Urethritis
Dr. med. Julia Schwarz is a freelance writer in the medical department.
More about the experts All content is checked by medical journalists.Urethritis is an inflammation of the lining of the urethra. Urethritis is often the result of a sexually transmitted disease. The therapy depends on the cause and is very important so that the urethritis does not become chronic and does not leave permanent damage. In most cases, urethritis is treated with antibiotics. Read everything you need to know about the causes, symptoms and treatment of urethritis here.
ICD codes for this disease: ICD codes are internationally recognized codes for medical diagnoses. They can be found, for example, in doctor's letters or on certificates of incapacity for work. N34
Urethritis: description
Urethritis is one of the infections of the lower urinary tract: The urethra is the last section of the urinary tract system. Urine from the urinary bladder escapes through the urethra. Urethritis causes the lining of the urethra to become inflamed, which can cause an uncomfortable burning sensation when urinating and discharge.
Men and women are equally likely to develop urethritis. However, the age group from 20 to 24 years of age is most affected by urethritis, which is attributed to the pronounced sexual activity in this age group. In men, the symptoms of urethritis are usually much more pronounced due to the longer urethra. Women, on the other hand, do not even notice urethritis in many cases, as the symptoms are often very mild.
Urethritis is divided into two forms: specific urethritis and non-specific urethritis. In specific urethritis, the sexually transmitted bacterium Neisseria gonorrhoeae (gonococci) is responsible for the inflammation of the urethra. Infection with this bacterium leads to the sexually transmitted disease gonorrhea (gonorrhea). Nonspecific urethritis, on the other hand, is caused by various other bacteria. The causative agents of unspecific urethritis include mainly chlamydia, mycoplasma and intestinal bacteria.
Urethritis is diagnosed using urine cultures and a swab from the urethra to identify the pathogen. This allows a specific antibiotic therapy, through which a complete cure is usually achieved.
Urethritis: symptoms
The symptoms of urethritis are similar to the symptoms of urinary bladder inflammation: many sufferers suffer from itching and burning of the urethra. This can make urination very painful. A glassy-cloudy or purulent discharge (fluor urethralis) from the urethra can also occur, which is very uncomfortable for many affected people. Sometimes the urethra exit on the genitals may be red.
The symptoms of urethritis are different in women and men: In women, the symptoms are usually much less severe and many report only an uncomfortable feeling when urinating. As a result, urethritis remains undetected in women for 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 strong symptoms because they have a significantly longer urethra and the inflammation therefore affects a larger area of the mucous membrane. In addition, the inflammation can spread to the prostate and testicles.
Urethritis symptoms at a glance:
Urethritis - man
- usually very pronounced complaints
- Burning in the urethra (at rest and when urinating) so-called "Bonjour drops": purulent discharge from the urethra in the morning before urinating for the first time (particularly typical for gonorrhea)
Urethritis - woman
- mostly mild or no symptoms at all
- Burning sensation in the urethra (at rest and when urinating)
- discharge
- Pelvic pain
Urethritis: causes and risk factors
In principle, women and men are affected equally often. In most cases, the urethritis is due to a bacterial infection after unprotected sex. The most common bacterial pathogens causing urethritis are chlamydia (Chlamydia trachomatis, about 25 percent of all urethritis) and gonococci (Neisseria gonorrhoeae, about 20 percent). There are also a number of other bacteria that can cause urethritis.
Since the bacteria are mostly transmitted through sexual intercourse, the best way to prevent infection is to use condoms during intercourse. Although these do not offer one hundred percent protection, they can prevent infection in many cases.
People who have to spend a long time in hospital and whose urine is drained through a urinary catheter are particularly at risk of urethritis: a urinary catheter that has been in place for a long time mechanically irritates the urethra. This makes their mucous membrane more sensitive to germs and has fewer opportunities to defend them. Injury to the urethra after inserting sharp objects (for example through autoerotic practices) also promotes the occurrence of urethritis.
