urethritis

Urethral inflammation: description

Urethral inflammation is one of the lower urinary tract infections. The urethra is the last part of the urinary system. The urine passes through the urethra from the urinary bladder. In urethritis, the mucous membrane of the urethra is inflamed, which can lead to an unpleasant burning during urination and outflow.

Men and women are equally affected by urethritis. However, the age group of 20 to 24 years is most affected by urethritis, which is attributed to the pronounced sexual activity in this age group. In men, the complaints of urethritis due to the longer urethra are usually much more pronounced. Women, on the other hand, do not notice urethritis in many cases, as their symptoms are often very weak.

Urethritis is divided into two forms: specific urethritis and nonspecific urethritis. In specific urethritis, the sexually transmitted bacterium Neisseria gonorrhoeae (gonococci) is responsible for urethritis. The infection with this bacterium leads to the venereal disease gonorrhea. The nonspecific urethritis, however, is caused by various other bacteria. Chlamydia, mycoplasmas and intestinal bacteria are among the most common causes of nonspecific urethritis.

Urethritis is diagnosed using urine cultures and a swab of the urethra to identify the pathogen. This allows a specific antibiotic therapy, which usually achieves a complete cure.

Urethritis: Symptoms

The symptoms of urethritis are similar to the symptoms of bladder inflammation: Many sufferers suffer from itching and burning of the urethra. This can make urination very painful. Also, a glassy-turbid, or purulent discharge (Fluor urethralis) from the urethra occur, which is very unpleasant for many sufferers. Sometimes the exit of the urethra may be reddened on the genitals.

The complaints of urethritis are different in women and men pronounced: In women, the complaints are usually much weaker and many report only an unpleasant feeling when urinating. As a result, the urethritis in women remains undetected longer. Treated too late, however, the urethritis can spread further up to the fallopian tubes and ovaries, causing serious consequences such as infertility. Men, on the other hand, usually have very severe symptoms, as they have a significantly longer urethra and the inflammation therefore affects a larger mucous membrane area. In addition, the inflammation can spread to the prostate and testes.

Urethral Inflammatory Symptoms Overview:

Urethritis – man

• usually very pronounced complaints
• Burning in the urethra (at rest and while urinating) so-called “Bonjour drops”: purulent discharge from the urethra in the morning before the first urination (especially typical of gonorrhea)

Urethritis – woman

• usually mild or no complaints
• Burning in the urethra (at rest and when urinating)
• discharge
• Lower abdominal pain

Urethral inflammation: causes and risk factors

In principle, women and men are equally affected. In most cases, the urethritis is due to a bacterial infection after unprotected sexual intercourse. The most common bacterial pathogens of urethritis include chlamydia (Chlamydia trachomatis, about 25 percent of all urethritis) and gonococci (Neisseria gonorrhoeae, about 20 percent). In addition, there are a number of other bacteria that can trigger a urethritis.

Since most of the bacteria are transmitted through sexual intercourse, the best way to prevent infection is to use condoms during sexual intercourse. While these do not provide 100% protection, they can prevent infection in many cases.

People who spend a long time in the hospital and in which the urine is discharged via a urinary bladder catheter are particularly at risk for urethritis: For a long-time lying bladder catheter irritates the urethra mechanically. As a result, their mucosa becomes more sensitive to germs and has fewer opportunities for their defense. An injury to the urethra after insertion of sharp objects (for example, by autoerotic practices) also promotes the occurrence of urethritis.

Urethritis: examinations and diagnosis

For the diagnosis of urethritis, the description of the symptoms already provides important information. This is followed by a physical examination in which the doctor can determine whether the urethral orifice is externally visibly inflamed and reddened.

For further clarification, a smear is usually taken from the urethra. For this, a sample is taken from the anterior urethra using a cotton swab or a small spatula. The tissue sample is then examined under the microscope. However, a urine culture is essential for the safe identification of the causative bacterium. It tries to multiply the bacteria from a urine sample in special nutrient media so strong that they can be reliably detected. It is important to use the first ray of the morning urine, as it flushes most of the bacteria out of the urethra. If the midstream urine is used, the bacteria can usually no longer be sufficiently detected. The installation of a urine culture has another benefit: if enough bacteria are present, then the effectiveness of various antibiotics can be tested in advance (antibiogram).

Urethritis: treatment

The therapy of urethritis always depends on the triggering factor. In a bacterial infection, the administration of antibiotics is usually indispensable. Depending on the pathogen, the appropriate antibiotic is selected. Chlamydia are treated with an antibiotic from the group of macrolides. These include agents such as erythromycin or clarithromycin. The antibiotic inhibits the growth of bacteria, which prevents them from multiplying. In the case of an infection with gonococci, an antibiotic from the group of cephalosporins is effective. It is also advisable to co-treat the partner, so that both do not catch each other again and again (“ping-pong effect”).

Home remedies urethritis

In addition, there are some home remedies that can support the recovery process in urethritis. It is especially important to drink a lot during the inflammation. Because even if the frequent urination is unpleasant, the bacteria are flushed out of the urethra more easily by the increased urination.

It is also an advantage to keep your feet warm. Because the blood circulation of the feet influences the blood circulation of the urinary tract via nerve-vessel reflexes. Sufficient blood supply in turn supports the defense mechanisms of the body.

Certain fruit juices such as cranberry juice, cranberry juice or currant juice additionally acidify the urine, which makes it difficult for the bacteria to multiply. There are already ready bubble blends in the trade, which should support a cure of urethritis.

The consumption of alcohol should be avoided for the duration of the infection, as it weakens the immune system and inhibits the body’s own protective mechanisms. Sexual intercourse or masturbation, where sex toys could irritate the urethra, should also be avoided during the disease phase.

Urethral inflammation: disease course and prognosis

The course of urethritis depends on the cause. In women, the urethritis often mild or even without complaints. In the case of a bacterial disease, treatment with the right antibiotic leads to a good prognosis. Consequential damages occur only rarely with a timely and consistently finished treatment. When taking antibiotics, it is important that they continue to be taken even after the symptoms have resolved until the period of treatment prescribed by the doctor has been reached. This is very important to avoid the formation of resistance to antibiotic agents among the bacteria. The inflammation of the urethra usually clears quickly with the right antibiotic therapy.

Possible complications

Nevertheless, complications can sometimes occur during urethritis. Chlamydia can cause inflammation of the prostate (prostatitis) or inflammation of the epididymis (epididymitis) in men with urethritis. These inflammations are often accompanied by fever.

In women, urethritis can also cause serious complications. In particular, because the infection often remains undetected for a long time due to the usually mild symptoms. For example, the infection may continue to rise and cause inflammation of the fallopian tubes (salpingitis) or ovaries (adnexitis). This type of complication is often accompanied by fever, chills and pelvic pain. There is a risk that the fallopian tubes may stick together as a result of inflammation (tube adhesion) and result in infertility.

In pregnancy, urethritis caused by chlamydia is particularly dangerous. Because chlamydia can lead to severe conjunctivitis in the unborn child, which can even lead to blindness.

One speaks of a so-called “Reiter syndrome” if in addition to the inflammation of the urethra conjunctivitis and a reactive inflammation of the joints (arthritis) are present. However, in most cases, this disease heals by itself.

To one Harnröhrenentzündung, the use of condoms during sexual intercourse makes sense. Also a strong immune system and a sufficient daily amount of drinking are of great importance.