How to treat urethritis in women. Structure and functions of the urethra in men and women

The urethra (urethra) is an organ of the urinary system. It is a tube-shaped channel through which urine is removed from the bladder to the outside.

The internal opening of the urethra is located in the wall of the bladder. The urinary tract is directed through the urogenital diaphragm. At the end of it, in the vestibule of the vagina, there is an external opening. The latter is round in shape, and next to it there are hard roller-shaped edges. The lumen of the urethra is not the same in diameter along its entire length. The outer opening is relatively narrow, while the inner one is wider and looks funnel-shaped.

Women's urethra is smaller in length compared to men's (up to 4 centimeters), but much larger in width - up to 1.5 cm. The posterior surface of the urethra is fused with the vaginal wall and is located strictly parallel to it. The urethra is surrounded by connective tissue. It is especially dense in the lower sections. The walls of the urethra consist of mucous membrane and muscle tissue.

The urethral mucosa is covered with several layers of prismatic epithelium. In some cases, this epithelium is flat, in others it is high.

The membrane is a series of longitudinal folds, and the transverse section of the urethra resembles a star in shape. The largest fold of the canal is called the ridge and is located on its posterior wall, from the bladder to the outlet.

Along the entire urethra there are periurethral glands that produce mucus. There are lacunae on the mucosa, and in the lower regions of the urethra there are the mouths of the gland ducts.

The muscles of the urethra include external, internal, circular and longitudinal layers, as well as smooth muscles with elastic fibers. The connective tissue of the canal is supplied with veins.

The urethra in women is equipped with a pair of sphincters, external and internal. The purpose of these valves is to keep urine from flowing freely.

The external sphincter is a paired muscle attached to the vagina. Internal - represents a stronger muscle in the bladder area.

Microflora of the urethra

The microflora of a healthy adult woman consists of epidermal and saprophytic staphylococci and lactobacilli. The maximum level of bifidobacteria is 10%, peptostreptococcus is 5%. The collection of these microorganisms is called Doderlein flora.

The composition and norms of the specific content of microorganisms in the microflora depend on the woman’s age.

Methods for studying microflora

Smear

The purpose of taking a smear is to detect and study the microflora to identify the microorganisms that caused the disease.

A smear is prescribed in the following cases:

risk of urinary tract infection;
pain in the canal area;
inflammatory process;
pregnancy.

An indication for taking a smear is also a preventive gynecological or urological examination.

Rules for preparing for a smear:

within a week, stop taking medications and, first of all, antibiotics;
do not drink alcohol for at least 24 hours;
abstain from sexual contacts within 12 hours;
Do not empty your bladder for an hour before the smear;
do not douche;
do not use vaginal medications.

Scraping

3 hours before scraping you need to stop urinating. If there is heavy discharge, the external opening of the urethra is wiped with gauze soaked in saline solution.

When performing a scraping, the probe is inserted into the urethra a couple of centimeters and held inside for about 5 seconds. In this case, the tool is rotated around its axis. The collected biological material is transferred into a test tube.

Pathologies

Inflammation of the mucous membrane of the urethra is called urethritis. Most often, the disease occurs in an acute form and is accompanied by colpitis and endocervicitis. Causes of the disease:

infection with viruses and bacteria, including mycoplasmas, chlamydia, trichomonas, gonococci, mycotic and mixed infections;
trauma to the mucous membrane (usually as a result of catheterization);
metabolic disorder;
influence of allergens;
stagnant processes.

Manifestations:

discharge from the canal;
discomfort, pain, stinging, itching.

Treatment of the disease consists of infusions of drugs into the urethra and oral administration of chemotherapy drugs and antibiotics.

Urethral prolapse. Prolapse of urethral tissue usually occurs in old age and may be accompanied by vaginal prolapse. The cause of the pathology is damage to the muscles of the pelvic floor and perineum due to heavy physical labor, prolonged labor, delivery, prolonged cough, and constipation. If the prolapse is characterized by severe prolapse of the walls, circular excision of tissue is used.

Polyps are benign tumors that arise on the urethral mucosa. They represent an enlarged area of connective fibers. The neoplasm is soft on palpation and grows rapidly in size. Eventually, the polyps close the internal lumen of the canal. Causes of pathology:

chronic inflammatory process resulting from infection;
hormonal imbalance;
inflammatory process in the intestines.

In the initial stage, the disease develops asymptomatically, but after a while, discomfort appears. Polyps are detected using a urethroscope. During diagnostic measures, bacterial culture of a smear from the urethra and a smear for microflora are carried out. Treatment consists of surgical removal of the tumor.

One of the types of polyps is the caruncle. Its size is from 3 to 5 millimeters. The neoplasm may have a stalk or be without it. The color of the polyp is scarlet. Trauma leads to bleeding, since the tumor contains many capillaries. At the beginning of their development, caruncles are soft, but as a person ages they become harder.

Typically, such polyps are detected in older women. Caruncles are rarely multiple and are located near the external opening of the urethra. The main symptoms of caruncles are bleeding and urinary incontinence. They are often accompanied by inflammatory processes in the bladder and urethra. Treatment of caruncles is carried out surgically and using electrocoagulation.

A manifestation of the papilloma virus is condylomas. The virus is transmitted through sexual contact. The period of latent infection in the body can be any. Externally, condylomas are similar in shape to cauliflower.

Having appeared for the first time, these formations can then spontaneously disappear. The transformation of endourethral condylomas into malignant tumors is an extremely rare occurrence. Although this condition is more common in men, it can also affect women.

