Urethritis is an inflammation of the urethra (urethra).

The frequency of detection of the disease in Russia reaches 250 million cases per year. Urethritis in women occurs as often as in men, but the symptoms of female urethritis are not so pronounced, because the disease often remains undiagnosed. Without timely treatment, urethritis can become chronic.

Very rarely, inflammation of the urethra is an independent disease. The female urethra is wider than the male one and has a length of only 1-2 cm, which is a favorable condition for the infection to penetrate into neighboring organs and causes their inflammation.

Reasons for the development of the disease

In most clinical cases, the onset of chronic or acute urethritis in women can be avoided. All factors predisposing to the development of the disease are divided into infectious and non-infectious effects. The practice of urologists involves the treatment of urethritis - both the first and second types, but inflammation caused by pathogens is more common.

Pathogenic microflora is the penetration of bacteria, fungi or viruses into the urinary tract. But the most common is bacterial urethritis. If the patient has dysbacteriosis, then the development of fungal urethritis is more likely. The relationship between inflammation and a pathogen can only be established in the laboratory.

Main reasons urethritis in women suggests the following factors:

1. The presence of diseases of venereal origin. Inflammation of the urethra can lead to both sexual infections of a latent course, and timely untreated diseases of the same type.
2. Periodic irritation of the urethra. This category includes wearing excessively close to the body, uncomfortable underwear; the use of intimate hygiene products, which contain aggressive chemical components.
3. Scratching and, as a result, damage to the mucous epithelium of the genitals. More often, such a nuisance occurs due to the intense itching that accompanies vaginal candidiasis in women.
4. Damage to the mucous membrane as a result of medical manipulations (urine evacuation, installation of a urethral catheter).
5. Failure to comply with the rules of personal hygiene (untimely change of underwear, prolonged absence of water procedures).
6. Non-observance of the sterility regime by employees of medical institutions (if urethral bougienage, catheterization or any other manipulation involving the use of instruments was performed, while the equipment was not sufficiently processed).
7. Contact of the urethra with contaminated surfaces. This cause often causes urethritis in childhood. For example, if a girl sits with her naked body on the sand, on a bench, on the ground.
8. Intimacy with a partner who does not observe personal hygiene.
9. Hypothermia (not only general, but also local).
10. Violation of the process of blood circulation in the pelvis.
11. The presence of chronic inflammation of the kidneys or bladder.

Also, inflammation of the urethra in women occurs due to malnutrition - the predominance of salty, acidic foods in the diet, which irritates the walls of the urinary tract. In certain cases, urethritis develops due to increased sweating on the surface of the genitals (if it is not eliminated in a timely manner due to water procedures, perspiration will irritate the urethra). Which doctor to contact directly depends on the spectrum of damage - if the disease is limited only to the organs of the urinary tract, the treatment is carried out by a urologist, when the genital organs are involved - a gynecologist or a venereologist.

Nonspecific urethritis

Nonspecific urethritis is an inflammation of the urethra, which occurs due to the penetration of opportunistic microflora into the urethra. It can be staphylococcus, streptococcus, proteus, E. coli, various fungal organisms, and so on. This form of pathology can also develop after sexual contact due to a massive cast of opportunistic microorganisms that occurs directly during the period of copulation. As a rule, this situation is observed constantly, however, in women with a well-functioning immune system, inflammation does not occur, but as soon as the body's defenses are weakened, unpleasant symptoms can immediately appear.

Specific urethritis

This form of pathology occurs in women suffering from one or another sexually transmitted disease (gonorrhea, chlamydia, trichomoniasis, mycoplasmosis, gardenerellosis, ureaplasmosis). It should be noted that in the female body at the same time there can be several different infectious agents. As a rule, specific urethritis in women makes itself felt after sexual contact. However, in some cases, the disease does not develop immediately, but after the incubation period, which can last from several hours to several days, and with a long-term course of the disease, an exacerbation of the pathological process can occur almost at any time.

Symptoms of urethritis in women

Depending on the nature of the course, the disease may have its own symptoms. Sometimes an ailment can generally pass without symptoms, so a woman does not even suspect that she is sick.

Acute urethritis - manifestation features

A kind of exacerbation is diagnosed at the very peak of the disease, as soon as the disease began to manifest itself aggressively. It is always accompanied by severe symptoms:

• severe pain and burning during urination;
• copious discharge with urethritis;
• mucous reddens and swells;
• purulent discharge appears;
• frequent desire to urinate;
• pain in the urethra;
• the level of body temperature rises;
• after urination, drops of blood appear.

During such acute manifestations of the disease, it is urgent to consult a doctor. If timely treatment is not started, then urethritis will become chronic.

Subacute urethritis - symptoms

This form of infection is characterized by a decrease in acute symptoms. Pain in the urethra gradually subsides. Allocations become scarce, or even stop altogether. In some cases, a woman in the morning can observe specific discharge in the form of crusts. Urine acquires a natural shade, turbidity disappears, but purulent threads are observed.

Chronic urethritis in women and its symptoms

The chronic form develops if the patient has not undergone any treatment at all, or inappropriate therapy has been selected for him.

Relapse is caused by hypothermia or excessive consumption of alcoholic beverages. Under the influence of harmful effects, all symptoms of acute infection gradually resume. Urethritis is treated for a very long time, it can take months or even years to recover. If the patient will conscientiously follow all the recommendations of the doctor, then recovery will definitely come.

During pregnancy, urethritis can also develop. This is due to a hormonal imbalance in the body. At the first sign, you should consult a doctor. The specialist will fully assess the condition of women and select a qualified treatment.

Urethritis in girls

In girls, the inflammatory process from the urethra quickly spreads to the bladder, leading to the development of cystitis. Therefore, in pediatric urology, inflammation of the urethra in girls is usually called urethral syndrome, since in most cases it is not possible to determine with accuracy the localization of the focus of inflammation.

