections are prescribed. In accordance with the symptoms of urethritis in women, antibiotic therapy drugs are selected by schemes - for monotherapy (prescribing one antibiotic), combined schemes of 2, 3, and 4-phase treatment.

Treatment with antibiotic drugs is supplemented by installations - the introduction of antibiotics directly into the urethra by catheterization and intravaginal suppositories.

Vaginal suppositories for urethritis are selected in three categories: those with antibacterial, anti-inflammatory and antiviral properties. Among them are Hexicon, Polygynax and Betadine.

An indispensable condition for successful therapeutic treatment is the correction of the diet with abundant fluid intake.

Treatment of chronic urethritis in women, drugs

In the treatment of chronic forms of female urethritis, long-term therapy includes:

• antibiotic therapy individually selected for this pathogen;
• washing the urethral canal with antiseptic preparations;
• antibacterial installation of the urethra;
• with pronounced signs of urethral narrowing - cauterization and bougienage of the urethra;
• vitamin complexes and enzyme treatment (enzyme therapy);
• immunomodulatory agents, interferons, antioxidants and probiotics.

Complications of the disease often develop as the consequences of a long asymptomatic course of the disease, or with the failure of treatment. One of the first complications of female urethritis is cystitis. The subsequent ascent of the infection can manifest itself as inflammatory reactions in the form of colpitis, andexitis or endometritis. The most unfavorable consequence of the disease is female infertility.

The prognosis of treatment is determined by the timeliness of diagnosis and a correctly drawn up treatment protocol. Compliance with these conditions, as a rule, excludes the development of complications.

All this can be avoided if you do not self-medicate, but entrust yourself to a specialist.

Urethritis in men and women. Causes, symptoms, signs, diagnosis and treatment of urethritis. Types of urethritis: acute, chronic, non-specific, specific types of urethritis. Bacterial, candidal, trichomonas urethritis

The site provides background information. Adequate diagnosis and treatment of the disease is possible under the supervision of a conscientious physician. All drugs have contraindications. Expert advice needed

Urethritis is a disease associated with the development of an inflammatory process in the wall of the urethra. It is one of the most common urological diseases.

In men, urethritis is slightly more common than in women, and always occurs in more severe forms. This is due to the anatomical features of the male and female urinary system.

Anatomy of the urethra in women and men

In women, the urethra has a length of only 1 - 2 cm and a fairly large width. Therefore, the infectious agents that enter here practically do not linger, but penetrate immediately into the bladder, causing cystitis (inflammatory damage to the bladder wall), or are excreted with urine. Due to the large width of the lumen, even a significant swelling of the mucous membrane of the urethra in women does not lead to a significant violation of the outflow of urine.

The male urethra can reach a length of 22 cm, and the width of its lumen is only 0.8 mm. In addition, it forms bends along its length. Therefore, the infection lingers in it more easily, and the inflammatory swelling of the mucous membrane leads to a pronounced violation of the outflow of urine, up to acute urinary retention.

Parts of the urethra in men:

• The prostate. Passes through the thickness of the prostate (prostate gland). It has a length of 3 - 4 cm and is the widest segment of the male urethra.
• The webbed part.It has a length of 1.5 to 2 cm. Passes from the prostate gland to the beginning of the penis. This part of the male urethra is the narrowest and practically does not stretch.
• Spongy part. Passes inside the penis. Unlike the prostatic and membranous parts rigidly fixed inside the pelvic cavity, the spongy one is mobile.

Causes of urethritis

Role of infection

There are infectious and non-infectious urethritis.

Infectious urethritis is the most common and is caused by pathogenic microorganisms.

Non-infectious urethritis occurs when the urethra is irritated by non-infectious factors.

