Urethritis treatment and kidney stones

Stones in the urethra and methods of treatment.

Stones in the urethra and methods of treatment

Stones in the urethra are a rare but very dangerous disease. It is predominantly found in men due to anatomical features.

Doctor urologist, oncologist, MD Hakobyan G.N.

Clinic of urology of the First Moscow State Medical University. I.M. Sechenov

Clinic of urology of the First Moscow State Medical University. I.M. Sechenov

Stones in the urethra and methods of treatment

Stones in the urethra and methods of treatment

Stones in the urethra are solid formations of various sizes that are localized in the urethra. They can form in the urethra, but most often enter the urethra descending from the bladder, ureters, or kidneys.

Epidemiology of stones in the urethra

Stones in the urethra can be secondary and primary. Primary formations are formed against the background of other diseases of the genitourinary system or intestines. With a large accumulation or large size, the stone gets stuck in the urethra, which causes severe pain. The calculus can partially or completely block the outflow of urine, which provokes incomplete emptying of the bladder. Also, a long stay of stones in the urethra leads to complications in the form of fistulas, urinary incontinence or the development of inflammatory processes.

The symptoms of the disease can vary greatly, as it all depends on the personal characteristics of the body and the location of the formations.

The patient complains of pain in the lower abdomen, which radiate to the perineum. The outflow of urine is very difficult, which in severe cases leads to a complete violation of urination. A large number of small formations provokes complete or partial incontinence.

When stones are located behind, a person experiences discomfort when walking or in a sitting position. It is also possible to have a fever, chills and general weakness without any external causes.

Diagnosis

Stones in the urethra in men are detected even with palpation. In women, a gynecologist's examination helps, as the calculi are palpated through the wall of the vagina.

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There are several treatment regimens for stones in the urethra.

• Remove with tweezers;
• Removal with forceps for ureteroscopy;
• Moving into the bladder and subsequent crushing;
• Surgical intervention in the presence of large calculi and their large accumulation.

After removing the stones, the patient is prescribed a special diet to prevent recurrence of the disease.

Stones in the urethra

If pain occurs and difficulty urinating, it can be assumed that the patient has stones in the urethra. This changes the urine stream and its color. At large sizes, the stones block the urethra and there is an acute retention of urine. With this disease, the bladder, and the urinary canals, and the urethra suffer. The stage of development of the disease is determined by the size of the stones. The choice of treatment method depends on many factors and is determined by the doctor individually for each patient. To prevent surgical intervention, you need to undergo a comprehensive diagnosis on time.

How to recognize urethral calculi?

Main appearance factors

The causes of stones in the urinary system are varied and numerous. Pathological processes taking place in the human body in any of the organ systems can negatively affect the urinary system as a whole and individual elements, such as the urinary canal. It is important to understand that there may be several reasons, and in order to fix the problem, you need to remove the calculus and eliminate the cause of its formation, otherwise there will be relapses. Reasons for the formation of stones:

• intestinal ailment;
• kidney disease;
• fistulas of the urinary canal;
• diseases of the prostate and urethra;
• mental state;
• presence of stress;
• metabolic disorder;
• impaired water-salt balance due to low fluid intake;
• poor nutrition;
• peptic ulcer, colitis and gastritis;
• diseases of the gastrointestinal tract in general.

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Types of stones in the urethra

The stones in the urethra are divided into primary and secondary. Their description is presented in the table:

First symptoms for which you need to see a doctor

Symptoms of the disease appear already at small sizes of formations.

The first symptoms to look out for are:

• intense pain when urinating;
• pain in the kidney area;
• Regular aching pain in the lower abdomen and head.

If, at the first symptoms, a person did not respond in time to the signals of the body and did not seek help, the disease worsens and the primary symptoms intensify. During this period, doctors state that patients have additional symptoms in the form of vomiting and dizziness. When the stones are located in the back of the urethra and bladder, when walking and sitting, the patient feels a sharp pain in the pelvic region. If the stone is stuck in the urethra, it completely blocks the urinary canal and causes severe urinary retention. With frequent visits to the toilet and the inability to control the urge to urinate frequently, doctors suspect that the stones are located directly in the bladder and are large. To determine the exact size, location, we need diagnostics and testing.

