Urethritis and urethral syndrome. Urethral syndrome (urethritis)

Urethral syndrome is a set of symptoms characteristic of urethritis, an infectious lesion of the mucous membrane of the urethra due to a bacterial or viral infection. It mainly manifests itself in the form of severe pain when urinating.

Cause of urethritis and urethral syndrome

Pyelonephritis, cystitis). Very rarely, the cause of urethritis is a decrease in immunity, chronically existing foci of infection in other organs. Urethritis can provoke complications if the spread of infection is not stopped in time. Among the complications

th: prostatitis, balanitis, vesiculitis, orchitis, su opening of the lumen in the urethra.

Symptoms of urethritis

Urethral syndrome is a key symptom of urethritis. Its presence is indicated by the following patient complaints:

pain and pain when urinating;
discharge of blood or pus in the urine;
a burning sensation in the urethral area;
redness around the urethra;
discomfort when the urethra and underwear fabric come into contact;
adhesion of the edges of the urethra.

Diagnosis in this case is simple for a specialist: to make a diagnosis, the patient’s complaints and the clinical picture of urethral syndrome are enough, which will be confirmed using laboratory diagnostic methods. To make a preliminary diagnosis, the doctor may be guided by the following signs: pain and burning during urination, inflammation and swelling of the tissues around the urethra, the presence of uncharacteristic discharge from the urethra. 2 or 3 symptoms from this list are enough for the doctor to give a referral for the following tests: smear, culture of urethral discharge, examination of the secretions of the bladder and women, the secretions of the seminal vesicles and prostate in men. The diagnosis is considered confirmed if studies show the presence of microorganisms in the urine . If necessary, the patient is referred for additional examination: ultrasound of the pelvic organs, tests for sexually transmitted diseases, etc.

Treatment for urethral syndrome

To treat urethritis, a set of measures is used to suppress the development of the infection that provoked the disease. I can prescribe the patient: a course of antibiotics (if the nature of the disease is bacterial), a course of antiviral drugs (if the origin of the disease is viral), a complex of anti-inflammatory drugs to generally facilitate the process of recovery. An experienced urologist will be able to identify urethral syndrome and provide effective treatment for urethritis.

Urethritis develops due to damage to the mucous membrane of the urethra by infectious agents. The infection leading to the lesion occurs in most cases due to a sexually transmitted disease. However, the formation of urethritis after inflammation of the urinary tract (due to pyelonephritis, cystitis) cannot be ruled out. Very rarely, the cause of urethritis is a decrease in immunity, chronically existing foci of infection in other organs.

Urethritis can cause complications if the spread of infection is not stopped in time. Among the complications: prostatitis, balanitis, vesiculitis, orchitis, narrowing of the lumen in the urethra.

Symptoms of urethritis

Urethral syndrome is a key symptom of urethritis. Its presence is indicated by the following patient complaints:

pain and pain when urinating;
discharge of blood or pus in the urine;
a burning sensation in the urethral area;
redness around the urethra;
discomfort when the urethra and underwear fabric come into contact;
adhesion of the edges of the urethra.

Diagnosis in this case is simple for a specialist: to make a diagnosis, the patient’s complaints and the clinical picture of urethral syndrome are enough, which will be confirmed using laboratory diagnostic methods. To make a preliminary diagnosis, the doctor may be guided by the following signs: pain and burning during urination, inflammation and swelling of the tissues around the urethra, the presence of uncharacteristic discharge from the urethra. 2 or 3 symptoms from this list are enough for the doctor to give a referral for the following tests: smear, culture of urethral discharge, examination of bladder secretions in women, seminal vesicle secretions and prostate in men.

The diagnosis is considered confirmed if studies show the presence of microorganisms in the urine. If necessary, the patient is referred for additional examination: ultrasound of the pelvic organs, tests for sexually transmitted diseases, etc.

Treatment for urethral syndrome

To treat urethritis, a set of measures is used to suppress the development of the infection that provoked the disease. I can prescribe to the patient: a course of antibiotics (if the nature of the disease is bacterial), a course of antiviral drugs (if the disease is of viral origin), a complex of anti-inflammatory drugs to generally facilitate the process of recovery.

An experienced urologist will be able to identify urethral syndrome and provide effective treatment for urethritis. You can find a suitable specialist in your city and make an appointment with them using the information from the Doc.ua website.

Urethral syndrome (urethritis) is an inflammation of the urethra (urethra), which is caused by various pathogenic microorganisms (bacteria or viruses).