Treatment of condylomas is carried out with cryotherapy and the drug Podophyllin. Moreover, it is not possible to remove the virus itself from the body. Prevention of relapse of the disease consists of strengthening the immune system, a healthy lifestyle, and consuming sufficient amounts of vitamins and minerals.

Cysts are glands filled with fluid. Cysts are located near the outer part of the canal and look like bulging anterior vaginal walls. Cysts are divided into 2 types:

associated with defects in the formation of the urinary organs;
appearing due to blockage of skin glands.

Most often, pathology occurs when the immune system is weak as a result of inflammation or injury.

The cyst is characterized by difficulty urinating. Bulges appear near the external opening of the urethra. If suppuration occurs in the cyst, the patient experiences pain and her temperature rises. Treatment of the cyst is surgical under local anesthesia.

Cancer of the urethra is a rare disease. However, this type of tumor is found approximately 10 times more often in women than in men. The location of the tumor in the canal can be anywhere, but most often it occurs near the external opening - between the urethra and the vulva. Manifestations of the disease:

pain syndrome, ;
pain during sexual intercourse;
urinary incontinence;
bleeding.

Diagnostics is carried out using the following methods:

inspection and palpation;
smear cytology;
histology;
cystography, cystoscopy.

The main methods of treatment are surgery and radiation.

Myomas, fibromas, angiomas are benign hormonal-dependent neoplasms. Consist of muscle and connective tissue. Treatment is only surgical.

Thermal burns are most often characterized by a small area, rapid scarring and usually heal without therapeutic procedures. Chemical burns cause inflammation and death of mucosal tissue.

The main symptom of a chemical burn is pain when the drug is administered. If this symptom occurs, you need to determine the temperature of the product introduced into the urethra. You also need to make sure that the exact drug that is prescribed is injected into the urethra.

In case of a chemical burn, it is recommended to rinse the urethra with a liquid that softens the effect of the irritant. For example, if acid gets on the mucous membrane, you need to rinse with a solution of baking soda. The alkali should be neutralized with a solution of citric acid or vinegar. After washing, the canal is treated with syntomycin ointment. The patient is advised to drink plenty of fluids. For severe burns, drainage is installed.

Prevention of urethral diseases consists of observing the rules of personal hygiene and abstaining from eating foods that irritate the mucous membranes. During sexual intercourse, the use of condoms is recommended. If pain, cutting sensations, discharge or other symptoms described above occur, you should consult a doctor to find out the cause and, if necessary, treatment.

Urethritis is an inflammatory disease localized in the mucous membrane of the urethra (urethra). The disease is equally widespread in both men and women, but in women it is much less often diagnosed in isolation from other inflammatory pathologies of the urinary system.

The danger of late diagnosis of urethritis in women lies in the possibility of ascending infection of the urinary organs and the transition of inflammation into a chronic recurrent form.

Urethritis in women, in more than half of the cases, is combined with cystitis and is caused by the presence of a genital tract infection. It is almost impossible to carry out a differential diagnosis and separate the symptoms of cystitis and urethritis in women from each other, based solely on clinical data.

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1. Features of the development of urethritis in women

Since the disease is based on the development of inflammation in the wall of the urethra, its anatomical features underlie the clinical picture of the pathology.

Clinical manifestations and symptoms of urethritis in women are usually less pronounced than in men. This is due to the fact that the urethra in women has a shorter length (about 1-2 cm) and a larger width.

This creates good conditions for the migration of pathogens from the woman’s urethra and their reproduction in the overlying parts of the urinary tract, while in the urethra itself the conditions for their attachment and reproduction are not particularly favorable (fast urine flow, absence of anatomical bends and significant narrowings).

Figure 1 - Where is the opening of the urethra in women

Even with the development of severe inflammation, with significant swelling of the mucous membrane, which happens infrequently, urethritis in women is not accompanied by a violation of the outflow of urine.

In men, everything is exactly the opposite; the urethra is long, narrow and has several anatomically significant bends and narrowings.

The listed anatomical features allow pathogenic pathogens to gain a foothold and multiply, localizing precisely in the urethral mucosa, without significant migration to the overlying sections.

In connection with the above, the symptoms of urethritis in women are erased, masked or combined with the clinical picture of acute cystitis, while inflammation of the urethra in men has a clear and specific clinical picture.

2. Classification

Depending on the type of pathogen that causes the inflammatory reaction, all types of urethritis can be divided into two types - nonspecific and specific.

The etiological factor of specific urethritis is sexually transmitted infections (STDs).

Among the pathologies of this group:

Gonorrheal urethritis is caused by a specific pathogen, Neisseria gonorrhoeae. The disease has a specific clinical picture, which is characterized by whitish-purulent urethral and vaginal discharge.

In women, the disease can be mild, which makes them dangerous as a carrier of infection. Gonococcal urethritis is one of the most studied types of urethritis associated with sexually transmitted infections, which made it possible to place all other types of specific lesions of the urethra in a separate group - non-gonococcal;

Chlamydial urethritis is caused by, which is one of the most common forms of STDs.

Often the first place for symptoms of inflammation of the genital organs (vaginitis, salpingitis, endometritis, oophoritis, etc.), while the manifestations of urethritis are weakly expressed.

In the absence of timely treatment, the symptoms of urethritis and damage to the genital organs may be accompanied by damage to the joints and eyes.