The following factors can lead to the development of urethritis in childhood:

• synechia of the labia minora;
• irregular urination;
• urolithiasis disease;
• hypothermia;
• abuse of salty or spicy foods;
• violation of hygiene rules.

One of the main symptoms of urethritis in young girls is urinary retention. Because of the expectation of pain, little patients refuse to sit on the potty or go to the toilet, and cry when urinating. With uncomplicated urethritis, the general condition of girls does not suffer. The development of complications may be accompanied by fever and the appearance of symptoms of intoxication.

The specificity of symptoms depending on the pathogen

There are many harmful microorganisms that provoke inflammation of the urethra in women. Symptoms of nonspecific urethritis are due to what pathogen provoked it. For instance:

1. Gonococcal infection causes gonorrheal urethritis in women. Gonococcal urethritis is manifested by profuse vaginal discharge.
2. Trichomoniasis causes severe overthrow and burning sensation in the vaginal area. There is also a separation of mucus of an unnatural color, which has a specific smell.
3. Mushrooms of the genus Candida provoke severe itching of the genital organs, external and internal burning.
4. Chlamydia bacteria. Their presence may be asymptomatic.
5. Koch's wand is a mycobacterium that causes an infectious disease - nephrotuberculosis, which provokes the occurrence of urethritis. It is manifested by a slight increase in body temperature and general malaise.

Diagnostics

The diagnostic program consists of a physical examination of the patient and the necessary diagnostic measures. During the initial examination, the doctor finds out the nature of the course of the clinical picture, collects an anamnesis.

Based on the data obtained, a diagnostic program is determined, which may include:

• UAC and BAC;
• urinalysis according to Nechiporenko or Zimnitsky;
• bacteriological examination of urine;
• ureteroscopy;
• ultrasound examination of the pelvic organs;
• analysis for Mycobacterium tuberculosis;
• STD test.

How to treat urethritis in a woman, the doctor determines only after the final diagnosis. In any case, treatment should be comprehensive.

Complications

In the case of a prolonged course of inflammation inside the urethra and the absence of therapy, the infection passes to neighboring organs of the genitourinary system, causing complications in the form of inflammation of the following organs:

• bladder (cystitis);
• pyelocaliceal system of the kidneys (pyelonephritis);
• vulva and/or vagina (vulvovaginitis, colpitis);
• ovaries and fallopian tubes (adnexitis);
• cervical canal (cervicitis);
• mucous membrane of the body of the uterus (endometritis).

Without treatment of complications, secondary infertility sometimes develops.

Treatment of urethritis in women

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

Until the culture results are obtained, a drug with a wide spectrum of action is selected. Regardless of the symptoms present, antibiotic therapy is indicated if:

• the presence of the causative agent of a venereal infection is confirmed;
• when examining a sexual partner (sex without barrier methods of contraception), a sexually transmitted disease was diagnosed;
• in the general analysis of urine there are signs of inflammation.

In all of the above cases, an antibiotic is prescribed, taking into account the cause of inflammation of the urethra.

The list of effective drugs for urethritis in women looks like this:

Type of urethritis	Most commonly used antibiotics
non-specific	Broad spectrum antibiotics: a group of cephalosporins (cefazolin, ceftriaxone, etc.); tetracycline, doxycycline; group of macrolides (erythromycin, azithromycin, clarithromycin); antibacterial drugs from the group of sulfonamides and fluoroquinolones.
herpesvirus	Antiviral drugs: Ganciclovir; Acyclovir; Famciclovir; Valaciclovir; Ribavirin; Penciclovir.
candida	Antifungal drugs: Nystatin; Levorin; Levorin sodium salt for the preparation of solutions; Amphotericin B; Amphoglucamine; Natamycin; Clotrimazole.
Trichomonas	Antibiotics: Metronidazole; Nimorazole; Nitazol; Benzydamine; Cidipol; Chlorhexidine; Iodovidone (in the form of vaginal suppositories); Tinidazole; Natamycin; Trichomonacid; Ornidazole; Furazolildone; Miramistin.
Gonorrheal	Antibiotics: Erythromycin; Olethetrin; Metacycline hydrochloride; Spectinomycin; Cefuroxime; Cefodizyme; Ceftriaxone; Fusidin-sodium; Oleandromycin; doxycycline hydrochloride; Rifampicin; Spiramycin; Cefaclor; Cefoxitin; Cefotaxime; Tienam.
Chlamydial	Antibacterial drugs from the Tetracycline group (Tetracycline, Doxycycline, etc.), Levomycetin, erythromycin, azithromycin, clarithromycin, drugs from the Fluoroquinolones group.
Mycoplasma	Antibacterial drugs from the Tetracycline group (Tetracycline, Doxycycline, etc.)

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

• limit the consumption of fatty, spicy, sour, highly salty foods;
• consume during the day a sufficient amount of liquid, at least 1.5 liters;
• avoid hypothermia;
• refrain from sexual intercourse until complete recovery;
• carefully follow the rules of personal hygiene.

Treatment of chronic urethritis

Chronic urethritis requires long-term and comprehensive treatment, which includes:

• antibiotic therapy, taking into account the sensitivity of the pathogen;
• antiseptic washing of the urethra;
• vitamin and mineral therapy.

In chronic urethritis of gonococcal etiology, an antibacterial drug is inserted into the urethra. If there are granulations, then collargol and silver solution are installed into the urethra, as well as bougienage and cauterization of the urethra with 10% - 20% silver nitrate solution (with pronounced narrowing).

In chronic trichomonas urethritis, installations of a 1% Trichomonacid solution into the urethra are carried out.

In chronic chlamydial urethritis, in addition to antibiotics, immunomodulators, interferon preparations, probiotics, enzyme therapy, vitamin therapy, hepatoprotectors, antioxidants are additionally prescribed.

Features of urethritis in pregnant women

Pregnancy is one of the factors predisposing to the occurrence of urethritis. The functions of the female immune system during the period of gestation are reduced, hormonal changes occur in the body, which can help reduce the body's resistance to bacteria.

Without treatment of complications, secondary infertility sometimes develops.