Causes

The main cause of this disease is urogenital infections. Therefore, urethritis can develop after unprotected sexual intercourse. General hypothermia contributes to the development of urethritis, as it reduces local immunity. Some medical procedures (smear taking, catheterization, cystoscopy) can also cause the development of urethritis, since when they are performed there is a risk of introducing pathogenic microflora into the urethra.Some errors in the diet, in particular a passion for spicy, salty, sour foods, also contribute to the appearance of urethritis, since they have an irritating effect on the urethra.

Urethritis can develop due to other infectious and inflammatory diseases of the genitourinary system: cystitis, prostatitis, acute and chronic pyelonephritis, balanoposthitis and others. Failure to comply with personal hygiene rules can also lead to the development of an inflammatory process in the urethra.

Symptoms of urethral syndrome

The main symptoms of urethritis are pain, itching, pain and burning in the urethra during urination. With urethritis, discharge from the urethra is noted, which can be mucous, mucopurulent with an unpleasant odor. Sometimes hematuria is observed - the release of blood in the urine. Also, with urethritis, a frequent urge to urinate is possible.

Diagnostics

Diagnosis of urethritis includes:

collection and analysis of medical history;
urological examination;
smear macroscopy (analysis of cells contained in a smear);
urethroscopy (contraindicated in acute urethritis);
urethrography - x-ray examination of the urethra using radiopaque agents;
microscopic examination of a smear taken;
general urine analysis;
bacteriological culture of a smear - carried out to detect pathogenic microorganisms and determine their sensitivity to antibiotics;
ultrasound examination of the pelvic organs;

Classification

Depending on the cause, urethritis can be infectious or non-infectious. The latter can be caused by an allergic reaction. According to the clinical course, acute and chronic urethritis are distinguished. Acute urethritis lasts up to 2 weeks, chronic - more than 2 weeks.

Depending on the pathogenic pathogen, gonorrheal and non-gonorrheal urethritis are distinguished.

According to the pathogenesis, urethritis is primary (inflammation begins from the urethra) and secondary, when the infection penetrates the urethra from another source.

Depending on the location of the inflammatory process, urethritis can be anterior, posterior and total.

Patient Actions

If symptoms of urethritis appear, you should consult a urologist to conduct all necessary studies. Until recovery, the patient must abstain from sexual intercourse. The patient must warn all of his sexual partners about his disease.

Treatment of urethral syndrome

The basis for the treatment of urethritis is antibiotic therapy, which is carried out taking into account the sensitivity of bacteria to the drug, and the use of broad-spectrum antimicrobial drugs (monural), nitrofuran derivatives (furazolidone, furadonin, etc.) and fluoroquinolones (cisfran). The patient is also prescribed drugs for immunocorrection.

Local treatment of urethritis is reduced to instillation of liquid medications into the urethra. In acute urethritis, such treatment is contraindicated.

For urethritis, the patient is advised to drink plenty of fluids, as well as avoid drinking alcoholic beverages, spicy foods and spices. The patient must abstain from sexual intercourse until recovery.

Complications

Urethritis can be complicated by the following diseases:

balanoposthitis;
epididymitis;
prostatitis;
cystitis;
pyelonephritis.

With prolonged urethritis, a narrowing of the urethra is possible, which can lead to urine retention in the bladder and kidneys. Urethritis can also be complicated by reactive arthritis (Reiter's syndrome).

Prevention of urethral syndrome

Prevention of urethritis comes down to following the following recommendations:

avoidance of casual sexual contacts;
regular examination by a urologist;
compliance with personal hygiene rules;
avoiding hypothermia;
limiting hot, spicy foods and alcohol;
timely treatment of diseases of the genitourinary system.

Urethral syndrome (urethritis) is an inflammation of the urethra (urethra), which is caused by various pathogenic microorganisms (bacteria or viruses).

Causes

The main cause of this disease is urogenital infections. Therefore, urethritis can develop after unprotected sexual intercourse. General hypothermia contributes to the development of urethritis, as it reduces local immunity. Some medical procedures (smear taking, catheterization, cystoscopy) can also cause the development of urethritis, since when they are performed there is a risk of introducing pathogenic microflora into the urethra. Some errors in the diet, in particular a passion for spicy, salty, sour foods, also contribute to the appearance of urethritis, since they have an irritating effect on the urethra.