Mycoplasma and ureaplasma urethritis - caused by M. hominis or genitalium, U. urealyticum. The clinical picture is erased, the phenomena are poorly expressed, which causes difficulties in diagnosing and treating this condition.
Trichomonas urethritis - caused by. In addition to the urethra, the vaginal mucosa and glands of the vaginal vestibule are affected, which provides a clear clinical picture of the infection with pain during urination, vaginal itching and yellow foamy vaginal discharge.

If, based on the results of the examination, no STIs were identified, then urethritis is called nonspecific. Nonspecific urethritis is based on the active reproduction in the urethral lumen of pathogenic and opportunistic flora, such as staphylococci, streptococci, gardnerella, Candida fungi and E. coli.

This type of disease most often develops in connection with sexual contact, during which the listed microorganisms are actively introduced into the urethra.

Predisposing factors are the location of the urethra close to the vagina, the presence of bacterial vaginosis, disorders of carbohydrate metabolism and decreased local immunity.

The most common type of nonspecific urethritis in women is postcoital (associated with sexual intercourse). In 50-60% of cases, the described pathology occurs under the guise of chronic recurrent cystitis, which creates certain difficulties in diagnosis and therapy.

T.I. Derevianko suggests that the main reason for the development of postcoital urethritis and cystitis in women is precisely the abnormal structure and location of the urethra - its location near the vestibule of the vagina or along its anterior wall.

All of the above creates a favorable environment for the migration of vaginal microflora through the meatus (external urethral opening) into the urethra, and then to the mucous membrane of the bladder.

In the vast majority of women, the debut of urethritis and cystitis coincides with the onset of sexual activity, and exacerbations are in one way or another associated with sexual intercourse.

However, recent studies have revealed that this type of urethral inflammation in 60% of cases can be associated with an incoming mycoplasma or chlamydial infection, which makes standard therapeutic regimens ineffective and leads to the development of chronic urethritis.

3. Predisposing factors

As was presented above, the etiological factor in the development of inflammation in the urethra is an infectious agent, however, the severity of the inflammatory reaction depends not only on the type of pathogen, but also on the general condition of the macroorganism.

Factors predisposing to the development and progression of the infectious process are:

1 Systematic (even short-term) hypothermia, especially local.
2 Disturbances of microbiocenosis in the vagina, a decrease in the level of functioning lactobacilli, as well as the proliferation of pathogenic and conditionally pathogenic flora.
3 Taking hormonal contraceptives.
4 Impaired carbohydrate metabolism, which leads to a decrease in both local and general immunity, and creates a more positive environment for the growth of bacteria.
Failure to maintain personal hygiene, washing in the direction from the anus to the vagina, inclination to frequent douching;
disruption of local and general immunity.
6 Low-protein nutrition, hypo- and avitaminosis.
7 Casual sexual relations, lack of sexual education, neglect of barrier contraception.
8 The presence of confirmed urolithiasis, which leads to constant injury to the surface of the mucous membrane by passing “sand” and the formation of a chronic nonspecific inflammatory process.
9 Violation of urine pH, which is one of the main protective factors that prevents the proliferation of pathogenic bacteria.
10 Eating large amounts of sweet, spicy, marinades, which causes irritation of the walls of the bladder and urethra.
11 Insufficient drinking regimen, rare urination, the need to constantly “endure”, leading to insufficiently frequent washing of bacteria from the walls of the urethra.

4. Main symptoms

Symptoms of urethritis in women, especially nonspecific ones, are usually mild and can go unnoticed for a long time.

Urethritis in women almost never occurs in isolation only with damage to the urethral canal. With a specific infection, the symptoms of urethritis in women are combined with symptoms of vaginitis, endometritis, salpingitis or bartholinitis. If it is nonspecific – with signs of acute cystitis.

Patients are concerned about pain and stinging when urinating, itching and burning in the urethra or perineum, discomfort and pain in the urethra. Patients are concerned about increased frequency of urination and false urge to urinate.

On examination, you may notice redness of the meatus, and discharge from the urethra is possible. Discharge from the urethra in women is more often observed with a specific infection. With specific urethritis, you can also identify redness of the labia, abnormal vaginal discharge and scratch marks on the genitals.

The disease occurs cyclically with periods of exacerbation and remission, sometimes symptoms may disappear altogether. Even with a large amount of damage to the urethral canal, a woman can feel relatively healthy for a long time until the inflammation affects the walls of the bladder.

Each subsequent exacerbation usually involves larger and larger volumes of the urethral mucosa, and the disease steadily progresses.

Complications of the pathology include the development of ascending cystitis and pyelonephritis. There is usually no systemic response of the body to inflammation.

Due to the meager and unspecific clinical picture of the pathology, differential diagnosis of urethritis or cystitis in women can be difficult.

Distinctive signs of urethritis in women are:

1 Burning and pain during the entire act of urination, while with cystitis there is an increased burning sensation at the end.
2 The pain may continue for several minutes after the end of urination.
3 Swelling and redness of the external urethral opening during examination is required.
4 In favor of urethritis is the presence of discharge from the urinary canal in a woman, itching of the urethra, vagina and genitals.
5 If there is vaginal discharge, urethritis due to sexually transmitted infection should be suspected.

5. Diagnostics

The main task of diagnosing urethritis is to identify the causative agent of infection (identification of the etiological factor), which completely determines the further management of the patient. Since there are two types of urethritis, one of which is caused by a sexually transmitted infection, and the other by a nonspecific pathogenic flora, determining the pathogen is extremely important for choosing a treatment regimen for the patient.