Treatment should be selected very carefully, since the use of most drugs during this period is contraindicated.

Folk remedies

In the complex therapy of urethritis, in agreement with the attending physician, infusions and decoctions of medicinal plants with diuretic, anti-inflammatory, antiseptic and antispasmodic effects can be used:

• infusion of parsley leaves;
• mood grass yellow Zelenchuk;
• infusion of black currant leaves;
• infusion of blue cornflower flowers; and etc.

Herbal preparations can be used both internally and externally - for example, in the form of medicinal baths.

Urethritis in women often occurs simultaneously with cystitis. This is due to the fact that the urethra in women is short (only 1-2 cm) and wide. Therefore, infectious agents from it easily penetrate the bladder, causing inflammation.

Other Therapies

As additional methods of therapy for inflammation of the urethra, the following are used:

1. Physiotherapy. It involves making daily lotions or sitz baths for the genitals. It is necessary to prepare a decoction of medicinal plants (chamomile, St. John's wort) and add it to the bath. Make lotions with the same solution, applying to the external genitalia. In the case when the urethra or bladder is inflamed, physiotherapeutic procedures are of great benefit and sense in therapy.
2. Lifestyle change. It is necessary to give up bad habits (smoking and drinking alcohol) at least for the duration of treatment. Alcohol and nicotine provoke an exacerbation of inflammation and prevent healing: they make medications ineffective, and inhibit the restoration of organs.

Prevention

Preventing a disease is much easier than treating it. In this case, it is enough to follow these simple recommendations:

• observance of intimate hygiene;
• exclusion of hypothermia;
• the use of hypoallergenic cosmetic care products;
• healthy intimate relationships - if necessary, you need to use special lubricants;
• STD prevention.

Be sure to undergo a preventive examination by a gynecologist at least once every six months. In the presence of chronic diseases or other predisposing factors, you need to visit a doctor more often.

Forecast

With timely detection and active treatment, urethritis in women usually ends in recovery. The transition of the disease to a chronic form may be accompanied by the development of complications, which worsens the prognosis.

Urethritis is an inflammatory process that occurs in the walls of the urethra.

Urethritis itself (as an independent disease) is more common in males. Women, along with inflammation of the urethra, also acquire inflammation of the bladder.

As soon as you suspect symptoms of urethritis, do not hesitate to contact your doctor. This disease can be caused by bacteria and viruses, the activity of which can subsequently lead to complications.

Most often, the disease occurs against the background of other diseases of the genitourinary system or pelvic organs, in addition, due to the structural features of the female urinary system, cystitis often develops almost simultaneously with urethritis. Therefore, every woman should know the symptoms and treatment of this disease.

Causes

What it is? Causes of urethritis include bacteria, fungi, and in some cases viruses such as the herpes simplex virus. Although usually only the urethra is affected, in some cases the vagina, fallopian tubes, uterus, and ovaries can also be affected. The E. coli bacteria that causes urinary tract infections can also cause urethritis.

Here are some situations or diseases that can cause this disease in women:

1. : The "Neisseria gonorrhoeae" organisms that cause gonorrhea can move up the female urethra during sex with an infected partner.
2. and herpes simplex are also common sexually transmitted diseases that can lead to this disease.
3. Insufficient hygiene: Poor vaginal hygiene can also cause problems. However, you should refrain from using strong-smelling soaps and perfumes in this area.

Forms of the disease

Depending on the cause, urethritis in women is divided into infectious and non-infectious. Infectious urethritis, in turn, can be of several types:

• nonspecific - most often caused by Escherichia coli, streptococci or staphylococci and proceeds as a classic purulent inflammation;
• specific - is one of the symptoms of sexually transmitted diseases (mycoplasmosis, chlamydia, trichomoniasis, gonorrhea, candidiasis);
• viral - caused by the herpes simplex virus or human papillomavirus (HPV).

According to the duration of the course, urethritis in women is divided into acute and chronic.

Signs of urethritis

The first signs of urethritis in women include:

1. Discharge from the urethra(the nature of the discharge depends on the pathogen, most often there are greenish or white-yellow or bloody discharge with an unpleasant odor).
2. Lower abdominal pain- it is constant, of low intensity.
3. Burning (itching) in the urethra, redness of the outlet of the urethra.

Most often, the symptoms of urethritis in women appear several hours or days after sexual intercourse.

Symptoms of urethritis in women

In acute urethritis, the characteristic symptoms in women are burning,. In some cases, there may be purulent discharge from the opening of the urethra.

In the future, pain and swelling become less pronounced, and the discharge may stop. Urine is usually clear with single purulent filaments.

In most cases, the acute form of urethritis is accompanied by frequent irresistible urge to urinate, as well as noticeable pain at the end of it.

Common symptoms of urethritis in women:

1. In acute urethritis, both in men and women, there is a decrease in appetite, weakness.
2. Subacute is characterized by a decrease in swelling and pain, the discharge becomes less abundant or stops completely. Crusts may come out of the urethra in the morning.
3. If there is trichomonas urethritis in women, symptoms develop several weeks after infection, while about a third of cases of the disease occur without specific manifestations. The disease is characterized by: itching and burning sensation in the urethra, as well as in the area of ​​the external genital organs. Chronicization of trichomonas urethritis leads to the disappearance of symptoms.
4. With insufficiently effective treatment, urethritis can provoke chronic development: complaints are usually associated with neurotic phenomena. Most often, these are small sections from the urethra, which increase under the influence of provoking causes: alcohol consumption, hypothermia, sexual arousal. Symptoms of chronic urethritis often resemble the clinical manifestations of torpid urethritis.
5. Candidal urethritis with yeast infection of the urethra. It is accompanied by mild symptoms: minor, discomfort in the lower abdomen, itching in the urethra.

If urethritis in women is not cured in a timely manner or the treatment was not prescribed correctly, then the disease can become chronic, in which case it will be much more difficult to treat the disease.