Symptoms of urethral syndrome

Diagnostics

Diagnosis of urethritis includes:

Collection and analysis of medical history;

Urological examination;

Smear macroscopy (analysis of cells contained in a smear);

Urethroscopy (contraindicated in acute urethritis);

Urethrography is an X-ray examination of the urethra using radiopaque agents;

Microscopic examination of a smear taken;

General urine analysis;

Bacteriological culture of a smear - carried out to detect pathogenic microorganisms and determine their sensitivity to antibiotics;

Ultrasound examination of the pelvic organs;

Polymerase chain reaction (PCR analysis) to identify pathogenic pathogens.

Classification

Depending on the pathogenic pathogen, gonorrheal and non-gonorrheal urethritis are distinguished.

According to the pathogenesis, urethritis is primary (inflammation begins from the urethra) and secondary, when the infection penetrates the urethra from another source.

Depending on the location of the inflammatory process, urethritis can be anterior, posterior and total.

Patient Actions

Treatment of urethral syndrome

The basis of treatment for urethritis is antibiotic therapy, which is carried out taking into account the sensitivity of bacteria to the drug. The patient is also prescribed drugs for immunocorrection.

Local treatment of urethritis is reduced to instillation of liquid medications into the urethra. In acute urethritis, such treatment is contraindicated.

Complications

Urethritis can be complicated by the following diseases:

Balanoposthitis;

Epididymitis;

Prostatitis;

Cystitis;

Pyelonephritis.

Prevention of urethral syndrome

Prevention of urethritis comes down to following the following recommendations:

Avoidance of casual sexual contacts;

Regular examination by a urologist;

Compliance with personal hygiene rules;

Avoiding hypothermia;

Limiting spicy foods and alcohol;

Timely treatment of diseases of the genitourinary system.

Owners of patent RU 2509556:

The invention relates to medicine, namely to urology, and can be used to treat urethral syndrome in women with the antibacterial drug gentamicin. Gentamicin is injected into the urethral wall in an amount of 80 mg, dissolved in 2 ml of anesthetic solution. In this case, the introduction is carried out parallel to the wall of the urethra. A 0.25% solution of novocaine is administered as an anesthetic. Then the vulva is subsequently irradiated with infrared laser radiation with a wavelength of 0.82 microns, a frequency of 3000 Hz, and a power of 10 mW. The duration of the procedure is 5-6 minutes, the course of treatment is 8-10 procedures. The claimed method is well tolerated, accessible and highly effective by increasing the concentration of gentamicin at the site of inflammation and stimulating reparative processes. 1 ex., 2 tables, 1 ill.

The invention relates to medicine, namely to urology.

Urinary dysfunction is common in women: up to 90% have experienced dysuria at least once in their lives. Infectious and inflammatory diseases of the lower genital tract in women are widespread everywhere; A lot of scientific research has been devoted to this problem.

Along with classic acute or recurrent cystitis, when the clinical picture is clear and consists of frequent painful urination in the presence of bacteria in the urine, an increased content of leukocytes and red blood cells, urethral syndrome often develops. Urethral syndrome in women is caused by chronic inflammation of Skene's paraurethral glands (skinitis), which are inaccessible to antibacterial drugs when prescribed as standard (per os, intramuscularly, intravenously). Patients with urethral syndrome are often mistakenly interpreted as having cystitis, and the correct diagnosis is made only in the case of suppuration of the tabernacle glands, which requires surgical intervention.

Conventional antibacterial therapy with the prescription of urotropic drugs (Furamag, Monural, Ceforal) is the closest analogue, but these drugs are intended only for oral administration; local administration is not possible.

Gentamicin is a drug for parenteral administration; therapy with intramuscular administration of gentamicin was adopted by us as a prototype. However, gentamicin administered into the gluteal muscle is distributed evenly throughout the body, without creating a peak concentration in the lesion.

In order to increase the concentration of drugs at the site of inflammation and stimulate reparative processes, a method of treating urethral syndrome in women with antibacterial drugs has been proposed, characterized in that 80 mg of gentamicin, dissolved in 2 ml of 0.25% novocaine, is injected into the wall of the urethra, followed by irradiation of the vulva with infrared laser radiation wavelength 0.82 microns, frequency 3000 Hz, power 10 mW, procedure duration 5-6 minutes, 8-10 procedures per course.

