Urethritis

definition

Urethritis is also known as urethritis in medical jargon. It is an inflammation of the mucous membrane around the urethra. This goes off the bladder and leads the urine to the outside. Urethritis, like cystitis, belongs to the group of lower urinary tract infections. The inflammation usually results from an infection with bacterial pathogens. The disease is usually transmitted sexually. In women in particular, if the disease is untreated, there is a risk that the disease will spread further, affect the reproductive organs and result in sterility (infertility).

causes

In most cases, urethritis is transmitted through sexual contact. This is the case with both men and women. By far the most common bacteria are the triggers that are transmitted through sexual contact. A distinction is made here between specific and unspecific urethritis:

• Specific urethritis is caused by the bacteria Neisseria gonorrhoeae and is better known as gonorrhea or gonorrhea.
• In most cases, unspecific urethritis is caused by bacteria known as chlamydia. This form of urethritis is also transmitted sexually.

In rarer cases, urethritis occurs as an accompanying symptom in the context of other diseases. For example in Reiter's syndrome, a rheumatic disease. This leads to a triad of symptoms consisting of urethritis, joint inflammation (arthritis), particularly of the knee and ankle, and conjunctivitis (conjunctivitis). Mechanical irritation of the urethra can also lead to inflammation. For example, through a urinary catheter. Allergic reactions, for example to lubricants, can also be the cause of urethritis.

Diagnosis

At the beginning of the diagnosis there is always the anamnesis. The doctor will ask what symptoms have existed, how long have they existed, whether there are previous illnesses, whether the disease has occurred before and whether there are currently changing sexual partners. This is followed by the physical examination, in particular the urethra is examined. Look for signs such as redness of the urethral entrance or discharge.

In men, the testicles and prostate are also examined as in some cases these can also be affected by the inflammation. Afterwards, a urine sample usually has to be submitted so that a urine status can be made. This checks whether there are inflammatory cells or red blood cells in the urine. A swab from the urethra can also be taken to determine the exact pathogen.

Concomitant symptoms

The main symptom of urethritis is a strong burning sensation every time you urinate. In addition, there is often noticeable itching in the urethra area. The entrance to the urethra is usually very red. This is often accompanied by a cloudy, yellowish discharge from the urethra.

Urethritis does not always have to cause symptoms, so it can also be asymptomatic. But even if there are no symptoms, the bacterial form of urethritis is contagious, i.e. sexually transmitted. Symptomatic courses usually lead to burning sensation when urinating, itching and discharge from the urethra.

You might also be interested in: Pain in the urethra

Concomitant symptoms in men

In men, other organs can also be affected. For example, inflammation of the prostate (prostatitis) or the testicles (orchitis) or epididymis (epididymitis) can also occur. These types of inflammation are usually extremely painful. It is often accompanied by fever and chills.

Concomitant symptoms in women

In women, urethritis is relatively often asymptomatic. Nevertheless, it is contagious. In women, there is a risk that the bacteria from the urethra will spread further and ascend into the uterus. From here they can reach the fallopian tubes and ovaries and cause an infection of the ovaries (adnexitis). In this case, there is severe pelvic pain, fever and a significantly reduced general condition.

A complication of such an inflammation of the fallopian tubes is the sticking together of the fallopian tubes. This can increase the risk of an ectopic pregnancy and in the worst case lead to infertility (sterility) of the woman.

In both men and women, there is also the risk that the pathogens will spread to the kidneys, i.e. ascend. This can lead to inflammation of the kidneys. There is dull flank pain, high fever and chills, the general condition is significantly reduced.

The pathogens can also get into the bloodstream and trigger urosepsis. Urosepsis is - like inflammation of the renal pelvis - usually associated with fever and marked malaise. Both diseases must be treated quickly as they can be potentially fatal.

Urethritis with discharge

Discharge is a typical symptom that occurs in connection with urethritis. In infections caused by bacteria, the discharge is usually yellowish and cloudy and smells unpleasant.

Urethritis with pain

The pain of urethritis occurs primarily in the form of a strong burning sensation in the urethra area when urinating. If the course is complicated, men can also develop inflammation of the prostate or the epididymis. This is often accompanied by severe pain in the area of ​​the affected glands.
Please also read our article on this Burning sensation in the urethra.

In women, the bacteria can spread to the uterus and fallopian tubes, which usually leads to severe pelvic pain on one side. If the inflammation rises to the kidneys, there is dull flank pain and severe knocking pain in the kidneys on the affected side.

Is urethritis an indication of HIV?

No. Urethritis basically has nothing to do with HIV. In most cases it is caused by bacteria. However, urethritis is a sexually transmitted disease, as is HIV. Unprotected sexual intercourse therefore carries both the risk of urethritis and HIV.

You can also read our topic: What are the signs of an HIV disease

Treatment / therapy

General information on treatment

The type of treatment depends on the triggering factor. For example, if the urethral inflammation is caused by mechanical irritation, as can be the case with the urinary catheter in place, then the therapy consists of removing the trigger (urinary catheter) and supporting measures such as the use of nourishing or cooling ointments.