Causes of noninfectious urethritis:

• Urolithiasis: small stones that form in the kidneys can move along with the flow of urine, penetrating the ureter, and then into the bladder and urethra, damaging and irritating its mucous membrane with their sharp edges;
• Injury to the urethra during cystoscopy (endoscopic examination of the urethra and bladder), catheterization, during masturbation with the introduction of various objects into the lumen of the urethra;
• Tumors of the urethra - malignant neoplasms are almost always accompanied by inflammatory reactions;
• allergic diseases;
• Narrowing of the urethra (tumors, prostatitis, benign prostatic hyperplasia), which is accompanied by narrowing of the urethra and urinary stasis;
• stagnation of blood in the veins of the pelvis.

Usually, urethritis, which occurs as a result of these causes, is non-inflammatory in nature only in the early stages. In the future, the infection joins.

Pathogenic microorganisms that cause infectious urethritis

Depending on the type of microorganisms that penetrate the urethra and cause inflammation, urethritis is divided into specific and nonspecific.

Nonspecific urethritis is a classic purulent inflammation. Its symptoms do not depend on the type of microorganisms that cause it.

Microorganisms that cause nonspecific infectious urethritis:

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

A specific infectious process in the urethra is usually caused by microorganisms that cause sexually transmitted infections.

Types of specific infectious urethritis:

• gonorrheal;
• Trichomonas;
• candida;
• mycoplasma;
• chlamydia.

Viral infectious urethritis is usually caused by herpes viruses.

Ways of infection with infectious urethritis

Infection with urethritis can occur sexually or hematogenously.

The sexual path is realized during sexual contact with a sick person. This is how specific infections most often occur.

The hematogenous and lymphogenous pathways are realized when the infection spreads through the blood or lymph flow from other foci of chronic inflammation in the body. For example, from inflamed tonsils or carious teeth.

Factors that contribute to the development of urethritis:

Symptoms of urethritis

Patient's complaints

The symptoms of urethritis do not occur immediately after infection. First, there is an incubation period, the duration of which can be from several minutes to two months in the case of nonspecific urethritis. Specific infections have clearer timelines.

Almost 50% of cases of acute urethritis are asymptomatic. The patient does not make any complaints. Most often, this pattern occurs in women. Infection with an asymptomatic disease is quite capable of being transmitted sexually and leading to complications characteristic of urethritis.

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

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

Common signs of acute urethritis:

• itching and other discomfort during urination;
• pain in the pubic area - periodic, aching;
• in men - impaired urination, difficulty in outflow of urine, up to acute retention;
• purulent discharge from the urethra;
• blood in the urine - hematuria;
• The external opening of the urethra seems to be stuck together in the morning.

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

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

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

Specificity in the symptoms of specific types of urethritis

In women: In the acute stage, there are mainly pains and cramps during urination. In the chronic stage, there are no symptoms, only examination and laboratory methods help to diagnose the disease.

In men: In the acute stage, the symptoms differ little from nonspecific urethritis. In the chronic stage, there is itching and burning during urination, purulent discharge from the urethra, which intensifies in the morning, after drinking alcohol, after sexual intercourse.

The incubation period of the disease is about 10 days. Sometimes it is reduced to 5 days, and sometimes it is stretched to 1 - 2 months.

In women: Basically, there is itching and burning in the urethra and external genitalia. In 26% 30% of cases, asymptomatic carriage is noted.

Men:

• burning, itching, crawling sensation in the area of the external opening of the urethra;
• small selections of white or gray;
• blood impurities in semen;
• pain and itching during urination, delays.

If left untreated, after 3-4 weeks, all symptoms subside. The disease passes into a chronic stage, which resembles that of chronic gonorrheal urethritis.

Candidal urethritis is a fungal infection, one of the conditions for the occurrence of which is a decrease in the body's defenses. The incubation period of the disease is 10 - 20 days.

Symptoms in men and women are approximately the same. At the beginning of the disease, pain, burning, and other unpleasant sensations appear, mainly during urination.

Small whitish-pink highlights are noted. They can be very viscous, thick. In men, inflammation often goes to the glans penis and foreskin - postitis and balanoposthitis develop.