Chronic urethritis

It is accompanied by periodic cramps during urination and sharp pains in the lower abdomen that occur from time to time. Acute symptoms of inflammation of the urethra in women disappear within 2-2.5 weeks. This does not mean that the disease has disappeared. On the contrary, this is a reason to go to a specialist to start treatment, until the pathogens have penetrated much deeper during the “dormant” stage.

The most common causes of this type of disease are local and general hypothermia, excessive alcohol consumption and frequent sexual intercourse.

Complications

With untimely access to a doctor and the transition of malaise into a chronic form, complications of urethritis occur. The most serious complication is the condition in which the urethra (urethra) bakes and hurts, the inability to eliminate pain in any way.

Another disease of the urethra in women can give complications to the bladder and kidneys: provoke cystitis or pyelonephritis, transform into purulent urethritis in women. With a neglected form, a urethral cyst may form, its narrowing or restriction of the urethra.

Treatment of urethritis in women

In the case of uncomplicated urethritis, treatment does not require hospitalization and occurs at home. A woman needs to clearly follow the doctor's prescriptions and periodically visit the clinic to monitor the progress of therapy.

Depending on the symptoms of urethritis, the appropriate treatment is prescribed, it will depend on the pathogen.

During the period of therapy should:

• avoid hypothermia;
• refrain from sexual intercourse (even with a condom) until a complete cure;
• strictly follow the rules of personal hygiene.

In most cases, the treatment of urethritis in women is limited to a course of antibiotics, they are actively fighting the causative agent of the disease, which was found during sowing.

How to treat utretritis in women can be divided into 3 main points:

1. The use of complex actions aimed at restoring the properties of the walls of the urethra. Of particular importance, this action acquires when diagnosing complex forms of the disease, when inflammation is no longer directly associated with infection.
2. Restoration of the microflora of the vagina. Urethritis will return again and again until the infection of the urethra by certain microorganisms from the vagina stops. There is only one way to break this vicious circle - to populate the vagina with microorganisms that should be there. This action is selected individually for each patient.
3. Work on the restoration of the immune system. With long-term treatment and inflammation of the urethra, immunity often suffers, both of the whole organism as a whole and of the wall of the urethra. As in the previous paragraph, an individual course of restoration of the immune system is prescribed. Therefore, weak immunomodulators will not give anything without additional actions and drugs.

Drug therapy depends on the diagnosed form of urethritis:

Nonspecific urethritis	Broad-spectrum antibiotics are shown: cephalosporins (cefazolin, cefotaxime, ceftriaxone); sulfonamides (sulfazol, urosulfan); macrolides (azithromycin, clarithromycin); fluoroquinolones (clinafloxacin).
Gonococcal	Antibiotics are prescribed: erythromycin, spectinomycin, oletethrin, ceftriaxone, cefuroxime, rifampicin, cefacor, etc. those that have a detrimental effect on chlamydia. But in each case, the drug is selected individually.
Trichomonas	The doctor may prescribe: the antimicrobial drug metronidazole (trichopol), as well as the drugs of choice - benzydamine, imorazole, ornidazole, chlorhexidine, iodovidone suppositories.
Candidiasis	It requires the use of antifungal drugs: levorin, nystatin, natamycin, amphoglucamine, clotrimazole.
Mycoplasma	It is treated with antibiotics from the tetracycline group (doxycycline, tetracycline).
Chlamydial	Antibiotics from the tetracycline group (tetracycline, doxycycline), erythromycin, clarithromycin, azithromycin, clinafloxacin have proven themselves well.
Viral	Treatment with antiviral drugs is often indicated - ganciclovir, acyclovir, ribavirin, famciclovir, penciclovir, etc.

At the end of this course of treatment, in most cases, all symptoms and pain disappear, but there are rare cases when traditional treatment does not help. This usually happens with advanced forms of urethritis, when the infection is gone and the symptoms remain.

A diet should become an obligatory component of treatment - salty and spicy foods, marinades and smoked meats are excluded from the diet, drinking plenty of water and observing a dairy-vegetarian diet during the acute stage (exacerbation of chronic inflammation) is shown.

During this period, it is important to reduce physical activity, exclude alcoholic beverages, smoking and hypothermia, and limit sexual contacts.

Drugs for the treatment of urethritis

Now a few words about how to treat urethritis in women, and what drugs are considered the most effective in the fight against this unpleasant disease. In the treatment of inflammatory lesions of the urethra, the following groups of medicines are used:

1. Antibiotics are essential to help fight infection. Their reception is possible only after a series of tests that determine the sensitivity of the infection to certain antibiotic drugs. Taking a general antibiotic without first determining the pathogen, in some cases, you may not achieve the effect of treatment.
2. Special antiseptic sitz baths, which will additionally help neutralize the infection.
3. Physiotherapy, involving the use of electrophoresis on disease areas, heating applications.
4. Tampons treated with medicated ointments that are inserted into the vagina.
5. All kinds of means that stimulate, support the immune system - immunomodulators, immunostimulants.
6. The vitamin complex will also help the body cope with urethritis.

Together with drug treatment, physiotherapeutic procedures are prescribed (vaginal electrophoresis or on the pubic area with Furadonin solution, diadynamic therapy of the lumbosacral zone). To increase immunity, immunomodulators, multivitamins are used.

Prevention

Prevention of urethritis in women includes the following activities:

• hormone replacement therapy for menopausal disorders;
• avoidance of physical and mental stress;
• careful observance of the rules of personal hygiene;
• avoidance of hypothermia;
• prevention of artificial termination of pregnancy;
• regular sex life with a regular partner, refusal of casual sex;
• preventive examinations at the gynecologist at least 2 times a year (according to indications more often).

Forecast

With timely detection and active treatment, urethritis in women usually ends in recovery. The transition of the disease to a chronic form may be accompanied by the development of complications, which worsens the prognosis.

