What Is the Meaning of Urethritis?
Urethritis is a condition wherein the urethra becomes swollen and inflamed. The urethra is a tube that transports urine from the urinary bladder to the outside of the body. Males also produce a liquid known as semen that passes through the urethra. The most typical symptom of urethritis is pain while urinating and a strong urge to pass urine. Bacterial entry and infection into the urinary tract or urethra is the most common cause of urethritis. Urethritis must not be confused with urinary tract infections because the two are entirely different. Urethritis is a condition wherein the inflammation is confined to the urethra. In contrast, urinary tract infections involve the entire urinary system. Though the patient experiences similar symptoms in urethritis and urinary tract infections, the management strategy varies for both. The treatment is done based on the causes of urethritis. Urethritis can affect people of all age groups, including children and adults. In addition, it can affect both males and females, but females are more likely to develop urethritis because of the anatomical differences in the urinary tract. Females have a shorter urethra than males, so bacteria can easily invade their urogenital tracts.
What Are the Causes of Urethritis?
Most urethritis occurs due to bacterial and viral infections, bacteria being the most common cause. The bacteria that affect the bladder and kidneys can also infect the lining of the urethra. Sometimes, the bacteria present in the genitals might enter the urethra and infect it. The bacteria responsible for urethritis are listed below:
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Neisseria gonorrhea.
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Chlamydia trachomatis.
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Mycoplasma genitalium.
The viruses that can cause urethritis are listed below:
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Herpes simplex virus.
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Trichomonas (a unicellular organism that gets transmitted sexually).
What Are the Signs and Symptoms of Urethritis?
The following symptoms are usually seen in males:
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Penile discharge.
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Burning sensation while passing urine.
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Burning or itching near the penile opening.
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Blood in the urine and semen.
The following symptoms are usually seen in females:
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Frequent urge to pass urine.
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Burning and itching sensation at the urethral opening.
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Pain and discomfort while passing urine.
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Abnormal vaginal discharge.
What Are the Different Types of Urethritis?
Urethritis can be classified into two different types based on its causes. The two different types of urethritis are listed below:
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Gonococcal Urethritis - It is caused by the bacteria Neisseria gonorrhea, and 20 % of the cases of urethritis belong to this type.
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Nongonococcal Urethritis - It is caused by infections other than gonorrhea. Chlamydia is one of the most common causes of non-gonococcal urethritis and other sexually transmitted diseases.
Who Is at Risk of Urethritis?
Urethritis is mainly linked to a person's behavior and daily habits, like not maintaining adequate genital hygiene and having unprotected intercourse. The following people are at the highest risk of urethritis:
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Having multiple sexual partners.
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Having sexual intercourse without a condom.
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Previous history of sexually transmitted diseases.
How Is Urethritis Diagnosed?
It is challenging for doctors to diagnose urethritis because the signs and symptoms resemble many other urologic conditions. However, the diagnosis of urethritis is based on the following:
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Medical History - A medical history is a verbal communication between a doctor and the patient to get an idea about the patient's general health, the signs and symptoms, and the other medical conditions he is suffering from.
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Physical Examination - A physical examination is done to check the physical signs of urethritis. The doctor will examine the rectum, abdomen, and genitals of the patient.
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Urine Test - A urine test is a simple procedure in which the patient collects urine in a container. The urine sample is then examined in the laboratory under a microscope to detect bacteria, white blood cells, and other abnormalities.
What Has Been Known So Far Related to Urethritis Empiric Therapy?
Empiric therapy is simply a medical term used to describe a therapy that is based on clinical experience and research. There is no complete or perfect information available related to the therapy. The empiric therapy regimen recommended for urethritis is described below:
1. If diagnostic tools are unavailable to treat patients with effective drug regimens, the empiric therapy regimen is listed below:
- A single dose of Azithromycin 1 g or Doxycycline 100 mg for seven days plus an intramuscular infusion of Ceftriaxone 250 mg or Cefixime 400 mg.
- Fluoroquinolones must not be used in empiric therapy.
2. Non-gonococcal Urethritis:
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First-line Regimen:
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A single dose of Azithromycin 1 g.
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Doxycycline 100 mg for seven days.
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Alternative Regimen:
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Erythromycin base 500 mg.
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Erythromycin ethylsuccinate 800 mg four times a day for seven days.
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Ofloxacin 300 mg twice a day for seven days.
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Levofloxacin 500 mg once daily for seven days.
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3. Recurrent and Persistent Urethritis:
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Recommended Regimens:
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Single dose of Metronidazole 2 g.
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Tinidazole 2 g and Azithromycin 1 g.
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What Are the Complications of Urethritis?
Medications can treat urethritis quickly and effectively. However, the problem arises when the condition is left untreated for a long period, and the infection spreads to the other parts of the urinary tract, including the kidneys, ureters, and urinary bladder. The infections might turn painful. Although the infections can be treated with more intensive antibiotics, organ damage is always risky. Sometimes, the infection might spread into the blood resulting in a condition known as sepsis or septicemia.
If urethritis occurs due to sexually transmitted infections, it can damage the male and female reproductive tract. Women might develop pelvic inflammatory disease, due to which they experience pelvic pain, infertility, and pain during sexual intercourse. Women who have not undergone any treatment for sexually transmitted infections are at risk of developing ectopic pregnancies, which can be life-threatening. Men are more likely to develop painful inflammation and infection of the prostate gland. The problems arise when a section of the urethra narrows, leading to scarring and painful urination.
How Can Urethritis Be Prevented?
Most bacteria that cause urethritis might get transmitted from one person to another during sexual intercourse. Therefore it is important to practice safe sex. The following tips help prevent urethritis:
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Avoid having sexual intercourse with multiple partners.
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Do not engage in sexual activities without using a condom.
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Avoid having sex if you or your partner is suffering from sexually transmitted diseases.
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Drink plenty of water to flush out the bacteria from the urinary tract.
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Limit the consumption of acidic foods.
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Avoid exposure to spermicides.
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Cranberry juice contains proanthocyanidins and is considered good for health and beneficial for people suffering from urologic diseases.
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The patient can take an over-the-counter drug like Pyridium.
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Do not use scented products or soaps in the genital area.
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Limit the consumption of salts, alcohol, caffeinated drinks, artificial sweeteners, tomatoes, and spicy foods.
Conclusion:
Urethritis is a common urologic condition that can affect both males and females of any age group. Antibiotics or empiric therapy is the first line of treatment for urethritis because it is mainly caused due to bacterial infection. Several preventive measures are available to treat urethritis in the mild stage. Though urethritis is not a life-threatening condition, the patient must get treated soon as the infection might spread in the blood and result in sepsis. Doctors prefer empiric therapy to treat urethritis because it saves the patient from surgical trauma. Hence the patient need not worry and consult the doctor at the earliest to know about the management of urethritis.