Urethritis in women and men symptoms

Urethritis is a process of inflammation of the urethra, a thin duct through which urine is excreted from the bladder. Often caused by a bacterial infection, urethritis can give different symptoms in men and women. Infectious agents( including carriers of chlamydia, gonorrhea and herpes) are transmitted through sexual contact and can cause urethritis in both men and women, while the woman may not have any symptoms. If the symptoms do appear, urethritis can be difficult to distinguish from a bladder infection;However, the treatment of both diseases is similar. Urethritis can also be caused by sexually transmitted diseases;such infectious diseases are most common among women. How to use folk remedies for this disease look here.

Detachable from the urethra is studied mainly for the diagnosis of the inflammatory process with non-gonococcal urethritis, gonorrhea, trichomoniasis, chlamydia, syphilis, etc. In addition, the study allows differentiating a number of pathological and physiological conditions characterized by discharge from the urethra( prostatea, spermatorrhea, urethrorrhea).

In the study of the discharge from the urethra, the amount and composition of the cell elements depend mainly on the severity and duration of the inflammatory process. According to the European guidelines on urethritis( 2001), the diagnosis of urethritis should be confirmed by the detection of polynucleated neutrophils in the anterior part of the urethra, since discharge in men does not always indicate a pathology. The informative material for the study is the smears from the urethra and / or the first portion of urine. Carrying out two types of research allows us to identify cases that can be missed when only one of them is used. Inflammatory state of the mucous membrane of the urethra( urethritis) is expressed by the presence of at least 5 polynucleated neutrophils in the field of vision when the microscope is immersed. The depth of the pathological process in the urethra is indicated by the predominance of epithelium in the smears-prints of the cylindrical and parabasal cells. At the initial viewing of preparations it is possible to make the following practical conclusions.

For more detailed examination of smears, the criteria for the diagnosis of urethritis according to the European guidelines for urethritis( 2001) are as follows.

The sensitivity of the above tests depends on how long the patient did not urinate before taking the material for the study. Usually a 4 hour interval is recommended.

If an inflammatory process in the urethra is detected, it is necessary to establish its etiology. Urethritis can be either gonococcal( with the detection of Neisseria gonorrhoeae), or non-gonococcal( gonococci do not reveal).A significant proportion of non-gonococcal urethritis is due to chlamydia. Cases in which it is not possible to detect either chlamydia or gonococci are classified as non-gonococcal non-chlamydial urethritis( nonspecific urethritis).

For examination on gonococci, simultaneously taken from the urethra, prostate gland, urine in men and separated from the vagina, cervix, para-urethral ducts, rinsing water of the rectum in women. For diagnosis, a bacterioscopic method is used( Gram stain color), which in acute gonorrhea in men has a high sensitivity and specificity( 95% and 98%, respectively).In chronic and treated cases of disease in men, a positive result is observed only in 8-20% of cases. In men, in acute cases, the urethra is affected, in the chronic - the prostate gland, seminal vesicles;women are primarily affected by bartholin glands, vagina and urethra, later - the mucous membrane of the cervix, fallopian tubes, rectum, girls - the vagina, urethra, rectum, eye conjunctiva. A single negative result is not conclusive, so repeated studies are needed.

In the study of smears in patients with gonorrhea, a bacterioscopic picture of three species is mainly observed:

Trichomoniasis is widespread among women aged 2-40 years, less often in men and extremely rarely in children. The causative agent of the disease is Trichomonas vaginalis. The disease in women is characterized by fluid, foamy or purulent discharge, irritation of the mucous membrane of the vagina. In most men, the disease runs unnoticed, in a number of cases, the so-called "morning discharge"( discharge from the urethra of a drop of pus) is noted, and only a small part of the infection takes an acute form with the phenomena of urethritis and prostatitis. In women Trichomonas are found mainly in the vulva and the vagina, less often in the urethra, the cervix of the uterus. In men, the urethra, prostate, seminal vesicles are affected.

Chlamydia. Bacteriologic methods of chlamydia infection are rarely diagnosed, mainly using serological methods or PCR.

Candidiasis. Candida is the most frequent pathogen of mycotic urethritis, sexually transmitted. Much less often, candidal urethritis develops as a consequence of dysbiosis after treatment with antibiotics. In smears from the urethra, a mycelium and spores are found, which confirms the diagnosis.