Burning and discomfort during urination in women may indicate inflammation of the urethra. The urethra of a woman is susceptible to all sorts of infections and irritations. This is due to its anatomical location between the vagina and the anus, which are potentially dangerous due to the possibility of the penetration of pathogenic bacteria into the external opening of the urethra. There are other causes of urethritis associated with mechanical irritation, allergies, viruses, and fungal infection.

What is urethritis in women

The urethra (synonym: urethra) is an organ with the function of removing fluid from the bladder into the external environment. It is a single tube through which urination occurs in both women and men.

The urethra is a tubular organ that connects the bladder to the outside

At any age, for various reasons, inflammation of the urethra, or urethritis, can develop. This fact applies to both sexes. However, women are at increased risk, due to the peculiarities of the structure of the genitourinary system of the fair sex. The female urethra is located in the pelvic area between the pubis and the vagina, its external opening extends into the region of the vaginal vestibule behind the clitoris. Anatomically, the organ is wider and shorter (about 4 cm) than in men (equal to the length of the penis), which means that bacteria enter the woman's urethra easier and faster.

Female urethritis in most cases is caused by bacterial pathogens and is manifested by painful urination and frequent trips to the toilet. It is not necessary, however, to identify urethritis with a urinary tract infection. Doctors distinguish between these conditions, despite the fact that they may have similar manifestations. The approach to treatment differs and depends on the underlying cause of the inflammation.

Types of disease and causes of infection

The main role in the development of inflammation of the urethra belongs to different types of infections, less likely causes include mechanical irritation or other non-infectious factors. Thus, urethritis is of two main types:

• infectious, which is caused by a certain type of pathogen (bacterial or viral);
• non-infectious, which is not associated with a specific pathogen.

Infectious urethritis is further divided into two large groups:

• gonococcal, which develops as a result of infection with a bacterium that causes gonorrhea (about 20% of cases);
• non-gonococcal, which is caused by other pathogens (chlamydia, trichomonas, mycoplasma, candida fungus, herpes or papillomaviruses, cytomegalovirus).

When urethritis has a set of symptoms characteristic of a particular type of pathogen, then such inflammation is called specific for this type of pathogen. Nonspecific infectious urethritis proceeds as a classic inflammatory reaction inherent in the body as a response to most types of infectious pathogens.

Non-infectious inflammation can be due to the following reasons:

Sometimes patients find a combination of several causes for inflammation.

Infection of the urinary canal occurs in one of two ways: as a result of sexual intercourse with an infected person (genital route) or from any focus of chronic inflammation in the body through the bloodstream (hematogenous route). Such foci can be purulent tonsils, inflammation of the maxillary sinuses, caries.

For the first time developed urethritis is referred to as acute inflammation. If, after a successful recovery, the disease recurs after 2-3 months, this indicates a chronic course of the inflammatory process.

Risk factors

Additionally, various conditions that negatively affect or exert a noticeable burden on the immune system contribute to the development of urethral infection. These states include:

• postoperative period;
• chronic or recent acute illnesses;
• poor diet,
• violations of the rules of intimate hygiene (untimely / improper washing);
• pregnancy;
• hypothermia;
• chronic stress;
• alcohol abuse.

Symptoms of inflammation

For female urethritis, severe symptoms are not typical. Specific manifestations are rare. The incubation period can range from 1 day to several weeks after infection. During this time, there are no signs of inflammation. Gradually, the following general signs and symptoms may appear:

• increased amount of urination;
• discomfort during a trip to the toilet;
• burning or irritation in the urethra;
• unusual vaginal discharge;
• purulent discharge or impurity (with an advanced form of the disease);
• elevated temperature;
• pain in the lower abdomen.

Urethritis - inflammation of the urethra as a result of an infectious or other lesion of the organ wall

Noninfectious urethritis does not cause fever, lower back or lower abdominal pain, or blood in the urine. Such symptoms indicate the presence of an infection, which means that it is necessary to consult a doctor for diagnosis and treatment.

In about half of the cases of diseases in women, there are no symptoms at all, especially if the causative agent is chlamydia or mycoplasma. The asymptomatic course of the disease is dangerous because the patient is a distributor of the infection, and in addition, she herself is in a situation that threatens with complications against the background of apparent well-being.

For this reason, it is important to get checked regularly. It will accurately indicate the presence or absence of sexually transmitted infections (STIs).

How is urethritis diagnosed?

Diagnosis of the disease in women, as in men, is carried out by a urologist. Initial physical examination may reveal an increase in size and redness of the external opening of the urethra and the surrounding area. Touching the inflamed area is painful and unpleasant.

The set of mandatory analyzes includes:

1. Clinical (general) analysis of urine, blood.
2. Urinalysis according to Nechiporenko is a special test that determines the number of leukocytes and erythrocytes in 1 ml of urine; used to detect inflammatory processes in the urinary system.
3. Urine culture and a pathogen sensitivity test to antibiotics - an analysis to identify a possible causative agent of infectious inflammation and determine its sensitivity to different types of antibacterial drugs. It is carried out by the method of sowing urine on special nutrient media. The result must be expected within 4 weeks, sometimes longer. May include a test for Mycobacterium tuberculosis (Koch's bacillus) of the genitourinary system.
4. A smear from the urethra is a sampling of biomaterial from the area of ​​inflammation for further study by PCR diagnostics. This modern method is highly accurate, since it is based on the study of DNA or RNA molecules that any virus or pathogenic microorganism contains.

Urethroscopy - examination of the inner surface of the urethra using a medical endoscope

Instrumental diagnostic methods are represented primarily by ureteroscopy. The examination is carried out using an endoscopic device in the form of a tube with an optical device, which is inserted into the urethra to examine the inner surface of the organ. At the same time, the doctor has the opportunity to collect biological material for analysis. Ultrasound diagnostics makes it possible to assess the overall picture of the state of the pelvic organs.

The final differential diagnosis is carried out by a specialist according to the results of the tests, since even specific symptoms do not give an unambiguous answer to the question of the type of pathogen. The correct prescription of therapy directly depends on the accuracy of the diagnosis.