To diagnose urethritis, the following are used:

1 Urine tests (urine culture to determine sensitivity to antibiotics);
2 Collection of smears from the urethral canal and vagina with further bacteriological and microscopic examination;
3 Urethroscopy is an endoscopic invasive research method that allows you to visually determine the degree of morphological changes in the urethra. It is practically not carried out in women.

An increased number of leukocytes and desquamated epithelium, as well as bacteriuria of varying severity, can be detected.

If necessary, it is possible to conduct a three-glass urine sample, where the largest number of epithelial cells and leukocytes will be observed in the first portion.

It must be remembered that the three-glass sample method is low-sensitive and directly depends on the correct collection of material for the study.

If deviations from the normal urinalysis are detected, especially in the presence of massive bacteriuria, urine culture is indicated with further determination of the sensitivity of the pathogen to antibiotics.

5.1. Examination of vaginal and urethral smears

One of the most accurate methods for diagnosing urethritis is taking specific smears using a special urethral brush, which slightly exfoliates the surface epithelium of the urethra.

The high accuracy of the method is due to the fact that the material is collected directly from the site of inflammation, and the study of exfoliated epithelial particles allows one to detect mycoplasmas and ureaplasmas living intracellularly in the smear.

There are several types of urethral smears, which are necessarily duplicated by vaginal smears:

1 General smear for visual microscopic examination. Material is collected from the urethra and vagina. The described method allows you to assess the state of the vaginal microflora, the level of leukocytes and visually detect pathogens such as gonococci, trichomonas, gardnerella and Candida fungi. The disadvantage of the method is its low sensitivity (40%).
2 A smear from the urethra and vagina for bacteriological examination (culture) and diagnosis of sexually transmitted infections using PCR.

It is necessary to strictly monitor compliance with all rules for collecting and transporting material, since pathogens of sexually transmitted infections are very sensitive to ultraviolet irradiation, temperature fluctuations and drying, which can lead to false negative results.

Rules for collecting smears from the urethra:

1 It is recommended to limit sexual activity 12 hours after the intended collection of the test material;
2 The study should be performed before starting antibacterial therapy;
3 Before collecting material, it is recommended not to urinate for 2-3 hours, so as not to wash away pathogenic microorganisms and discharge from the urethra.

6. Treatment of specific urethritis

The choice of treatment regimen for specific urethritis in women directly depends on the type of pathogen that caused it. Antibacterial therapy includes the administration of the following drugs:

1 The antibiotic of choice for gonococcal urethritis is ceftriaxone 250 mg once intramuscularly (A). An alternative is cefixime 400 mg once orally, spectinomycin 2 g intramuscularly once;
2 Chlamydial urethritis - first-line antibiotic - azithromycin 1.0 g once. Alternative drugs - doxycycline 100 mg twice a day or josamycin 500-1000 mg twice a day for 7 days;
3 Mycoplasma and ureaplasma urethritis - the following drugs are used for treatment: doxycycline 100 mg 2 times a day, ofloxacin 300 mg 3 times a day, josamycin 500 mg 3 times a day for 7-10 days;
4 Urethritis of trichomonas etiology - first-line treatment metronidazole 500 mg 2 times a day (A), ornidazole 500 mg 2 times a day (B), tinidazole 500 mg 2 times a day for 5 days. Alternative agents are metronidazole 2.0, ornidazole 1.5 or tinidazole 2.0 once.

Treatment must be prescribed to the sexual partner, even if he has no signs of inflammation, to exclude reinfection. After completion of antibacterial therapy, it is necessary to monitor its effectiveness and control the eradication of the pathogen.

7. Therapy of nonspecific urethritis

In the absence of STDs, the choice of treatment regimen for urethritis in women depends on the severity of the clinical picture of inflammation and the sensitivity of the pathogen to antimicrobial therapy.

1 The first-line drug is fosfomycin (orally in the form of packets, 3.0 grams once).
2 Alternative drugs are nitroxoline, azithromycin, ofloxacin, ciprofloxacin (tablets and other oral forms) in standard dosages for 3-5 days. Before prescribing these drugs, it is advisable to determine the sensitivity of pathogens to them.
3 Fungal infection of the urethra with white discharge from the urethra (urethral candidiasis) is eliminated by taking fluconazole (Flucostat), itraconazole (Orungal, Orungamin), ketoconazole, natamycin (Pimafucin). It should be remembered that the presence of a fungal infection may indicate a decrease in general immunity, intestinal and vaginal dysbiosis.

In addition to drug therapy, a diet is prescribed. It is advisable to reduce the consumption of spicy, sour and salty foods, and also drink at least 1.5 liters of water during the day.

To enhance the clinical effect for inflammation of the urethra, it is possible to use herbal preparations and berries with diuretic properties (lingonberries, cranberries), as well as herbal uroantiseptics (Canephron, Cyston, Phytolysin, etc.).

Urethra - what is it? It is to this issue that we will devote the article. In addition, you will learn about the differences in the structure of this organ in men and women, as well as what diseases can arise and how to treat them.

General information

The urethra is what connects the bladder to the external environment. The walls of this organ are covered inside with mucous membrane. After it come the connective fibers, as well as the muscular layer. It should be especially noted that the urethra in both girls and men has the shape of a tube. However, its structure is different for representatives of different sexes.

The urethra in women: where is it located?

