Urethritis

Urethritis is an inflammation of the mucous membrane of the urinary canal. There are urethritis infectious and non-infectious.
Infectious urethritis cause various pathogenic microorganisms, fungi, viruses, infectious urethritis share for sexually transmitted and Nevinomysskaya. To sexually transmitted urethritis include: gonorrhea (see Gonorrhoea), Trichomonas (see Trichomoniasis), viral, bacterial, and the last is called Bacillus vaginalis haemophilis.
Pathogens of sexually transmitted urethritis are found mainly on the mucous membrane of genitals. Infection occurs through sexual intercourse.
Nevinomysskiy urethritis caused by staphylococci, streptococci, pneumococci, and viruses. They arise when the General and local infectious diseases, when the causative agent is logged into the urethra the blood. The infection can penetrate into the urethra when balanoposthitis (see Balanitis, balanopostit). Secondary mycotic urethritis occurs as a complication of the use of antibiotics (see Candidiasis).
For venereal and nevinomyssky urethritis is almost the same. The incubation period of bacterial sexually transmitted urethritis 3-5 days, virus - 10-12 days. The disease can be limited front Department of the urethra; often involved the back part of the urethra, and in these cases, urethritis complicated prostatitis (see), vesiculitis (see), epididymitis (see)and cystitis (see). Rarely observed rheumatism and arthritis. For viral sexually transmitted urethritis characterized by the simultaneous lesions of the conjunctiva (oculo-genital syndrome), as well as joints (retro-oculo-virus syndrome).
Non-infectious urethritis are observed when the frequency of intercourse, Masturbation, chronic constipation, tumors in the urethra, injury. Allergic urethritis caused increased sensitivity of the mucous membrane of the urinary canal to substances excreted in the urine. Contact allergens may be chemical contraceptives, the selection of the vagina and other Allergic urethritis recurs periodically. The discharge from the urethra contains a large number of eosinophils, bacteria may be missing. At infringement of metabolism in the body, accompanied phosphaturia (see), oxaluria (see), uraturia (see), also sometimes there urethritis. Urethritis may occur as a result of different influences on the mucous membrane in the urethra (for example, if you frequently catheterization, permanent catheter after administration in the channel solutions of silver nitrate, of protargol , and others).
The clinical picture. All kinds of urethritis appear purulent or mucous discharge from the urethra, the pain and pain during urination. Common manifestations of the disease depends on the etiology of urethritis.
The diagnosis of all forms of urethritis is made on the basis of the anamnesis, clinical and laboratory research. You should find out the nature of the microbial flora in the discharge from the urethra. To detect Trichomonas should be investigated as native products and painted 0,5-1% water solution of methylene blue (see the Colour of microorganisms). Mycotic urethritis is diagnosed based on the detection of fungal yeast infection in the discharge from the urethra and obtain cultures of this fungus in sowing in special environments (see Nutrient medium). The diagnosis of viral urethritis is based on the "sterility" of urethral discharge and the exclusion of other forms of urethritis non-bacterial etiology. The presence of large quantities of salts in the urine indicates urethritis caused by infringement of a metabolism in an organism of the patient. Ureteroscopy (see) allows to reveal the pathological changes of tumor and foreign body in the urethra.
Forecast of urethritis in most cases, with proper treatment favorable.
Treatment of patients with non-infectious urethritis should be aimed at eliminating the root cause of the disease. In infectious urethritis recommended antibiotics, primarily biomitsin, terramycin, tetracycline and chloramphenicol. Biomitsin, terramycin and tetracycline prescribed by 0.3 g 5 times a day the first 3 to 4 days and 0.2 g 5 times a day next 3-4 days; chloramphenicol - 0.5 g 6 times a day the first 3-4 days 3-4 days to 4 times a day. When negonoreiny urethritis also needed washing urethra solution oxycyanides mercury 1 : 6000, solution of etakrydina 1 : 5000, a solution of nitrate of silver 1 : 8000, installation of 0.25-0.5% solution of silver nitrate or 1-2% solution of protargol. Recommended nystatin 500 000 UNITS 3-4 times a day for 10 days.
Preventive measures to sexually transmitted urethritis are the same as in patients with gonorrhea and trichomoniasis.

Inflammation of the urethra (urethritis)