Urethritis: examinations and diagnosis
The description of the symptoms already provides important information for diagnosing urethritis. This is followed by a physical examination, during which the doctor can determine whether the urethral orifice is visibly inflamed and reddened from the outside.
For further clarification, a smear is usually taken from the urethra. For this purpose, a sample is taken from the anterior urethra with the help of a cotton swab or a small spatula. The tissue sample is then examined under the microscope. However, a urine culture is essential to reliably identify the causative bacterium. The attempt is made to multiply the bacteria from a urine sample in special nutrient media to such an extent that they can be reliably identified. It is important to use the first stream of morning urine as it is used to flush most of the bacteria out of the urethra. If the midstream urine is used, the bacteria can usually no longer be sufficiently detected. The creation of a urine culture has another benefit: If there are enough bacteria, the effectiveness of various antibiotics can be tested in advance (antibiogram).
Urethritis: treatment
The therapy of urethritis always depends on the triggering factor. In the case of a bacterial infection, the administration of antibiotics is usually essential. The appropriate antibiotic is selected depending on the pathogen. Chlamydia is treated with an antibiotic from the group of macrolides. These include active ingredients such as erythromycin or clarithromycin. The antibiotic inhibits the growth of the bacteria, which means that they can no longer multiply. When infected with gonococci, an antibiotic from the group of cephalosporins is effective. It is usually also advisable to treat the partner as well, so that both do not repeatedly infect each other ("ping-pong effect").
Home remedies for urethritis
In addition, there are some home remedies that can aid the recovery process from urethritis. It is especially important to drink a lot during the inflammation. Because even if frequent urination is uncomfortable, the bacteria are more easily flushed out of the urethra due to the increased urination.
It is also beneficial to keep your feet warm. The blood circulation in the feet influences the blood circulation in the urinary tract via nerve-vascular reflexes. Adequate blood flow, in turn, supports the body's defense mechanisms.
Certain fruit juices such as cranberry juice, lingonberry juice or currant juice also acidify the urine, which makes it difficult for bacteria to multiply.There are ready-made bladder tea blends on the market that are supposed to support the healing 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, during which sex toys could irritate the area around the urethra, should also be avoided during the illness phase.
Urethritis: disease course and prognosis
The course of urethritis depends on the cause. In women, urethritis is often mild or even without symptoms. In the case of a bacterial disease, treatment with the right antibiotic leads to a good prognosis. Consequential damage rarely occurs with timely and consistently completed treatment. When taking antibiotics, it is important that they continue to be taken after the symptoms have subsided until the duration of treatment prescribed by the doctor has been reached. This is very important to prevent the bacteria from developing resistance to antibiotic agents. The inflammation of the urethra usually subsides quickly with the right antibiotic therapy.
Possible complications
Nevertheless, complications in the course of urethritis can occasionally occur. Chlamydia can lead to inflammation of the prostate (prostatitis) or inflammation of the epididymis (epididymitis) in men as part of an inflammation of the urethra. This inflammation is often accompanied by a fever.
In women, urethritis can also cause serious complications. Especially because the infection often goes undetected for a long time due to the mostly mild symptoms. For example, the infection can rise further and cause inflammation of the fallopian tubes (salpingitis) or the ovaries (adnexitis). This type of complication is often accompanied by fever, chills, and pelvic pain. There is a risk that the fallopian tubes will stick together as a result of the inflammation (tube sticking) and infertility occurs.
Urethritis caused by chlamydia is particularly dangerous during pregnancy. Because chlamydia can lead to severe conjunctivitis (conjunctivitis) in the unborn child, which can even lead to blindness.
One speaks of a so-called "Reiter's syndrome" if, in addition to the urethritis, there is also conjunctivitis and reactive inflammation of the joints (arthritis). In most cases, however, this disease heals on its own.
To prevent urethritis, the use of condoms during sexual intercourse makes sense. A strong immune system and sufficient daily drinking are also of great importance.
Tags: Baby Child stress eyes