The urethra of the fairer sex is much shorter, but much wider than the urethra of men. As a rule, its length varies between 3-4 centimeters, and its width is approximately 1.4 times that of a man's. The mucous membrane of the urethra forms numerous folds. This organ begins in the form of an internal opening from the bladder. Next, the canal passes from top to bottom under the symphysis of the pubis along the anterior wall of the vagina. It opens with an external hole in the depths of the genital slit, or rather, under the clitoris, located between the labia minora.

What structure does it have?

Where is the urethra in women? You have received the answer to this question. In this section I would like to talk in detail about the structure of the urethra in the fairer sex.

As you know, the external opening of the urethra is round in shape. At the entrance to the vagina, it is surrounded by hard, ridge-like edges. The canal itself runs strictly parallel to the vagina, along its anterior wall, with which it fuses. It should be especially noted that the lumen of the urethra in women is different throughout. It expands funnel-shaped at the bladder and then narrows at the external opening. In this case, the entire canal is literally surrounded by connective tissue, which is especially dense in the lower parts of the vagina. The wall of the canal is also formed by muscle tissue.

Mucosa of the urethra

The mucous membrane of the urethra is covered with stratified prismatic epithelium, which is flat in some areas and high in others. Thus, the shell forms a series of longitudinal folds. In this regard, the transverse section of the canal has the shape of a star.

The highest and largest fold of the urethra is located on the posterior wall and is called the urethral crest. It stretches from the front corner of the bladder to the very end. On the mucous membrane of the urethra there are lacunae, and in the lower parts of the canal the so-called orifices of the ducts of the glands of the urethra open. Near the outlet on both sides there are paraurethral ducts. It is also worth noting that the connective tissue of the urethra has numerous veins and elastic fibers.

Muscular tissue of the urethra

The muscular layer consists of circular, outer, longitudinal and inner layers, as well as a layer of smooth muscle with elastic fibers. In the area of the urogenital diaphragm, its tissues join the circular canal and form the urethral sphincter.

The urethra in men: where is it located?

The male urethra, unlike the short female one, is about 18-24 centimeters long. Moreover, in a state of erection this value increases by a third. The posterior urethra in representatives of the stronger sex begins from the internal opening and ends at (or before the beginning of the corpus cavernosum). As for the anterior canal, it is located more distally.

What structure does it have?

Where is the urethra in men? We presented this information just above. And now we will talk in detail about the structure of the male urethra.

Conventionally, the urethra of the stronger sex is divided into 3 parts, namely:

membranous;
prostate (or prostatic);
spongy (or spongy, cavernous).

The urethra in men along its entire length has 2 S-shaped bends: the upper subpubic (or subpubic, prostatic), which is formed when the membranous part of the canal passes into the cavernous (from top to bottom), bending around from below, and the lower prepubic (or so-called prepubic), arising when the moving part of an organ transitions into a non-fixed part, arching upward. If the penis is raised towards the stomach, then both of these curves transform into a common one, which is concave forward and slightly upward.

Throughout its entire length, the male urethra has a different lumen diameter. So, wide parts alternate with narrower ones. One narrowing is located at the internal opening, the second - in the urogenital diaphragm, and the third - at the exit itself. By the way, the male urethra also has three dilations: in the prostatic region, in the bulbous region and at the very end of the urethra, where the scaphoid fossa is located. As is known, on average the width of such a channel in representatives of the stronger sex ranges from 4 to 7 millimeters.

Microflora in women

The female urethra, or more precisely, its normal microflora, can vary depending on age. In adults and healthy representatives of the fair sex, most microorganisms consist of lactobacilli, as well as saprophytic and In addition, the presence of up to 5% peptostreptococci and up to 10% bifidumbacteria is allowed in the urethra. The presented combination of microorganisms in medical practice is called Doderlein microflora.

Male microflora

The female urethra is significantly different from the male urethra. And this applies not only to the location of the channel in the body and physical parameters, but also to the microflora. It is especially worth noting that it remains unchanged throughout the life of men. A few hours after birth, epidermal and saprophytic staphylococci appear in the urethra of boys. In this case, these microorganisms inhabit only the first five outer centimeters of the urethra. Further, the urethra is practically sterile.

Urethra - what is it? Now you know the answer to this question. Many people are interested in what diseases can arise as a result of various abnormalities in the functioning of this organ.

Urethral diseases

Diseases of this organ may be associated with the following phenomena:

1. With inflammation in the canal. Inflammation of the urethra, the treatment of which is reduced to taking antibiotics and other chemotherapy drugs, is quite common in medical practice. This disease is called urethritis. It manifests itself in the form of discomfort, burning and stinging. As a rule, this disease, which occurs in an acute form, is combined with colpitis and endocervicitis.

2. With anomalies of the channel itself. This may manifest as an absence of the posterior wall (hypospadias) or the absence of the anterior wall (epispadias). This abnormality should only be treated with surgery.

3. With urethral prolapse. This pathology is a strong protrusion of the canal outward. In the fairer sex, this disease most often occurs in old age. It may be accompanied by vaginal prolapse. The reasons for the presented deviations are damage to the pelvic floor muscles, including the perineum, during prolonged physical work, as well as delivery operations, prolonged labor, prolonged cough, strong straining during constipation, etc. To treat this pathology, circular excision of the prolapsed urethral wall is used.

4. With polyps. A urethral polyp is a small tumor-like formation that can only be eliminated by surgical methods. The reasons for this deviation may be chronic inflammatory processes that were caused by any infection, as well as hormonal imbalances and intestinal diseases. In the first stages, the urethral polyp develops without any symptoms, but after some time this disease causes a feeling of discomfort. This pathology is diagnosed using a urethroscope.