Inflammation of the urethra (urethritis) in most cases is caused by pathogenic microorganisms or viruses, less chemical exposure or injury. Accordingly, there are infectious and non-infectious urethritis.
Infectious urethritis may be associated with entering into the urethra pathogenic infection with intercourse - sexually transmitted urethritis or napolovi by - nevinomysskiy urethritis.
From sexually transmitted urethritis first frequency place gonorrheal urethritiscaused by gonococci, open Nasceram in 1879
Symptoms of gonorrhea, urethritis appear in 3-5 days after infection. Except itching and meketane in the urethra and the head of the penis, appear lucabrazzi purulent discharge yellowish-green color of the external opening of the urethra, which appears to be damaged, swollen. If the inflammatory process is limited to the front part of the urethra (the external sphincter), urination remains nucamendi, but painful in the beginning of the process. In the transition process towards the rear of the urethra becomes frequent urination, painful at the end of the act. Simultaneously with the discharge becomes cloudy urine: at the front urethritis is only the first, in total - in both portions dvuhstadialnoj samples.
The diagnosis is based on detection in a smear of urethral discharge, painted methylene-blue dye gonokokkov, situated in the early stages of the disease mainly inside of cells (intracellular), and later - out of leukocytes (extracellular). In case of doubt, of great importance gram stain - gonococcus is a gram-negative bacterium.
To treat gonorrhea, urethritis prescribe antibiotics: penicillin 2 times a day for 200 000 - 300 000 IU per injection; the total dose up to 1 000 000 IU; syntomycin or chloramphenicol 0.5 g 4 times, the total dose of 5-b g; biomitsin or terramycin over 200000 UNITS 4-5 times a day, the total dose of 2 000 000 IU. Usually, recovery occurs during the first or second day of treatment. It is strongly recommended diet with the exception of spicy food and spirits.
Except of gonococci, the causative agent of infectious urethritis may be other bacteria, such as E. coli, Streptococcus, pneumococcus, Enterococcus and others, as well as Trichomonas vaginalis, viruses, yeast fungi. Cause urethritis may be sores, granulomas and tumors of the urethra. If in the old days, the number of gonorrheal urethritis many times exceeded the number negonoreiny (non-specific) urethritis, the result of the successes achieved in treating gonorrhea antibiotics this difference in the frequency currently erased.
Men in Union women who suffer by Trichomonas colpitis, quite common Trichomonas urethritis. The incubation period is from 5 to 15 days. The disease is expressed in the emergence of scarce mucous or mucopurulent discharge, which differ whitish color and weak spumescence. Trichomonas fungus can be found in smears taken from urethra, native or painted a 1 % solution metilenovogo blue in the urine or in the secret of the prostate. Subjective feelings expressed weakly.


Syphilis urethritis is extremely rare. The symptoms are the same as in other negonoreiny urethritis. The scraping of erosion of the mucous membrane is detected Treponema pallidum. On syphilis character urethritis also points seal and pitting external opening of the urethra, where most often is chancre, painless hilly increase inguinal lymph nodes, positive Wasserman.
For the treatment of infectious bacterial urethritis used antibiotics, sulfonamides and other antibacterial means. When choosing a drug proceed from the sensitivity of microflora to certain antibiotics. Pathogens nonspecific urethritis are not sensitive to penicillin. Better work levomitsetin, syntomycin 0.5 g 4 times a day, and biomitsin or terramycin 0.2 g 5 times a day for 5-7 days. In viral urethritis most effective biomitsin. In protracted and chronic cases daily washed the urethra a solution of silver nitrate, oxycyanides mercury or rivanol (1:5000), or buried 1-2% solution of protargol, 0.25% solution of silver nitrate in a day.
Trichomonas urethritis treated by washing oxycyanides mercury 1 :5000 with following instillation suspension osarsola and boric acid in water (Osarsoli 5,0, Ac. borici 3,0, Aq. destill. 100,0) in the amount of 5-8 ml for 1-2 hours. The installation can be replaced with a dusting mucous membrane in the urethra powder of equal parts osarsola and boric acid through the cone of urethroscope. Gradually removing it, put the powder on the whole mucous membrane. In the same way you can lubricate the mucous membrane of the 2% solution metilenovogo blue, which moisten a cotton ball on thin probe. The course of treatment is 5-7 days sometimes have to repeat several times, making 3-day breaks, as Trichomonas urethritis runs persistently or recurs.
Excellent, almost faultless result gives the treatment of flagyl, which is for oral administration in tablets of 25 mg treatment: 4 days 3 tablets and 4 days to 2 tablets. Throughout the course of treatment requires 5 g flagyl.
Offered for treatment of Trichomonas urethritis trigonitis little effective.
Syphilis urethritis requires specific treatment.
Infectious nonspecific urethritis may occur after sexual intercourse with a healthy woman in the early postpartum period, during menstruation (increased virulence vaginal flora), and chronic inflammation of the female genitalia. Saprophytes male urethra may become pathogenic due metaplasia of the epithelium of the urethra after the transferred gonorrhea (nonspecific postguaranty urethritis).
Infectious nonspecific urethritis occur 3-5 days after sexual intercourse. They are sluggish, accompanied by itching and tickling in the urethra, poor mucopurulent discharge from the urethra, pasting its external opening.
Viral urethritis occurs in 10-15 days after sexual intercourse; the role of its pathogen is attributed mainly to the so-called L-organism, which occupies an intermediate position between a virus and a bacterium. In the discharge urethra microorganisms are missing. Special bacteriological research finds a virus. For sluggish, chronic, allocation of scarce.
To nevinomysskiy infectious urethritis are also urethritis, sometimes observed after the common infections: typhoid, malaria, paratyphoid, and so on; when balanoposthitis, due to constant incursions from prepucialna bag in the urethra; chronic or recurrent prostate, where the infection enters the urethra lymphogenous or canaliculatum way. Therapy is to treat the underlying disease.
Non-infectious urethritis meet people with phosphaturia, oxaluria or diabetes, as a result of irritation of the mucous membrane in the urethra salt or sugar. Inflammation of the urethra may be caused by the use of a permanent catheter, frequent introduction to the urethra tools, cauterizing solutions, such as silver nitrate, colloid and so on, systematic urethral trauma among cyclists, riders, presence on the mucous membrane of the urinary canal papillomatosic growths. Treatment is to eliminate the causes and symptomatic therapy.