Symptoms in candidal urethritis from the very beginning are not as pronounced as in other types of acute urethritis. Therefore, it is often said that the pathology initially develops in a subacute form.

The disease rarely begins acutely. Acute course is observed in no more than 5% of patients. Most often, it begins as subacute or chronic, symptoms are mild or absent.

In women: there is slight itching and discomfort during urination, small discharge from the urethra, which quickly passes. Most patients do not seek medical help at all.

In men: in the acute form, the disease proceeds in the same way as gonorrhea. Then, when mycoplasmosis becomes chronic, its symptoms significantly decrease or disappear. There is only slight itching and burning during urination, small mucous discharge when squeezing in the morning.

The incubation period for chlamydial urethritis is estimated to be 1 to 2 to 3 weeks.

Symptoms practically do not differ from symptoms of urethritis of other origin. But they are less pronounced. In particular, the patient is much less worried about pain, itching and other discomfort.

The reason for going to the doctor most often is the appearance of discharge from the urethra. They may be clear or purulent. After 2-3 weeks, the disease can go away on its own, without treatment. But it is highly likely that it will recur in the future.

What does a doctor reveal when examining a patient with urethritis?

Clinical manifestations of urethritis:

• redness in the area of the external opening of the urethra;
• in women, there is redness of the labia majora and labia minora, vulva;
• in men, if urethritis is accompanied by balanitis and balanoposthitis, there is reddening of the head and foreskin of the penis;
• when touching the penis, it becomes hot and painful;
• the doctor can directly see the discharge from the urethra or the crust that formed when it dried up;
• palpation of the area of the external opening of the urethra is most often painful.

Urologists, andrologists, gynecologists, and sometimes dermatovenereologists examine patients with urethritis. In women, a gynecological examination is carried out in parallel to detect inflammatory changes in the external genital organs.

In men, a digital examination of the prostate through the rectum can be performed: the doctor inserts the index finger into the rectum and probes the prostate gland through its wall.This reveals prostatitis - the spread of inflammation to the prostate.

Diagnosis of urethritis

Urine analysis

A general urine test is the simplest and fastest, it allows you to immediately establish the presence of an inflammatory process in the urethra. During the study, a high content of leukocyte cells is detected in the urine.

In order for the study to show a reliable result, urine must be taken in the morning, the first portion, after the patient has not urinated for at least 4 hours.

Together with a general urinalysis, a general blood test is usually prescribed. It also determines the increased content of leukocytes.

Bacteriological culture of urine and testing of sensitivity to antibacterial drugs

Bacteriological urine culture is an accurate diagnostic method that allows you to identify the causative agent of urethritis and prescribe the most effective antibacterial treatment.

The essence of the technique

Urine collected for research is delivered to a microbiological laboratory, where it is placed on a nutrient medium favorable for the growth of microorganisms. If the nonspecific nature of urethritis is assumed, then agar is used as a nutrient medium. If the inflammation is specific, then special nutrient media are used.

Bacteriological research can be not only qualitative (positive / negative), but also quantitative. The number of pathogens is measured in CFU - colony-forming units. This is the number of bacteria or fungi that can give rise to a new colony. Quantification allows you to judge the severity of infection and inflammation.

Antibiotic sensitivity

In order to determine the sensitivity of the identified pathogens to the action of antibiotics, antibacterial drugs are added to the nutrient medium with grown colonies. If the antibiotic inhibits the growth of the colony, then it will be effective in this patient.

How to collect and donate urine for bacteriological examination with urethritis?

For bacteriological examination, the morning average portion of urine is collected in the amount of 3 - 5 ml. It is collected in a plastic sterile container, which is obtained in advance from the laboratory. Then it must be delivered to the laboratory within 2 hours.

Examination of smears from the urethra

The study of smears from the urethra is a more accurate method for diagnosing urethritis, since in this case the material is taken aimingly from the affected area.