5. With fibromas, myomas and angiomas. Such abnormalities are benign, hormone-dependent tumors consisting of muscle-connective tissue. Their treatment is carried out only through surgery.

6. With genital warts. This is a disease that most often affects the external opening of the urethra. This formation is removed surgically.

7. C is a fluid-filled gland that is located near the outer urethra. It looks like a bulging front wall of the vagina. Pain in the urethra, difficulty urinating, and noticeable bulges around the opening are all signs that a person has paraurethral cysts. This disease can only be treated by removing the cysts under (local) anesthesia.

8. With stricture. Narrowing of the urethra is most often associated with complications in the treatment of prostate tumors. In severe cases, the lumen of the urethra is completely blocked, which causes great discomfort to the patient.

9. With cancer. It is extremely rare. More often observed in women than in men.

Let's sum it up

Urethra - what is it? We have answered the question asked in detail. It should also be noted that, in order to avoid serious diseases of the urethra, experts recommend maintaining personal hygiene daily, not consuming foods that can irritate the mucous membrane of this organ, and also using contraception during casual relationships.

Urethritis in women is a disease that is much more common than the number of registered 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 the guise” of other lesions of the urinary and reproductive system.

This feature worsens the prognosis of cure, because this course of urethritis is the root cause of ascending infection. And attempts to treat it yourself without medical help and examination only worsen the form of inflammation and contribute to chronicity.

A clear connection between urethritis in women and the disease or carriage of a sexually transmitted infection by a male partner determines the requirement for joint treatment. And this is not always assessed correctly.

Anatomy and physiology of the female urethra

The urethra, or urethra, is the final structure for the passage of urine from the bladder. Female structural features include:

short length (3–5 cm) compared to men (up to 18 cm);
wide diameter when stretched (up to 10–15 mm);
the presence of three narrowed areas (internal at the exit from the bladder and 2 in the area of the external sphincter);
one expansion closer to the bubble;
the presence of Skene's secreting glands, which are an analogue of the prostate gland in men, which in every tenth woman during sexual arousal secrete a fluid similar to prostatic fluid.

The urethra runs in front of the vagina through the pelvic floor muscles. At the same time, at the exit, her own muscle corset is weakened.

Compared to the male urethra, the female urethra has features that must be taken into account in treatment

The process of urine excretion involves reflex relaxation and closure of the channel, contraction of the bladder walls, and intravesical pressure.

Functions of the urethra in women:

evacuation of the accumulated volume of urine from the bladder;
providing support for muscle tone to create a reservoir with a volume of up to 15 ml;
one of the erogenous zones.

It is impossible to treat the urethra as a simple tube. Urethritis in women breaks down the reflex functioning system, which subsequently affects sexual intimacy.

Causes of urethritis in women

All types of urethritis are divided into 2 large groups:

non-infectious;
caused by infectious pathogens.

The non-infectious nature of inflammation is observed when:

mechanical damage to the urethral mucosa from passing stones during urolithiasis;
injury during an examination of the bladder with a cystoscope, the procedure for removing urine with a catheter, or intentional actions;
allergic reactions;
malignant neoplasms;
diseases of the genital organs;
venous stagnation in the pelvis.

Inflammation can be a consequence of defloration or radiation therapy.

Infectious pathogens play a leading role in inflammation of the urethra. If symptoms and treatment are determined by pathogenic flora, then urethritis is specific. This group includes sexually transmitted infections:

gonococci (gonorrheal);
trichomonas;
chlamydia;
mycoplasmas;
herpes viruses (herpetic urethritis) and genital warts.

One of the practical classifications divides all urethritis in women and men according to the medical profile of the doctor who needs to be contacted for treatment into:

gonorrhea - dealt with by venereologists at the dermatovenerological dispensary;
non-gonorrheal (non-gonococcal) - you should go to the clinic to see your local physician.

Since patients do not know without analysis what nature of urethritis is bothering them, it is best to start with a therapist, then follow his direction. Often women turn to a gynecologist. This does not change the tactics of examination and identification of the cause of the disease.

Inflammation with classic signs is considered nonspecific. Its causes are most often:

staphylococci;
coli;
streptococci;
Proteus;
fungi of the genus Candida.

The listed flora is classified as conditionally pathogenic, since it is constantly present in the body. When combined with additional factors, it causes inflammation. Some authors classify fungal urethritis as a group of specific diseases.

What factors contribute to the disease?

In addition to the impact of a specific pathogen, the following factors influence the occurrence of inflammation in the urethra:

hypothermia of the body;
injury to the genital organs, disruption of innervation during surgery on the uterus and vagina;
decreased immunity after suffering stress or serious illness;
undermining the body’s protective function through poor nutrition and restrictive diets;
consequences of alcoholism;
hypo- and vitamin deficiencies;
the presence of chronic inflammatory diseases (tonsillitis, tuberculosis, sinusitis, caries, cholecystitis, adnexitis);
diseases of the urinary system;
pregnancy and menopause;
ignoring the rules of personal hygiene.

How does infection occur?

The causative agent of infection can enter the urethra in three ways:

contact - in a descending direction with urine from the source of infection in the kidney, bladder;
sexual - during unprotected sex with a sick person;
hematogenous - spreads through the bloodstream and with the movement of lymph from its own chronic foci of inflammation.