The method is carried out as follows. The patient is placed in a gynecological chair with her legs apart, and the external opening of the urethra is exposed by introducing a transparent disposable Cusco vaginal speculum. The external opening of the urethra and the anterior wall of the vagina are treated with a 1% aqueous solution of chlorhexidine, after which 80 mg of gentamicin per 2 ml of 0.25% novocaine solution is injected parallel to the urethral wall. After this, the urethral area is irradiated using an infrared laser with the following parameters: wavelength 0.82 microns, radiation frequency - 3000 Hz, power - 10 MW. The duration of exposure is 5-6 minutes, for a course of 8-10 procedures.

After the course of treatment, the patients' pain was steadily relieved, urination parameters were restored, and dyspareunia ceased.

Example. Patient E., 24 years old. There is a history of defloration cystitis, chronic cystitis with frequent exacerbations. Nonspecific antibacterial therapy had an incomplete and short-term effect. When examined on the chair, it was discovered: the walls of the urethra are thickened, painful on palpation; the external opening of the urethra is swollen. Treatment was carried out according to the proposed method of treating urethral syndrome in women. 80 mg of gentamicin in 2 ml of 0.25% novocaine solution was injected into the urethral wall, followed by irradiation of the vulva with infrared laser radiation with a wavelength of 0.82 microns, a frequency of 3000 Hz, a power of 10 mW, the duration of the procedure was 6 minutes, for a course of 10 procedures (taking into account the duration disease and the severity of clinical changes, the maximum duration of laser therapy and the maximum number of procedures were selected). After 10 days, the pain was completely relieved, urination was free and painless, and uroflowmetric parameters were normal.

A method for treating urethral syndrome in women was tested at the Federal State Budgetary Institution NNIIT in six patients; the results are presented in tables 1 and 2 and in the diagram.

As follows from Table 1, the initial volume of the bladder in patients was on average only 165.2 ml, after treatment it increased to 253.7 ml. Both the average (Q ave) and maximum (Q max) urine flow rates increased significantly after treatment.

table 2
Severity of clinical manifestations initially (abs./%), n=6
Symptom/score	0 no sign	1 weak	2 unsharp	3 moderate	4 strong	5 very strong
Pain when the bladder is full	0	0	0	27,8%	22,2%	50,0%
Imperative urge	0	0	0	52,8%	27,8%	19,4%
Burning at the end of urination	0	0	0	47,2%	33,3%	19,4%
Discomfort after urination	0	0	5,5%	13,9%	38,9%	31,7%

From Table 2 it follows that when included in the study, all patients had serious urinary disorders, with pronounced complaints; their changes during treatment are reflected in the diagram (see Fig.). Starting from the first day, all patients noted a decrease in urethral pain syndrome, by the 7th day - an improvement in urine tests to normalization in most of them, by the 10th - recovery. The proposed method is highly effective, well tolerated, and available for use both in hospitals and on an outpatient basis.

LITERATURE

1. Pushkar D.Yu., Zaitsev A.V., Godunov B.N., Davidyants A.A. Diagnosis and treatment of various forms of cystitis in women. - M., 2002 - 39 p.

2. Rafalsky V.V., Strachunsky L.S., Kogan M.I. and others. Antibacterial therapy of complicated urinary tract infections in outpatients. // Urology. - 2004. - No. 5. - P.25-31.

A method of treating urethral syndrome in women with the antibacterial drug gentamicin, which is injected into the urethral wall in an amount of 80 mg, dissolved in 2 ml of an anesthetic solution, characterized in that the administration is carried out parallel to the urethral wall, and a 0.25% novocaine solution is administered as an anesthetic followed by irradiation of the vulva with infrared laser radiation with a wavelength of 0.82 microns, frequency 3000 Hz, power 10 mW, procedure duration 5-6 minutes, 8-10 procedures per course.

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The invention relates to medicine, namely to urology, and can be used to treat urethral syndrome in women with the antibacterial drug gentamicin. Gentamicin is injected into the urethral wall in an amount of 80 mg, dissolved in 2 ml of anesthetic solution. In this case, the introduction is carried out parallel to the wall of the urethra. A 0.25 solution of novocaine is administered as an anesthetic. Then the vulva is subsequently irradiated with infrared laser radiation with a wavelength of 0.82 microns, a frequency of 3000 Hz, and a power of 10 mW. The duration of the procedure is 5-6 minutes, the course of treatment is 8-10 procedures. The claimed method is well tolerated, accessible and highly effective by increasing the concentration of gentamicin at the site of inflammation and stimulating reparative processes. 1 ex., 2 tables, 1 ill.