Doctors know how to help

Importance of timely diagnosis

Correct, comprehensive and timely diagnosis is very important for making a diagnosis and finding the exact location of stones. In addition to hardware diagnostic methods, an examination is carried out through palpation. This procedure is only available to men due to body structure. To fully extract all available stones, it is important to carry out the full range of available studies, which are described in the table:

Two main treatments

The choice of stone extraction method depends on their number, location, mobility and the presence of pain in the patient. The procedure for removing stones takes little time. The operation is performed under local anesthesia and is considered a relatively easy procedure. It is important to understand that any treatment is carried out under the supervision of a doctor who decides which method of removing stones to use in the safest and most effective way.

When can I do without surgery?

For small stones, treatment is prescribed with drugs that can dissolve stones and turn them into small grains. This sand is able to easily and painlessly come out on its own, without causing the patient severe discomfort. When choosing this method, the doctor prescribes the use of antispasmodics, since the process of crushing and dissolving causes discomfort. And also used herbal infusions for bathing. It is important to understand that the patient should not prescribe this sparing method to himself. Such an act can cause complications and inflammation. It is applied only after comparing all factors by the attending physician and is not applicable in some cases.

Need for surgery

The choice of method and instruments during surgery depends on the size and location of the stone. Anesthesia is used during the procedure. When the stone is stuck near the exit in the urinary canal, it is removed using an endoscope and medical tweezers. If the calculus is large and located deeper, the lithotripsy method is used. This procedure involves crushing the stone with electromagnetic shock waves. The crushed stone is removed with tongs or left to come out naturally.

In medical centers, laser lithotripsy is used, which is gentle on the stone and causes less discomfort when it is crushed. The method of deep surgical intervention is used by doctors when inflammation occurs and purulent masses begin to form or when it is impossible to achieve a positive result with conservative methods of treatment.

Stone formation can be prevented

If you do not start the disease and seek help when the first symptoms occur, removing a stone from any part of the urinary system is simple and fast. It is worth remembering that the formation of stones is a manifestation of deviations in the work of not only the urinary system, but also other organs, and simply removing the consequences is not enough. To avoid relapses, you need to find the cause of the deviations and approach the treatment comprehensively. After the removal of stones or for prevention, it is important to maintain the body's water-salt balance in the normal range. After determining the type of extracted formations, you need to choose the right diet.

Treatment of urethritis in urolithiasis

Urethritis treatment and prevention

Urethritis is an inflammation of the lining of the urinary tract. This ailment is very common, while both women and men are at risk of getting sick with the same probability. Risk factors include frequent change of sexual partner, diabetes mellitus, stones in the organs and ducts of the urinary system, examination of the urethra and bladder by instrumental methods. To avoid the transition of urethritis into a chronic form, you can not self-medicate, but you need to carry out treatment under the strict supervision of a doctor.Also, in order to reduce the risk of complications, it is recommended to be examined in a timely manner and undergo a full course of complex treatment. Depending on the reasons for the development of urethritis, there are infectious (can be specific and non-specific), non-infectious (caused by injuries during masturbation, the introduction of foreign objects), metabolic, allergic, and as a result of intestinal diseases (hemorrhoids, constipation). Infectious urethritis of a specific nature is always the result of infection with "sexual" infections (gonorrhea, Trichomonas). Infectious urethritis of a nonspecific nature is caused by pathogenic microflora (viruses, bacteria, mycoplasmas and chlamydia, fungal pathogens, etc.). Also, this type of urethritis can appear with a frequent change of sexual partners who have had an infectious disease of the genitourinary system. This is due to the reflux of infection during intercourse.

The first symptoms that should push you to seek medical advice are painful urination with severe burning, possibly with cutting pain in the lower abdomen. Also, the appearance of abundant discharge from the urinary tract, swelling and bright red color of the genitals. If at least one symptom is detected, you should immediately consult a doctor. The longer the patient does not seek help, the more complications await him. The consequences of delaying treatment may be the transition to a chronic form, the spread of the disease to nearby organs (the prostate gland, testicles and their appendages) as a result of the development of infertility. In addition, the infection can pass from the urethra to the kidneys and cause inflammation. It is important to know that urethritis does not always give the necessary symptoms, it can also be asymptomatic, and this makes it difficult to diagnose and treat the patient in a timely manner. The course of the disease depends on a number of factors, one of which is the general condition of the body. Women are more prone to asymptomatic urethritis, as this is due to their anatomical features. In women, the urethra is wider and shorter, which does not give such sharp pains as in men. The final diagnosis is made on the basis of microscopic analysis of discharge from the urinary canal and a two-glass urine sample. In order to determine the spread of infection to other organs, additional studies are assigned. Specific urethritis will make itself felt within a few days, non-specific - a maximum of 20 days. Untimely or incorrect treatment contributes to the transition to a chronic form. Manifestations of chronic urethritis include scanty discharge from the urethra, tolerable pain and occasional itching in the urethra. Exchange urethritis is caused by a violation of metabolic processes (purine and mineral). These disorders lead to phosphaturia, uraturia and oxalaturia.