Depending on the nature of the spread of infection, urethritis is distinguished:

primary - occur with direct penetration of an infectious agent into the urethra (from the bladder, during sexual contact);
secondary - microbes enter hematogenously from the pelvic organs, intestines, or other chronic focus.

Symptoms of urethritis

Let's look at the signs of urethritis in women using the example of the course of bacterial inflammation.

According to the clinical course, the forms of the disease are distinguished:

spicy;
chronic.

The acute form occurs after an incubation period after exposure to microorganisms (sexual contact, bladder catheterization).

The duration of the latent period is determined by the state of the body: when weakened, inflammation appears after a few hours

The woman feels:

sudden pain and pain when urinating;
itching, burning in the area of the urethral outlet;
the discharge is mucopurulent or purulent in nature;
unpleasant smell.

In the case of allergic urethritis, a woman simultaneously has:

nasal congestion;
skin rash;
lacrimation;
dyspnea.

An examination by a urologist reveals slight swelling of the mucous membrane and redness of the surrounding tissues of the external urethra.

Features of chronic urethritis:

symptoms are not constant;
itching and burning are minor;
as a rule, chronic cystitis is associated with frequent painful urges;
urinary incontinence may occur.

If the infection is caused by a sexually transmitted infection, it is recommended to treat the male partner as well.

During the treatment period, the patient will require a restrictive regimen:

you should stop having sex;
sharply reduce physical activity;
keep your feet warm and avoid the slightest hypothermia;
in your diet you will have to give up salty, pickled, smoked dishes and foods, alcohol in any form;
significantly increase the volume of fluid you drink (up to 2 liters), if there are no contraindications due to other diseases;
include dairy dishes, cereals, fruits and vegetables in your daily diet.

The treatment regimen includes drugs with various anti-inflammatory effects; injections, tablets, vaginal suppositories, and local baths are used.

The course of antibiotics ranges from five to ten days. The most commonly used:

group of fluoroquinolones (Ciprofloxacin, Leofloxacin, Ofloxacin, Gatifloxacin);
macrolide antibiotics (Roxithromycin, Azithromycin, Clarithromycin);
semisynthetic penicillins (Amoxiclav, Flemoxin, Augmentin).

The dosage is selected by the doctor depending on the severity of inflammation, weight and age of the patient. You cannot cancel it yourself or take it longer than the prescribed period. Microorganisms develop resistance to the drug and have no further effect.

Intramuscular injections of drugs from the cephalosporin group (Cefatoxime, Ceftriaxone, Cefuroxime) are used much less frequently. Such indications arise if a woman has a concomitant disease of the stomach or intestines, if an ascending infection is suspected and there is a threat of pyelonephritis.

The photo shows a popular antifungal agent in tablets

The nature of treatment depends on the type of pathogen:

for a disease caused by fungi, antifungal agents are prescribed (Terbinafine, Fluconazole);
if the pathogen belongs to mycoplasmas - the imidazole group (Ornidazole, Metronidazole, Tinidazole).

For severe allergic manifestations and itching, Loratadine, Diphenhydramine, Suprastin are recommended.

To enhance the effect, the same drugs are prescribed in vaginal suppositories. Absorbed into the pelvic vessels, the composition of the suppositories has an anti-inflammatory effect on neighboring organs.

For local irrigation at home, the following are recommended: warm sitz baths with a solution of potassium permanganate or herbal decoctions.

The following physiotherapeutic techniques are used:

vaginal electrophoresis with Furadonin, the active electrode is also placed in the pubic bone area;
diadynamic currents in the lumbosacral zone.

In order to support the immune system, a woman is prescribed multivitamins, ginseng tincture, lure, aloe (herbal immunomodulators). With secondary urethritis, the result of treatment of the underlying disease is important.

What folk recipes can be used for urethritis?

Urethritis must be treated with medications. It is impossible to replace them with folk remedies. However, the anti-inflammatory properties of many plants may well help medications. For this purpose, herbs and fruits are selected that also have diuretic, antimicrobial and antispasmodic properties.

juices from lingonberries, cranberries, carrots (we are talking only about fresh juices without preservatives and sugar);
celery greens, parsley, beets;
A decoction is prepared from the berries and leaves of black currant (half a liter of boiling water for 3 tablespoons of the dry mixture), infuse it for 30 minutes, drink it 2-3 times a day;
prepare a mixture in milk from the leaves and stems of parsley (simmer in the oven for 1 hour);
a decoction of linden blossom is known for its ability to relieve burning and pain when urinating;
Cornflower flowers are dried and used as tea.

The composition of plant components can be changed, different herbs can be combined into collections. They need to be stored separately. Examples of fees:

№1

mint leaves,
calamus roots,
nettle leaves and stems.

№2

elderberry flowers,
juniper berries,
horsetail.

To infuse, take an equal amount, brew overnight in a thermos, and drink over the next day.

№3

St. John's wort,
sage,
horsetail,
wheatgrass roots,
caraway fruits.

№4

knotweed,
shepherd's purse,
tansy flowers.

№5

heather grass,
fennel,
motherwort,
immortelle flowers,
black poplar buds.

Women need to come for examination to a gynecologist at least twice a year, even if nothing bothers them

How can a woman prevent urethritis?