Differential diagnosis of infectious urethritis varieties - table

Type of infectious urethritis	Specific Symptoms
Gonorrheal	The first symptoms appear a few weeks after infection and include: pain and cramps when urinating, urinary retention, turbidity of urine, greenish discharge from the urethra. Without timely treatment, the disease becomes chronic, in which symptoms may be absent.
Trichomonas	One third of episodes of Trichomonas urethritis are asymptomatic. In other cases, symptoms appear 2-3 weeks after infection. Characterized by itching and burning in the vulva and urethra, frothy greenish-yellowish discharge.
candida	In addition to painful urination, this type of urethritis is characterized by the presence of a moderate amount of whitish discharge of a thick consistency.
Mycoplasma	Mucous discharge from the vagina with an unpleasant odor, discomfort and burning sensation when urinating, pain in the lower abdomen.
Chlamydial	Yellowish vaginal discharge, painful urination, fever (not always).
tuberculosis	It usually develops in the complex of tuberculosis of the genitourinary system. Characteristic signs (in addition to the general signs of urethritis): weakness, excessive sweating, subfebrile temperature, blood in the urine, frequent urination.

Features of the treatment of different types of urethritis

Antibiotic therapy is the basis for the treatment of infectious inflammation of the urethra. In some cases, antiviral or antifungal agents are used, depending on the diagnosis. The drug is selected based on the specific type of pathogen. The course of treatment takes place at home and takes about a week. The tablet form of drugs is mainly used, less often - antimicrobial ointments, topical creams, antiseptic solutions. Hospitalization may be necessary in rare complicated cases.

Drug therapy

Nonspecific inflammation is treated with broad-spectrum antibiotics, these include drugs from the following groups:

• cephalosporins (ceftriaxone, cefazolin, cefotaxime);
• sulfonamides (Urosulfan, Sulfazol);
• macrolides (Azithromycin, Clarithromycin);
• fluoroquinolones (Levofloxacin, Clinafloxacin, Oflosacin).

The gonococcal type of inflammation is treated with antibacterial drugs that are active against the causative agent of gonorrhea - Neisseria gonorrhoea. These include:

• antibiotics of the cephalosporin group (Ceftriaxone, Cefuroxime, Cefacor);
• combined antimicrobials (Oletetrin);
• aminocyclitol antibiotics (Spectinomycin);
• anti-tuberculosis antibiotic active against gram-positive and gram-negative cocci (rifampicin);
• macrolides (erythromycin).

If it is established that the causative agent is chlamydia or mycoplasma, then the drugs of choice are:

• tetracyclines (Tetracycline, Doxycycline);
• macrolides (Azithromycin, Clarithromycin, Erythromycin);
• fluoroquinolones (oflosacin, clinafloxacin).

Trichomoniasis, as one of the causes of urethritis, is treated with the antimicrobial agents Trichopolum (Metronidazole) or Ornidazole, as well as a nitroimidazole antibiotic called Nimorazole. In the complex of therapy, local antiseptics and anti-inflammatory drugs can be used:

• Benzydamine;
• Chlorhexidine;
• Yodovidone (candles).

Antimycotic drugs, such as Clotrimazole, Nystatin, Levorin, are used in the inflammatory process caused by the Candida fungus. Clotrimazole is applied topically in the form of an ointment, as well as in the form of tablets for oral administration.

Viral urethritis is treated with antiviral agents, which may include:

• Acyclovir;
• Ribavirin;
• Penciclovir.

If the drug is chosen correctly, then the first improvements can be observed 1-2 days after the start of therapy. If the disappearance of symptoms occurred before the course of treatment prescribed by the doctor ended, it is necessary to take the medicine for as many days as recommended by the specialist, otherwise the infection may resume with renewed vigor.

If urethritis is associated with a sexually transmitted disease, then the patient's sexual partner must be diagnosed and, if necessary, treated. Sexual life can be resumed no earlier than 1 week after the complete recovery of both partners.

Treatment of the chronic form

A protracted or recurrent course of the disease requires an integrated approach to treatment with a versatile effect on the focus of inflammation. This approach includes not only systemic antibiotic therapy, but also local antiseptic treatment with solutions (for example, Chlorhexidine) or anti-inflammatory ointments (Cycloferon, Viferon), which have an additional immunomodulatory and antiviral effect. Therapy includes taking multivitamin complexes and drugs to increase the body's immune forces (for example, based on Echinacea purpurea), taking probiotics and hepatoprotectors (in the treatment of chlamydia).

Instillation into the urethra - a procedure for dripping a medicinal solution into the urethra

In chronic urethritis of gonococcal origin, drip infusions of liquid medicines (antibiotic solutions) are performed into the opening of the urethra. In the presence of strictures (narrowing of the canal lumen), colloidal silver instillations into the urethra are used, as well as the bougienage procedure - the introduction of a hard or soft metal rod (bougie) into the canal cavity in order to expand it. In this case, the diameter of the rod is gradually increased to a predetermined size.

If chronic urethritis is caused by the mechanical impact of the catheter or other trauma, then the decision to prescribe antibiotic therapy to prevent infection is made by the doctor. Sometimes a course of antihistamine (antiallergic) drugs is shown, the action of which relieves swelling and irritation.

Dieting

1. Caffeinated drinks and sweets such as coffee, tea, cola, chocolate. It is better to reduce or exclude these drinks as much as possible, replacing them with bottled drinking water.
2. Fruits and vegetables rich in natural acids, such as citrus fruits: lemons, limes, oranges, grapefruit, tomatoes. It is necessary to limit only temporarily until recovery occurs.
3. Spicy foods and products, such as horseradish, mustard, hot peppers, barbecue sauce, spicy snacks (chips, croutons, crackers).
4. Alcoholic drinks. It is desirable to exclude completely for the entire period of treatment.

It is useful to use freshly squeezed carrot juice, mixed in equal proportions with apple or celery, which is a recognized remedy for the symptoms of urethritis.