Urethritis refers to diseases of the genitourinary organs treated by doctor 8212; urologist. Women are treated in parallel with urologists by gynecologists, or the treatment is carried out by one specialist uro-gynecologist (a doctor specializing in both urology and gynecology). The peculiarities of urethritis include its etiology associated with sexual intercourse. That is, a specific infection caused by pathogens transmitted through the genital tract should be treated exclusively by a dermatovenereologist. The use of traditional medicine, as well as the chaotic and misuse of medicines, leads to the fact that the treatment of urethritis and its complications becomes difficult even for a specialist doctor. It is worth noting that there are a number of drugs and herbs that can worsen the patient's condition. For example, with urolithiasis, you can enhance the process of passing stones and thereby increase the risk of injury to the urethra, and hence its inflammation.

The main measures for the prevention of urethritis are a strict diet and drinking regimen. The diet excludes spicy foods, and consumes a lot of fluids. At the same time, purified water without gas perfectly performs the role of a liquid. The use of cucumber and linden tea gives a diuretic effect, and lingonberry or cranberry juice, as well as freshly squeezed blackcurrant juice, gives an anti-inflammatory effect. Particularly useful is parsley and its juice, which has both anti-inflammatory and diuretic effects.

Factors that can cause urethritis: - Urolithiasis, in particular its manifestation, when sand or stone themselves begin to pass through the channels and, getting into the urethra, injure it. - Hypothermia. - Infrequent urination. With a frequency of urination less than three hours, bacteria stagnate on the walls of the urethra. - Excessive physical stress. - Excessive consumption of salty, fried, spicy and sour, as well as alcohol and liquids with gas. - The presence of concomitant diseases of other organs.

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Characteristic signs of urethritis and its treatment

Urethritis is called inflammatory processes in the urethra of a chronic or acute course.Ureteritis in men can develop as infectious and as non-infectious pathology, and each form has its own etiology. For the disease, the sexual path is characterized. The disease is diagnosed more often from relatively young patients living active sexual life. The inflammation of the urethra is not dangerous for the life of the patient, but for the period of treatment, the patient will have to lead a ascetic lifestyle, eliminating sexual contacts.

Symptomatic manifestations

The incubation period largely depends on the inflammatory pathogen process and can be 3-8 days from the date of infection. The main symptom characterizing the urethritis in men is the discharge with purulent impurities that appear from the urethra. Such discharge can have a pale yellow or greenish-yellow shade. Acute urethritis begins with sudden burning, painful sensations and itching when the bladder is emptying. Usually, similar symptoms begin at the beginning of the urine release process. At the edges of the holes of the urethra appear characteristic signs of inflammation, the patient notes that they often stick together. The inflammatory process is usually accompanied by purulent discharge, although it happens that all the listed features are concerned with a patient without purulent discharge.

The incubation period in some cases can be reduced to several hours, and some strains are stretched to several months.

Depending on the severity of symptomatic manifestations, urethritis is sharp and chronic. The acute form of urethritis is characterized by burning and painful syndrome that occurs when the bladder is emptying. From the urethra, as already mentioned, the purulent content begins to stand out. The edges of the hole of the urethra sweeping, hyperemia appears, the inflammation develops in the walls of the canal of the urethra. Even with a weak pressure on the head of the penis, purulent content occurs.

When waking, a man can detect characteristic purulent spots on underwear. With palpation, some density of the urethra can be tested. When the patient is launched, the patient's disease is beginning to disturb the frequent urge to emptying the bladder, the temperature can rise, in the urethral there is clearly soreness. Urination can be completed with a small number of bloody impurities.

Due to insufficient treatment, or its complete absence, the disease acquires a chronic form in which the impact of provoking factors is necessary for the appearance of symptomatics. Characteristic minor discharge may appear on the background of abuse of alcohol products, hypothermia, etc. Over time, the exacerbation may pass, but when new factors occur, it will appear again. If a chronic form has a long flow, the stricture of the urethra can begin, in which the absurd of urethra is narrowed, the difficulty of urination and pain appears.

Causes of

There are many etiological factors explaining the emergence of the man of urethritis:

• The main cause of urethritis is the infection of any venereal disease with unprotected sex contact.
• less often infectious inflammation arises against the background of a dismissive attitude towards personal intimate hygiene.
• also the pathogens of the infection can penetrate the urethra of a man from organs above (prostate, testicles, etc.), or infection occurs homogeneous or lymphogenic pathway from more distant infectious foci in the body. Inflamed almonds or glands, dental inflammatory diseases, purulent sinusites, sinusites, hymorites, etc
• It happens that the disease develops against the background of exchange disorders or diabetes.
• The occurrence of urethritis in the urolithic disease is possible, which is associated with the movement of pebbles or sand along the urethra, as a result of which damage to the walls of the ureas canal occurs.
• It happens that the occurrence of the disease contributes to the too active sexual life, or its impermanence.
• contributes to the development of urethritis and the use of some products, among which marinades are leading, sour salty and sharp dishes.

Ureterite Classification

Distinguish urethritis in the men of primary and secondary shape. For primary urethritis, an inflammatory start in the urethra itself, which is usually happening after sexual intercourse with an infected partner. When uretrite, the secondary form infectious processes fall into urethra from another organ, where there is an inflammatory hearth (prostate, bladder or seeds).

Urethritis in men is divided into 2 large groups: specific and nonspecific urethritis. The occurrence of a specific form of the disease contributes to infectious pathologies transmitted by sexual communications.Among these pathologies, the most common are viruses like ureaplasma, gonococcus, Trichomonas or herpes. Much less often, these infections can be caused by chlamydia, mycoplasmas, or gardnerella. The provoking factor of nonspecific urethritis is usually opportunistic microflora like streptococci, staphylococci, fungi and E. coli.

Also, urethritis can be infectious and non-infectious. From the name it is clear that various kinds of infections contribute to the occurrence of infectious urethritis. A non-infectious form can develop with physical trauma to the urethra. Similar phenomena can be observed during chemical or thermal exposure, impact, as well as during diagnostic procedures. It happens that a non-infectious form acquires an allergic character when it occurs as a result of a reaction to drug or food allergens.

Therapeutic activities

The basis of the treatment of all forms of urethritis is antibiotic therapy with a preliminary antibiogram, designed to determine the sensitivity to various antibiotic drugs of the causative agent of urethritis. For the time being, while the antibiogram is being compiled, the patient is prescribed antibiotics with a wide spectrum of action. Usually these are preparations of semi-synthetic penicillins, which are distinguished by a strong effect on pathogens (Augmentin or Amoxiclav).

It is not recommended to start taking any drugs before visiting a urologist, since taking these drugs can affect the picture of the disease, distorting it, which complicates the diagnosis.

If treatment with penicillin drugs is ineffective, then more potent antibiotics are prescribed. Usually these are preparations of a number of fluoroquinolones (Ofloxacin) or cephalosporins (Ceftriaxone). Additional therapeutic procedures are also prescribed, such as washing the urethra with antiseptic drugs (Furacilin, Dekasan). According to patients' reviews, this procedure is extremely unpleasant, so it is better to entrust it to professionals.

An integral part of the treatment is a special diet that requires the exclusion of products that increase the secretion of urethral mucus. These products include a variety of seasonings and spices.

Diagnosis of urethritis in men: what should I pay attention to?

Inflammation of the urethra, the urethra, is called urethritis. Both sexes are susceptible to the disease, but for men it brings more discomfort due to physiological characteristics. Causes of urethritis include infection and mechanical trauma.

Pathogenic microorganisms infect the male urethra during sexual intercourse with an infected partner. or due to regular non-observance of hygiene rules. Injury is possible from a blow, due to inaccurate medical procedures or urolithiasis.

The disease can also develop due to hypothermia, the presence of chronic inflammatory diseases. metabolic disorders and for some other reasons.

Urethritis itself is not a serious disease, although it is not pleasant. A much greater danger is the transition of the disease to the chronic stage. which may develop impotence or infertility.

It is possible to avoid such consequences if you start treatment in time and strictly follow medical recommendations.

Basic rules for the treatment of urethritis

With the help of analyzes and special tests, the type of microorganism that causes the disease is revealed, and then the specialist determines the conduct of treatment and what specific drugs the patient should take depending on the form and stage of the disease.

The main therapy for urethritis is medication. Various means are used, acting in the complex:

• Antibiotics (if the disease is bacterial);
• Probiotics - to prevent dysbacteriosis;
• Anti-inflammatory drugs;
• Antihistamines;
• Medications that stimulate the immune system.

In the advanced stages of urethritis, physiotherapeutic procedures and installations are also prescribed - the introduction of disinfecting and antibacterial medical fluids into the urethra.

Symptoms of the disease

The disease begins to manifest unpleasant symptoms after 5-7 days from the moment of infection. In rare cases, urethritis can be asymptomatic for one month or even longer, but after the signs of the disease are detected, treatment will be longer and more difficult. So, what are the characteristic symptoms of the disease?

• burning during and after urination;
• itching in the genital area;
• discharge from the urethra, purulent or mucous, with an unpleasant odor;
• discomfort during intercourse;
• redness near the external opening of the urethra;
• sticking of the urethra;
• Presence of blood in urine and semen.

Medicine treatment

Antibacterial drugs are something without which a cure for urethritis is impossible (except when the disease is caused not by infections, but by injuries, which is much less common). Preparations are selected strictly individually, and the dosage is also calculated. Urethritis is treated with antibacterial agents of the group of nitroimidazoles, tetracyclines, fluoroquinolones, triozols, macrolides and quinoxalines.

Of the nitroimidazoles, metronidazole or secnidazole is usually prescribed. Especially these funds are effective in urethritis caused by Trichomonas. Side effects may include nausea, headache, dry mouth, and decreased appetite. Metronidazole is not prescribed if the patient has CNS disease or renal failure.

Doxycycline from the tetracycline group is prescribed if urethritis is provoked by the activity of gonococci. side effects of the drug are digestive disorders, and contraindications are liver problems and leukopenia.

Fluoroquinolones (ofloxacin, moxifloxacin, levofloxacin) are used very widely in the treatment of the disease, as they have a detrimental effect on many types of bacteria. When applied, sometimes there are violations of taste and smell, dizziness, abdominal pain, and a decrease in pressure.

Fluconazole from the group of triazoles is an antibiotic for the elimination of candidal urethritis, which has a destructive effect on many forms and types of fungi. Unpleasant aspects of treatment (possibly) - flatulence, change in taste, dizziness.

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Macrolides (clarithromycin, erythromycin) stop the synthesis of proteins of a wide range of microorganisms and are very often prescribed to patients suffering from urethritis. During priming, tinnitus and digestive problems are possible. Contraindicated if the patient is taking certain medications.

To reduce side effects, relieve inflammation and eliminate the appearance of allergies, antihistamines are prescribed, for example, tavegil, miramistin, suprastin. To improve the functioning of the gastrointestinal tract and prevent possible problems, probiotics are indicated, and to strengthen the body's defenses - immunomodulators and vitamin complexes.

Local treatment, which is carried out as needed, is carried out with the help of antiseptics in liquid form. miramistin, hydrocortisone, dioxidine, as well as silver preparations.

Treatment with folk remedies

Folk recipes for the treatment of urethritis help to relieve inflammation and quickly reduce the severity of symptoms. Medicines based on natural ingredients will be an excellent addition to the drug therapy of the disease.

It is recommended to drink natural cranberry juice regularly. and also use tinctures of blackcurrant or parsley. For currant tincture, you will need not berries, but leaves - you need to take 3 tablespoons of them and pour 400 milliliters of boiling water. Divide the day into 2 or 3 prima. And from blackcurrant berries it is useful to drink compotes and decoctions, including for the prevention of urethritis and other inflammatory diseases of the urogenital area.

Parsley tincture is prepared as follows: you need to take a large spoon with a slide of plant seeds, add a liter of warm water. After 8 hours, strain through a sieve and drink three tablespoons three times a day. But from parsley, you can also create a healing agent. Drink a couple of tablespoons every hour.

During the complex treatment of urethritis, you should drink more liquid in the form of plain water, tea, compotes and exclude alcohol, hot spices and smoked meats.