To prevent urethritis, a woman must exclude possible routes of infection. For this:

you should be more selective about your sexual partners, exclude unprotected sex and casual contacts;
do not neglect personal hygiene, regular washing with weak disinfectants;
do not use alcohol solutions or soaps for hygiene, which lead to severe irritation of the urethra;
exclude from food foods that irritate the urinary organs (spicy spices, pickles, canned food, smoked meats);
dress according to the weather, avoid hypothermia, do not wear trousers that sharply compress the stomach (cause stagnation in the pelvis);
monitor the condition of teeth, promptly treat sore throats and other acute bacterial infections.

Although urethritis is not a fatal disease, it leads to serious disruptions to a woman’s health. Constant pain and itching contribute to irritability, cause insomnia, and reduce ability to work. Preventing the disease is much easier than treating the advanced form. With all the described manifestations, a woman must immediately contact a therapist or gynecologist. You should not self-medicate and turn the disease into chronic inflammation.

In the female body, the reproductive and urinary systems are closely interconnected into one, called the genitourinary system.

The structure of the female genitourinary system is quite complex, and is based on the performance of both reproductive and urinary functions. We will talk about the anatomy of this system in detail later in the article.

What does it look like and what does it consist of?

Urinary system in women (see close-up photo) not much different from men's, but there are still some differences.

The urinary system includes:

kidneys (which filter many harmful substances and are involved in their removal from the body);
renal pelvis (urine pre-accumulates in them before entering the ureter);
(special tubules connecting the kidneys to the bladder);
(the organ that directly contains urine);
urethra (urethra).

The kidneys, in both men and women, have the same shape and structure, and their size is about 10 cm. They are located in the lumbar region and are surrounded by a dense layer of fat and muscle tissue. This allows them to stay in one place without falling or rising.

The bladder in women has an oblong, oval shape, and in men it is round. The volume of this important organ can reach 300 ml. From it, urine flows directly into the urethra. And here, too, there are significant differences in the structure of the female and male body.

In women, urethral length cannot exceed 3-4 cm, while in men, this figure is 15-18 cm or more. Moreover, in women the urethra functions only as a channel for the removal of urine, but in men it also has a fertilizing function (delivery of semen to the uterus).

In the urethra of any person there are special valves (sphincters) that prevent the spontaneous outflow of urine from the body. They are external and internal, and it is the internal valve that allows us to independently control the process of urination.

As for the female reproductive system, it includes the external genitalia and reproductive (internal) organs. The external organs are usually called the labia majora, clitoris, labia minora and the opening leading to the vagina.

In young girls and girls, this hole is tightly closed with a special film (hymen).

The reproductive system includes:

vagina (a hollow tube, about 10 cm long, connecting the labia to the uterus);
uterus (the main organ of a woman in which she bears a child);
fallopian (uterine) tubes, through which the sperm moves;
(glands that produce hormones and egg maturation).

The urethra is very close to the vagina, therefore all these organs, due to their location, are called a single genitourinary system.

How does urination occur in women?

Urine is formed directly in the kidneys, which take an active part in cleansing the blood of harmful substances. During this cleansing process, urine is formed (at least 2 liters per day). As it forms, it first enters the renal pelvis, and then through the ureters into the bladder.

Due to the structure and shape of this organ, a woman can endure the urge to urinate for quite a long time. When the bladder is filled to capacity, urine is released from the urethra.

Unfortunately, the length and location of the female urethra contribute to the penetration of all kinds of infections into the body and the development of inflammatory processes. While, thanks to the length of the urinary canal, they are protected from this.

What diseases are the female genitourinary system susceptible to?

As already noted, most of these diseases are provoked by infections. Moreover, the close location of the urinary and genital organs causes not only urological problems and ailments, but also gynecological.

There are several other causes of genitourinary diseases:

fungal infections;
viruses and bacteria;
gastrointestinal diseases;
hypothermia;
endocrine disorders;
stress.

Most often, women suffer from the following diseases:

In addition, women are often exposed to infection sexually transmitted diseases and STIs (sexually transmitted infections). The most common of them:

mycoplasmosis;
HPV (papilloma virus);
syphilis;
ureaplasmosis;
gonorrhea;
chlamydia.

Ureaplasmosis, like mycoplasmosis, are transmitted only sexually, affecting the urethra, vagina and uterus. They are characterized by itching, pain, and mucus discharge.

Chlamydia- This is a very dangerous infection, difficult to treat and affecting absolutely the entire genitourinary system. Accompanied by weakness, fever, purulent discharge.

HPV in women it occurs without pronounced symptoms and pain. The main symptom is the presence of papilloma formations in the vaginal area. It is not easy to cure; it causes a huge number of complications.

Syphilis and gonorrhea also dangerous and extremely unpleasant illnesses that require immediate hospital treatment. And if you can diagnose gonorrhea in the first days after infection, by characteristic painful urination and discharge, then syphilis is much more difficult to detect.

Prevention of her diseases

It is much easier to prevent any disease than to try to get rid of it.

Just a few simple rules will reduce the risk of genitourinary lesions to a minimum. Adviсe on prevention:

avoid hypothermia;
Wear underwear only from natural fabrics, comfortable and not restricting movement;
observe all necessary hygiene procedures daily;
avoid promiscuous sex or regularly use a condom;
lead a healthy and fulfilling lifestyle, engage in moderate physical activity;
spend more time in the fresh air, strengthen the immune system, take additional vitamin supplements.

It is important to remember that the female genitourinary area is a complex, interconnected system. Any disease can lead to dire consequences: from chronic damage to internal organs, to infertility or oncology. Therefore, it is so important to take preventive measures to prevent their development.

How the female reproductive system works - watch the video: