The urethra is the connection between the urinary bladder and the outside world. Although the urinary stream regularly flushes out potential pathogens, some germs still manage to travel up the urethra. Infectious urethritis is one of the most common consequences of sexually transmitted diseases. In addition, there are other causes of inflammation of the urethra.
Urethritis: groups of people at risk.
Urethritis can affect both men and women. It can occur alone or in combination with other inflammations of the kidneys and urinary tract. Particularly susceptible are:
- People whose urethra is pre-damaged, for example, by a narrowing or bulge.
- Patients with weakened immune defenses, for example, cancer, diabetes mellitus or chronic inflammation.
What forms of urethritis are there and how do they develop?
Experts distinguish specific from non-specific urethritis:
- Specific urethritis (gonorrheal urethritis): the cause of this urethritis is an infection with the gonorrhea pathogens Neisseria gonorrhoeae (gonococci), which are transmitted during sexual intercourse.
- Nonspecific urethritis (non-gonorrheal urethritis): this form is also often caused by germs (in 50 percent chlamydia), but also other bacteria, viruses and fungi), which can be transmitted mainly during sexual intercourse or, for example, during an examination such as cystoscopy. However, non-specific urethritis can also be due to other causes. It can be acute or chronic.
Three mechanisms of development of acute urethritis.
In the acute form, there are basically three mechanisms of origin:
- An infection caused by pathogens that come from the outside and travel up the urethra (“ascending infection”).
- An inflammation caused by germs that are already above the urethra in the urinary bladder, prostate or kidneys and migrate down (“descending infection”)
- A rare allergic inflammation caused by contraceptives inserted into the vagina, such as suppositories or ointments.
Other causes of urethritis.
The chronic or recurrent form can be caused either by particularly resistant pathogens, an acute infection that has not been adequately treated, or re-infection by a sexual partner.
In women after menopause or after removal of the ovaries, there may be a change in the mucous membrane of the vagina and urethra as a result of estrogen deficiency, which can also cause inflammatory reactions (senile urethritis).
In Reiter’s disease, urethritis is one of the typical symptoms, along with inflammation of the joints and the conjunctiva.
Other causes of the chronic form include:
- Mechanical stimuli (for example, when a urinary catheter is constantly in place).
- Chemical stimuli (example by cancer drugs that are excreted in the urine).
- Irradiation (in cancer treatment).
Such a pre-damaged urethra is then in turn more susceptible to germs and thus to urethritis.