What is Urethritis?

Urethritis is a common disease, which refers to inflammation of the urethral mucosa, which is more common in women. Clinically, it can be divided into acute and chronic, nonspecific urethritis and gonococcal urethritis. The latter two clinical manifestations are similar and must be identified based on medical history and bacteriological examination. Mostly caused by retrograde invasion of pathogenic bacteria into the urethra.

Basic Information

English name: urethritis
Visiting department: Urology
Multiple groups: female

Common causes: Urethral injury, foreign body in the urethra, urethral obstruction, unclean sex, etc.
Common symptoms: Frequent urination, urgency, urgency, and hematuria, redness of the urethra during acute episodes

Causes of urethritis

The common causes of urethritis are as follows: urethral injury: urethral mucosal abrasion caused by urethral device examination can damage the urethral mucosal defense function and cause bacterial infection; foreign body in the urethra: foreign body inserted from the outside or stones in the urethra, etc. A short pause can cause urinary tract infections; urethral obstruction: such as narrow foreskin, outer urethral stricture, urethral stricture, posterior urethral valve, urethral tumor, female hymen umbrella, urethral hymen fusion, etc. due to poor urination, urine Accumulation in the urethra can cause secondary urinary tract infections; Inflammation of adjacent organs, such as prostatitis, seminal vesiculitis, vaginitis, or cervicitis, can spread to the urethra, which is often a stubborn focus of chronic posterior urethritis; often with sex Related, dirty sex is easy to cause urinary tract infection.

Clinical manifestations of urethritis

Frequent urination, dysuria, urgency, and hematuria. Males in the acute phase may have urethral discharge, initially mucus, followed by purulent discharge; females have fewer discharges, and when chronic, they show urethral tingling and urination Discomfort, urinary tract secretions are reduced, showing a thin serous form, dull pain in the upper pubic area and perineum during acute attacks, redness and secretions in the urethral mouth can be seen.

Urethritis test

Routine urine examination showed an increase in white blood cell count or pyuria, accompanied by an increase in red blood cells, and a few showed gross hematuria. Three urine cup tests showed that there were a large number of pus cells and red blood cells in the first cup, while the second and third cups were basically Normal, the number of bacteria in the first stage of urinary cell culture is significantly higher than that in the middle stage of urine, urethral or vaginal discharge smear examination. Gonorrhoea urethritis can see intracellular or extracellular gonorrhoeae. Nonspecific urethritis can be cultured with secretions or anterior urethral swabs. Seeing a large number of bacterial growth, no bacteria found in the smear and culture of secretions, that is, mycoplasma, chlamydia may be infected, special methods can be cultured or PCR inspection.

Chronic urethritis requires urethral cystoscopy to determine the cause of the disease. Sometimes metal urethral probes can be used to test for stenosis in the urethra. If necessary, urethral angiography is performed. Instruments in the acute phase of urethra are contraindicated.

Diagnosis of urethritis

Clear diagnosis based on etiology, clinical manifestations, and laboratory tests.

Differential diagnosis of urethritis

Acute cystitis

Mainly manifested as bladder irritation symptoms such as frequent urination, urgency, dysuria, etc. However, patients with cystitis are mainly painful at the end of urination, and there is bacterial growth in the middle section of urine culture.

2. Acute pyelonephritis

Mainly manifested as sudden urinary tract irritation symptoms such as sudden urinary frequency, urgency, dysuria, often accompanied by low back pain and chills, fever and other symptoms, physical examination has knocking pain in the kidney area, routine urine examination with pus cells.

3. Acute prostatitis

Manifestations include frequent urination, urgency, and dysuria, but prostatitis has perineal discomfort, difficulty urinating, and fever; digital rectal examination revealed an enlarged prostate with tenderness.

4. Gonococcal urethritis

Manifestations include frequent urination, urgency, and dysuria. There is also redness and swelling at the urethral opening, thin or purulent secretions, and a history of unclean sexual intercourse. Neisseria gonorrhoeae can be seen by smear examination of the urethral secretions, which can confirm the diagnosis.

5. Bladder tuberculosis

Presented as frequent urination, urgency, dysuria, pus cells found in the urine, often a history of urinary tuberculosis, and acid-fast staining of the urine can find acid-fast bacilli.

6. Trichomonas urethritis

Manifestations include frequent urination, urgency, and urinary burning pain and itching. Trichomonas can be found in urethral secretions.

Urethritis complications

Complications in male patients include epididymitis, prostatitis, seminal vesiculitis, etc .; complications in female patients include endometritis, salpingitis, pelvic inflammatory disease, and peritonitis.

Intraurethral infection can spread directly to the bladder or prostate and cause cystitis or prostatitis. Acute urethritis can be accompanied by a paraurethral abscess if it is not handled properly. The abscess can penetrate the skin of the penis and become a urethral fistula. Fibrosis can cause urethral strictures during the urethral inflammation healing process.

Urethritis treatment

Antibiotic application

At present, there are many kinds of drugs used for treatment. According to the types of pathogenic bacteria and the sensitivity to the drugs, a combination of 2 to 3 drugs should be used, which has a good effect. The drug should be discontinued for 7 to 10 days after the symptoms completely disappear, the urine test is normal, and the bacterial culture is negative.

2. Adjuvant therapy

Drink more water in the acute phase to increase urine output and flush the urethra. When you have frequent urination, urgency, and dysuria, you can take antispasmodics and remove all the causes of urethritis. Urinary tractitis caused by sexually transmitted diseases should be treated at the same time as the spouse, otherwise it is difficult to cure.

3. Local treatment

Applicable to chronic urethritis, contraindication in the acute phase. urethral dilatation. Drugs are injected into the urethra. endoscopic electrocautery.