Recipes of folk healers

Some well-established alternative methods of treatment can be used as part of complex therapy if the attending physician approves of such actions. Effective folk methods are easy to use and not dangerous in terms of side effects, they include:

1. Baths or lotions with essential oils. Add a few drops of essential oil of cypress, pine (which is especially useful), or parsley to clean, cool water and rinse the external opening of the urethra with it. You can also moisten a clean soft cloth, towel or cotton wool with water, applying it to the inflamed area for several minutes. This remedy has an anti-inflammatory, analgesic and antiseptic effect. It can be applied as needed.
2. Cranberry juice. The most effective remedy for inflammation and urinary tract infection. Cranberries stimulate the production of hippuric acid in the urine, which inhibits the growth of bacteria that cause urethritis. It also prevents pathogens from attaching to the urinary tract mucosa. To prepare the drug, squeeze the juice from the washed fresh berries. The resulting concentrate is mixed in half with boiled water. If desired, add honey to taste. Take from 2-3 glasses of fruit drink per day. In some people, cranberries can cause a hypersensitivity reaction in the form of a rash or indigestion. In this case, treatment with this remedy is stopped.
3. Soda solution. A common problem with urethritis is urine, which irritates the lining of the urinary tract and causes a burning sensation when going to the toilet. To neutralize excess acid in urine, people use a solution of soda inside. The therapeutic effect of sodium bicarbonate is expressed not only in the more gentle effect of alkaline urine on the walls of the urethra, but also in the fact that the alkaline environment ensures the natural death of harmful microbes. To prepare a solution, 1 teaspoon of soda is poured into 250 ml of hot drinking water. A fizzy reaction occurs. It is necessary to wait until the solution cools down a bit and drink in small sips. Take 1-2 glasses of solution per day.

Alternative treatment of urethritis - gallery

Cypress Oil Helps Relieve Burning and Discomfort from Urethritis Cranberry juice prevents the reproduction of bacteria in the urinary tract Baking soda is a great way to alkalize urine

Treatment prognosis and possible complications

The disease is most often effectively and quickly treated if the infection has not had time to spread to other organs of the urinary system. In advanced cases, when the bladder or kidneys are involved, treatment is much longer, and complications are potentially dangerous to health.

Sexually transmitted diseases, common causes of inflammation of the urethra, threaten women with the development of chronic inflammation of the reproductive organs and potential infertility. Other complications include chronic pain in the lower abdomen, discomfort during intercourse. Women with untreated sexual infections are more susceptible to ectopic pregnancy, which carries a serious risk to life.

Preventive measures

The transmission of most pathogens that cause inflammation of the urethra occurs through sexual contact. Therefore, sexual intercourse precautions help to prevent undesirable consequences to a large extent. A few simple rules below will help protect yourself from contracting STIs and their consequences in the form of urethritis:

1. Avoid sexual relations with several partners at the same time.
2. Use condoms during intercourse with a casual or non-regular partner.
3. Regularly undergo a medical examination and take the necessary tests.
4. If you become aware that you have an STI, be sure to tell your loved ones who are in close contact with you so that they can take protective measures regarding their health.
5. Remove wet swimwear or swimming trunks immediately after swimming.
6. Do not sit on extremely cold or hot surfaces.

Other prevention methods include drinking plenty of fluids, preferably clean drinking water. This technique will speed up the process of urine production. So the infection will be washed out of the body in a natural way. It is not recommended to abuse foods and drinks that irritate the urinary tract, as well as to use cosmetics for intimate areas (sprays, lubricants, etc.) that irritate the mucous membrane or cause allergies.

Causes and symptoms of urethritis: video

Urethritis is a common infection that is successfully treated and rarely causes complications. Do not ignore any symptoms of discomfort during urination, as well as the presence of unusual discharge, in order to prevent the transition of the disease into a chronic form, which is more difficult and longer to treat than acute inflammation.

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What it is? 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, it 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 mucosal 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 meeting with 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, outgoing 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 triggers are:

• Trichomonas vaginalis;
• 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, 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 weakened immunity due to:

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

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 vivid 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;
• recurring aching painful symptoms in the pubic area;
• manifestation of urethral discharge with purulent inclusions;
• the appearance of bloody impurities in urine;
• feeling of "stuck together" urethra in the morning.

At the same time, the manifestation of signs of urethritis is not necessarily 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 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 when symptoms appear, since in a chronic course, there may be no signs of the disease.

2) Trichomonas urethritis has a latent period of 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. With the chronicization of the process, the signs generally disappear.

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 tuberculous 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 - complex 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:

1. Preparations of the cephalosporin group: Cefotaxime, Cefazolin, Ceftriaxone. Means of the sulfanilamide group in the form of "Sulfazol" or "Urosulfan". Macrolide antibiotics: Azothromycin or Clarithromycin. Means of the fluoroquinolone series of the "Clinafloxacin" type.
2. Venereal infections are stopped by "Erythromycin", "Tetracycline", "Cefuraxime", "Oletetrin", "Rifampicin", etc.
3. With fungal genesis, antifungal drugs are selected - Natamycin, Levorin, Nystatin and Clotrimazole.
4. Antimicrobials and analogues of "Benzydamine", "Ornidazole", "Metronidazole", "Chlorhexidine".
5. With a viral etiology of the disease, antiviral agents are indicated: Anciclovir, Famciclovir, Ganciclovir, Ribavirin.

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 (appointment of one antibiotic), combined schemes of 2, 3, and 4 phase treatment.

Treatment with antibiotics 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 treatment with enzymes (enzyme therapy);
• immunomodulating 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.

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.

Sometimes they manifest themselves in the form of irreversible changes in the urethral canal itself - the narrowing of its vessels, the so-called proliferation of scar tissue. All this can be avoided if you do not self-medicate, but entrust yourself to a specialist.

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 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, 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;
• trauma;
• hypothermia;
• stress;
• exacerbation of other diseases of the urinary and reproductive spheres.

The cause of urethritis in women can also be, and. 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, according to signs 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 nonspecific (E. coli, staphylococci, streptococci).