If - as in most cases - a bacterial infection is the trigger, antibiotic therapy should usually be initiated. The type of antibiosis depends on the trigger. In the case of an infection with chlamydia, the antibiotic doxycycline is usually used for 7 days. Alternatively, azithromycin can be used once.

If it is not certain whether it is an infection with Chlamydia or Neisseria gonorrhoeae or if the gonorrhea is certain, azithromycin should be preferred. Ceftriaxone should then be used as a single dose. Either as an intramuscular injection, i.e. a syringe into the muscle like a vaccination, or as an intravenous administration, i.e. via an access in the vein.

If it is a sexually transmitted disease, in most cases the sexual partner should also be treated, otherwise the disease can always be transmitted from one to the other. If complications arise such as inflammation of the prostate or (epididymis) testicles in men or inflammation of the fallopian tubes in women, additional antibiotic therapy may be necessary. The same applies to inflammation of the renal pelvis or urosepsis that develops from the urethritis.

In the case of a bacterial infection, non-drug measures are recommended to drink a lot to flush out the pathogens and prevent them from ascending.

Sexual contact should be avoided during urethritis. In addition, if you continue to change sexual partners, preference should be given to protected intercourse, as this significantly reduces the risk of infection.

Which drugs are used?

Antibiotics are primarily used to treat urethral infections or their complications. Doxycycline is the drug of choice for chlamydial infection.

An infection caused by Neisseria gonorrhoeae (gonorrhea) should be treated with a combination of azithromycin and ceftriaxone.

In the case of complications such as inflammation of the prostate or epididymis in men or ovarian inflammation in women, as well as inflammation of the kidney or urosepsis, other antibiotics may also be used. If the patient suffers from pain, prescribing a pain reliever such as ibuprofen can make sense. If there is a fever, antipyretic drugs such as metamizole or paracetamol can be used.

When do i need an antibiotic?

In the case of urethritis caused by bacterial pathogens, and this is by far the most common form, antibiotic therapy should always be given. In addition, the sexual partner should also be treated with antibiotics so that the two partners do not repeatedly infect each other.

Mechanically induced inflammations do not require antibiotic therapy, just as allergies do not require any infections.

Which antibiotic works best?

As already described above, clarithromycin is usually used for a chlamydial infection.

For gonorrhea, azithromycin and ceftriaxone are used.

Which home remedies help with urethritis?

In the case of urethritis, it is important to avoid mechanical irritation. Sexual intercourse should therefore be avoided until the disease has healed. It is important to drink a lot in order to flush out the germs (if germs were the trigger). The use of heat, for example in the form of a hot water bottle that is placed on the lower abdomen, can also alleviate the symptoms.

Warm hip baths, for example with chamomile, can provide relief.

Various teas are said to have a positive effect on urethritis. These include tea made from watercress, bearberry leaves, cranberry leaves, field horsetail, goldenrod, lovage and juniper berries.Cranberry - in juice or tablet form - is said to prevent the colonization of the bladder and urethral mucosa with bacteria.

Homeopathy for urethritis

For the treatment of urinary bladder inflammation, a homeopathic remedy is recommended above all: Cantharis vesicatoria (Spanish fly). It is said to have a pain relieving effect, especially for pain in the lower pelvic area.

The use of Cantharis vesicatoria is said to significantly relieve the pressure on the bladder and the burning pain when urinating. The frequent need to urinate can also be treated with it. The recommended dose is 3 Cantharis 5X globules every 30 minutes.

Schüssler salts

There is little mention in the literature of the use of Schüssler salts for the treatment of urethritis. Most likely, the intake of Schüssler salt number 9, sodium phosphoricum, can be recommended. In the case of acute complaints, 1 tablet can be taken every 10 to 15 minutes.

Duration of urethritis

Urethritis is not always associated with symptoms. Therefore, no general statement can be made about how many days the disease will last.

Bacterial urethritis should always be treated with antibiotics. After the start of antibiosis, the symptoms - if any - usually subside after 2-3 days at the latest. However, that does not mean that the disease has healed. It is important to know this, especially with bacterial urethritis, as it is very contagious (sexually transmitted). In general, after a healed urethritis, only protected sexual intercourse should initially take place in order to avoid renewed infection or infection of the sexual partner.

Who treats urethritis

Urethritis is usually not just treated with antibiotics, often a smear is taken from the urethra beforehand in order to be able to precisely determine the pathogen. Even if the family doctor is normally the first point of contact for these types of illnesses, he usually does not have the material to take and examine smears.

It can therefore make sense to go to the urologist (man) or to the urologist / gynecologist (woman). First, however, you can see your family doctor, who can then decide how to proceed.

L.find out more about this topic at: The urologist

Is urethritis contagious?

Urethritis caused by bacteria is contagious. The transmission route is via smear infection as part of sexual intercourse. The infection rate is high. With strange and frequently changing sexual partners, only protected sexual intercourse should take place. If handled correctly, this protects against infection in the majority of cases.