The urethra—the tube that carries urine from the bladder to the outside of the body—swells or becomes inflamed when someone has urethritis. Urination for those with this illness causes excruciating discomfort. A bacterial infection brought on by E. coli, Gonococcus (which also causes gonorrhea), and Chlamydia trachomatis is one of the most frequent causes of urethritis (responsible for chlamydia). HSV-1 and HSV-2 viruses may potentially be at fault.
During sexual contact, the bacteria that cause urethritis are frequently passed from one person to another. The most frequent cause, however, is poor cleanliness close to the genitals, which allows parasites to enter the urethra. More severe infections, such as epididymitis in males and pelvic inflammatory disease (PID) in women, may result from this. These disorders can cause infertility if not treated.
Pathophysiology
The many described organisms are known to be spread through sexual activity. The risk of spreading these organisms is present during both genito-rectal and vaginal sexual activity, with genito-rectal sexual activity being more dangerous.
Chlamydia is unique because they are obligate intracellular organisms similar to mycoplasma. Because of this, they can be shielded from our immune system. Regardless of the causative organism, an inflammatory response is thought to play the most important role in causing the typical semiology of urethritis.
Because this condition is infectious in etiology, it is commonly found as part of other infectious syndromes, such as epididymitis, orchitis, prostatitis, or urinary tract infections. Patients with untreated urethritis might develop ascending urinary tract infection and bacteremia. This can lead to the development of pneumonia.
Anatomy of Urethra
Types
Doctors have historically classified sexually transmitted (infectious) urethritis into two categories: gonococcal urethritis, caused by gonorrhea bacteria, and nongonococcal urethritis, caused by bacteria other than gonorrhea.
Gonococcal urethritis, commonly called clap, is caused by Neisseria gonorrhoeae bacteria. Gonorrhea infections are passed from person to person during sexual activity (vaginal, oral and anal intercourse).
Nongonococcal urethritis is caused by all sexually transmitted bacteria other than N. gonorrhea. The most frequent cause is Chlamydia trachomatis bacteria, which cause the sexually transmitted infection Chlamydia. Nongonococcal urethritis is the one of the commonest forms of sexually transmitted infection. In addition to C. trachomatis, other possible infectious causes of nongonococcal urethritis include Ureaplasma urealyticum, Mycoplasma genitalium and Trichomonas vaginalis.
Not all urethritis is caused by an infection or trauma. Reactive arthritis (formerly known as Reiter’s syndrome) is an inflammatory disorder that usually has three features:
Painful and swollen joints, one or many
Conjunctivitis
Sterile urethritis
Urethritis risk factors
It is more common in women. Other factors that may increase your chance include:
Being sexually active
Use of spermicides
Recent change in sexual partners
Unprotected sex (without use of a condom)
History of other STDs
Having catheters or tubes placed in the bladder
Medications that lower resistance to bacterial infection
Causes
It’s thought that around 20% of urethritis cases are caused by gonorrhoea. This is known as gonococcal urethritis. If it’s caused by some other form of infection, this is known as non-gonococcal urethritis. The condition can also occur if your urethra is injured, or becomes irritated for some reason.
Common causes include:
Other STIs, such as chlamydia or herpes
A parasitic infection, such as trichomonas vaginalis, which is passed on through unprotected vaginal sex
A urinary tract infection (UTI), often caused by kidney stones, a full bladder, using a catheter, or a weak immune system. Pregnancy also increases your likelihood of developing a UTI.
A virus
An injury caused during sex or masturbation
Squeezing the urethra
Damage caused when taking out or putting in a catheter
Bathroom products or deodorants
In women, wiping your bottom from back to front
In some cases, no obvious cause can be found. In this case, your doctor will diagnose you with non-specific urethritis (NSU).
Symptoms of Urethritis
The primary symptoms are urethral inflammation and painful urination. In addition, symptoms include:
Frequent or urgent need to urinate
Difficulty starting urination
Itching, pain or discomfort when not urinating
Pain during sex
Vaginal or urethral discharge
Abdominal and pelvic pain
Fever and chills
Complications
Complications of untreated urethritis can be serious, even life threatening in some cases. You can help minimize your risk of serious complications by following the treatment plan you and your health care professional design specifically for you. Complications include:
Chronic pelvic pain
Epididymitis
Infertility
Pelvic inflammatory disease (PID, an infection of a woman’s reproductive organs)
Perinatal transmission of infection to newborn
Proctitis
Prostatitis (inflammation and infection of the prostate)
Reiter syndrome (joint and ocular inflammation)
Spread of infection (endocarditis, meningitis, sepsis)
Urethral scarring and narrowing
Diagnosis and test
Your healthcare provider will examine you and ask about your symptoms and health history. You may also have one or more of the following tests:
Urine test to take samples of urine and have them checked for problems.
Blood test to take a sample of blood and have it checked for problems.
Vaginal culture to take a sample of vaginal discharge to have it tested for problems. A cotton swab is inserted into the vagina.
Cystoscopy to allow the healthcare provider to look for problems in the urinary tract. The test uses a thin, flexible telescope called a cystoscope with a light and camera attached. The scope is inserted into the urethra.
Ultrasound to allow the healthcare provider to see a detailed image of the inside of your pelvis. It will not show whether you have urethritis, but it may show other signs of sexually transmitted diseases that can also cause urethritis. Ultrasound will not show whether you have urethritis, but it may show other signs of sexually transmitted diseases that can also cause urethritis.
Nucleic acid test (NAT) to detect the presence of a virus or bacteria. It may be done instead of a culture because it allows for a faster diagnosis.
Treatment and medications
The goal of the treatment is to eliminate the cause of infection, prevent the spread of infection and improve your symptoms. There are different treatment options depending on the cause and severity of infection. Pain relievers may also be used in conjunction with other medications to lessen painful symptoms of urethritis.
People with urethritis who are being treated should avoid sex or use condoms during intercourse. If an infection is the cause of the inflammation, your sexual partner must also be treated.
Treating urethritis caused by bacteria
Antibiotics can successfully cure urethritis caused by bacteria. Many different antibiotics can treat urethritis, but some of the most commonly prescribed include:
Doxycycline (Adoxa, Monodox, Oracea, Vibramycin)
Ceftriaxone (Rocephin)
Azithromycin (Zithromax, Zmax)
Urethritis due to trichomonas infection (called trichomoniasis) is usually treated with an antibiotic called Flagyl (metronidazole). Tindamax (tinidazole) is another antibiotic that can treat trichomoniasis. Urethritis that does not clear up after antibiotic treatment and lasts for at least six weeks is called chronic urethritis. Different antibiotics may be used to treat this problem.
treating a virus-induced urethritis
Several drugs, including the following, can be used to treat it because it is caused by the herpes simplex virus:
Famciclovir (Famvir) (Famvir)
Valacyclovir (Valtrex) (Valtrex)
Acyclovir (Zovirax) (Zovirax)
Prevention of urethritis
It occasionally happens as a result of unprotected sex. You should make an effort to engage in sexual activity safely in such a setting. In addition, you should abide by the guidelines listed below to prevent urethritis.
When engaging in physical contact, use a condom.
Avoid having sexual relations with multiple people.
Do not conceal your sexually transmitted disease history from anyone. As soon as you can, consult a physician.
Up your water intake. Clean the penis and vagina with water after intercourse. You must urinate.
Thank you for reading this article please share with your families and friends.