Symptoms

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 - pain with urethritis persists all the time of emptying the bladder;
• itching of the vulva and vagina, which increases immediately 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:

1. Trichomonas. A few weeks after infection, symptoms of the Trichomonas urethritis variant will be observed - intense, exhausting itching, not stopped by local baths and frequent showers. An unpleasant burning sensation in the area of ​​​​the inflammatory focus, as well as in the genital area. When the process is chronic, the symptoms disappear.
2. Gonoea. For gonorrheal urethritis in the acute stage is characterized by a sharp soreness with pain when emptying the bladder. A distinctive feature is a pronounced discomfort in the projection of the urethra with a delay for any reason of urination.
3. Candida (fungus). Often, urethritis provoked by fungal microflora is disguised as. A woman is worried about severe pain when visiting the toilet room. In addition, whitish, viscous discharges are observed. Symptoms are moderate.
4. Chlamydia. The defeat of chlamydia in most cases is completely asymptomatic. Women most often do not pay attention to mild itching. Concern is caused only by discharge that appears by the end of the first month after infection.
5. Mycoplasma. The mycoplasmal variant of urethritis develops gradually, the patient may be disturbed only by slight itching, as well as discomfort during the act of urination. Timely detected urethritis in a woman, with treatment carried out according to accepted standards, contributes to a quick recovery.

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 the stage of remission is asymptomatic, 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 inflammation of the urethra occurs together with cystitis or thrush (colpitis), the symptoms may include both discharge and pain in 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 doesn’t matter what kind of chronic or recurrent urethritis a woman has, the first method for diagnosing a disease is a doctor’s examination and laboratory tests, which include:

• bacteriological culture of urine, which allows you to determine which drugs will be most effective in each case;
• a general urine test, 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 if mucus or pus is released from the urethra;
• smears from the urethra to detect the concentration of leukocytes and sensitivity to antibiotics;
• ureteroscopy - 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 develops.

Running 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:

1. Broad-spectrum antibiotics are prescribed as soon as the diagnosis is made, without waiting for the results of bakposev. In case of non-gonococcal urethritis (if no sexually transmitted infection is detected in the smear), antibacterial drugs of different groups are used in the treatment of women, of which azithromycin, clarithromycin, ofloxacin, ciprofloxacin, amoxiclav, etc. are most often prescribed.
2. Local treatment: medicinal herbs in the form of decoctions with anti-inflammatory properties (calendula, chamomile, knotweed) and antiseptic solutions (potassium permanganate) in the form of trays.
3. Physiotherapeutic treatment - electrophoresis, warming applications.
4. Installations into the urethra of uroseptics - chlorhexidine, protargol, collargol.
5. Compliance with the diet: pickled, spicy, salty, smoked foods are excluded, a large amount of liquid is shown and the transition to lactic acid foods.
6. Exclusion for the period of treatment of alcohol, smoking, limitation of physical activity, sexual intercourse, hypothermia.

The main and most effective treatment for 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 should be highly sensitive to the selected drug.

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

Type of urethritis	Therapy
Gonococcal	Antibiotics are indicated for gonorrheal urethritis: erythromycin, spectinomycin, oletethrin, ceftriaxone, cefuroxime, rifampicin, cefacor, etc. those that have a detrimental effect on chlamydia. But in each case, the drug is selected individually.
Chlamydial	With chlamydial urethritis, antibiotics from the tetracycline group (tetracycline, doxycycline), erythromycin, clarithromycin, azithromycin, clinafloxacin have proven themselves well.
Trichomonas	With trichomonas origin of urethritis, the following is prescribed: the antimicrobial drug metronidazole (trichopol), as well as the drugs of choice - benzydamine, imorazole, ornidazole, chlorhexidine, iodovidone suppositories.
Candidiasis	Candidal urethritis requires the use of antifungal drugs: levorin, nystatin, natamycin, amphoglucamine, clotrimazole.
Viral	With a viral origin of urethritis, treatment with antiviral drugs is indicated - ganciclovir, acyclovir, ribavirin, famciclovir, penciclovir, etc.
Mycoplasma	Mycoplasma urethritis is treated with antibiotics from the tetracycline group (doxycycline, tetracycline).
non-specific	With nonspecific urethritis, broad-spectrum antibiotics are indicated: cephalosporins (cefazolin, cefotaxime, ceftriaxone); sulfonamides (sulfazol, urosulfan); macrolides (azithromycin, clarithromycin); fluoroquinolones (clinafloxacin).

With urethritis, antibacterial drugs with a wide spectrum of action are initially prescribed. This is done in order not to waste time and not start an infection, since bacteriological examination and setting the sensitivity of bacteria take some time.

Also during the period of treatment should:

• avoid hypothermia;
• refrain from sexual intercourse (even with a condom) until a complete cure;
• strictly follow the rules of personal hygiene.

In addition, it is recommended to limit the consumption of fatty, sour, spicy, salty foods. It is imperative to normalize the drinking regimen and drink at least one and a half liters of free liquid (in addition to liquid in dishes) per day.

What is needed for prevention?

To prevent urethritis, a woman should exclude possible ways of infection. For this:

1. Do not neglect personal hygiene, regular washing with the use of weak disinfectants;
2. You should be more selective about sexual partners, exclude unprotected sex and casual contacts;
3. Exclude from food products that irritate the urinary organs (spicy spices, pickles, canned food, smoked meats);
4. Do not use for hygiene alcohol solutions, soap, leading to severe irritation of the urethra;
5. Monitor the condition of the teeth, treat tonsillitis and other acute bacterial infections in a timely manner;
6. Dress according to the weather, avoid hypothermia, do not wear trousers that sharply squeeze the stomach (cause stagnation in the pelvis).

Although urethritis is not a fatal disease, it leads to serious disruptions to a woman's health.

Forecast

With timely detection and active treatment, urethritis in women usually ends in recovery. The transition of the disease to a chronic form may be accompanied by the development of complications, which worsens the prognosis.