Types of examinations of smears obtained from the urethra:

• microscopic examination: the material is examined under a microscope, while an increased content of leukocytes is detected in it;
• bacteriological examination and determination of sensitivity to antibacterial drugs: carried out in the same way as the corresponding urine tests.

How is a urethral swab taken?

The material is taken by the urologist using a special sterile spoon (Volkmann spoon) or a probe ("brush"). The procedure is quite unpleasant, especially for men. The material is collected in a sterile container and immediately sent to the laboratory.

Preparing to take a swab from the urethra:

• within 12 hours before the sampling of the material, exclude sexual contact;
• preferably one week before the study, do not take any antibacterial drugs;
• no urination for 2 hours

Examination of discharge from the urethra

PCR (polymerase chain reaction)

PCR is a highly accurate method for the detection of many infectious urethritis pathogens. Especially often it is used to diagnose inflammatory processes in the urethra, which are caused by chlamydia and herpes viruses.

Urine or a swab from the urethra is used as a material for research. In the laboratory, a polymerase chain reaction is carried out, as a result of which the genetic material of the pathogen (DNA or RNA) is repeatedly reproduced in large quantities. This makes it much easier to identify.

Three-cup test

Purpose

A three-glass test is carried out in order to establish the localization of the pathological process, when it is necessary to conduct a differential diagnosis between urethritis, cystitis, prostatitis, pyelonephritis.

Preparing for the study

Before the 3-glass test, the patient should not urinate for 3 to 5 hours. The study is carried out in the morning.

Research progress

The patient urinates into three containers:

• in the first - about 1/5 of all urine;
• in the second - about 3/5 of all urine;
• in the third - the remaining 1/5 of urine.

Then all three portions are sent to the laboratory for a general analysis of urine and samples according to Nechiporenko. The main thing is to evaluate the content of leukocytes in each serving.

Evaluation of the results after a three-glass urine test:

• an increase in the content only in the first portion of urine - urethritis, moreover, there is a lesion in the main anterior part of the urethra;
• an increase in leukocytes only in the third portion of urine - prostatitis and, possibly, posterior urethritis (damage to that part of the urethra that passes through the thickness of the prostate gland);
• an increase in white blood cells in the first and third portions of urine - a combination of urethritis and prostatitis;
• an increase in the content of leukocytes in all three portions of urine - most likely, there is cystitis (inflammation of the mucous membrane of the bladder) or pyelonephritis (inflammation of the pelvicalyceal system of the kidneys).

Ureteroscopy

Ureteroscopy is an endoscopic technique in which the doctor inserts special equipment into the urethra and examines the inside of the urethral mucosa.

Preparation for ureteroscopy:

• A week of antibiotic treatment is usually given before the test;
• immediately before the manipulation, a strong antibiotic is injected in order to prevent the spread of the inflammatory process;
• patient should urinate before ureteroscopy;
• In younger children, especially those who are restless, ureteroscopy is performed under general anesthesia.

Possibilities of ureteroscopy:

• examination of the mucous membrane of the urethra from the inside;
• the ability to perform a biopsy (take a small piece of the mucous membrane of the urethra for examination under a microscope);

Varieties of ureteroscopy:

• dry - in this case, the doctor inserts a ureteroscope lubricated with petroleum jelly into the patient's urethra and can examine the urethra throughout;
• irrigation - at the same time, a flushing fluid is constantly supplied to the urethra, due to which it is stretched, and it is possible to examine its rear sections.

Additional studies for urethritis, which are prescribed by a doctor according to indications:

• Ultrasound examination of the pelvic organs.
• Voiding cystourethrography is an X-ray examination in which a radiopaque substance is introduced into the cavity of the bladder.
• Urethrocystoscopy is an endoscopic examination in which not only the urethra, but also the bladder is examined using special equipment - a urethrocystoscope

Urethritis treatment

Antibiotic therapy

Since in most cases urethritis is of inflammatory origin, the main method of its treatment is the use of antibacterial drugs.

The choice of antibiotic for urethritis should be carried out only by the attending physician. If the antibacterial drug is chosen incorrectly, then it will not work on the pathogen and can lead to side effects. The correct selection of antibiotic therapy is possible after a bacteriological study and determination of the sensitivity of microorganisms to antibiotics.

Methods of using antibacterial drugs for urethritis:

• in the form of tablets;
• in the form of intravenous and intramuscular injections;
• in the form of vaginal suppositories;
• in the form of instillations (infusion of a medicinal substance) into the urethra using a special catheter.

The use of antibiotics in various forms of urethritis:

Broad spectrum antibiotics:

• a group of cephalosporins (cefazolin, ceftriaxone, etc.);
• tetracycline, doxycycline;
• macrolide group (erythromycin, azithromycin, clarithromycin);
• antibacterial drugs from the group of sulfonamides and fluoroquinolones.

First, a broad-spectrum drug is prescribed that acts on most pathogens. After the data of bacteriological examination and determination of sensitivity to antibiotics are obtained, the drug can be replaced with another, more effective one.

Treatment can only be strictly prescribed by a doctor! In order for antibacterial drugs to be effective, they must be taken strictly on time, without missing a single dose.

Diet and recommendations for urethritis:

• limit fatty, spicy, sour, highly salty foods;
• drink enough liquid throughout the day, at least 1.5 liters
• avoid hypothermia
• abstain from sexual intercourse until completely cured
• carefully follow the rules of personal hygiene

Treatment of chronic urethritis

Chronic urethritis is more difficult to treat than acute.

Directions for the treatment of chronic urethritis:

• the use of antibacterial drugs - the same as for acute urethritis, taking into account the sensitivity of microorganisms to antibiotics (periodically controlled - swabs are taken from the urethra for bacteriological examination and determining the sensitivity of microorganisms to antibacterial agents);
• instillation (washing) of the urethra with antiseptic solutions, for example, furacillin;
• immunocorrectors - drugs that increase the body's defenses;
• vitamin-mineral complexes - necessary to maintain the protective forces and restore the mucous membrane of the urethra.

Additional treatments for gonorrheal urethritis:

• In chronic gonorrheal urethritis - instillation of antibiotics into the lumen of the urethra.
• With soft granulations (growths of the mucous membrane of the urethra), a solution of silver nitrate and collargol is injected into the lumen of the urethra.
• For pronounced granulations, cauterization with 10% 20% silver nitrate solution.

After the complete disappearance of all symptoms of gonorrheal urethritis, after 7 days, a study should be carried out that will confirm the recovery. A provocative test is carried out: the patient is given spicy food or alcohol, or a bougie (a special metal rod) is inserted into the urethra. After that, urine is given daily for 3 days, and if leukocytes or gonococci are found in at least one analysis, then the disease is not considered cured. The provocative test is repeated after 1 month. After curing chronic gonorrhea, it is carried out monthly for 2 months.

Additional treatments for Trichomonas urethritis

Additional treatments for chlamydial urethritis

Folk treatments for urethritis

Folk remedies for the treatment of urethritis can only be used as an adjunct to antibiotic therapy. If the disease is not completely cured and becomes chronic, then it will be much more difficult to cope with it.

Folk remedies used in the treatment of urethritis:

• Parsley. Soak a tablespoon of crushed plant leaves in 500 ml of cold water. Infuse overnight, then take 3 tablespoons of the resulting infusion every 2 hours.
• Zelenchuk yellow. Brew a teaspoon of herbs in 1 cup of boiling water. Insist for some time, then drink. Drink 1 glass of infusion in the morning, afternoon and evening.
• Blackcurrant. This plant has a pronounced anti-inflammatory effect on the organs of the genitourinary system. Pour 500 ml of boiling water over three teaspoons of leaves, take as a tea.
• Blue cornflower. Take flowers without baskets. Pour 200 ml of boiling water. Take 2 tablespoons of infusion in the morning and evening, before meals.