Brief overview
- Symptoms: Itching, burning and/or redness of the urethral outlet, pain when urinating, purulent discharge from urethra, possible abdominal pain, fever, chills.
- Causes and risk factors: Mainly caused by bacteria, mostly gonococci, but also chlamydia (sexually transmitted diseases), risk factors: unprotected sex, indwelling catheter, insertion of sharp objects into the urethra.
- Treatment: Depending on the cause, usually with antibiotics, supportive also home remedies such as drinking a lot, warm feet, cranberry juice.
- Course of disease and prognosis: Timely treatment usually good prognosis, complications possible such as chronic course, inflammation of other organs (prostate, epididymis, fallopian tubes, ovaries), possible consequences without therapy: infertility (women), during pregnancy (chlamydia) eye disease to blindness of the unborn child possible
What is urethritis?
Urethritis or urethritis is one of the infections of the lower urinary tract. The urethra represents the last section of the urinary system. Urine passes from the bladder to the outside through the urethra. In urethritis, the mucous membrane of the urethra is inflamed, which sometimes leads to an unpleasant burning sensation during urination and to discharge.
In men, the symptoms of urethritis are usually much more pronounced due to the longer urethra. Women, on the other hand, often do not even notice urethritis, as their symptoms are often very mild.
Doctors divide urethritis into two forms: Specific urethritis and nonspecific urethritis.
- Various other bacteria, on the other hand, cause non-specific urethritis. The pathogens of non-specific urethritis include mainly chlamydia, mycoplasma and intestinal bacteria.
Regular testing for sexually transmitted diseases such as gonorrhea or chlamydia is advisable, especially if you have changing sexual partners. These often go unnoticed for a long time. There are also self-tests that can be performed at home, but in a doctor’s office, experts are directly available for consultation and – if necessary – for prompt treatment.
What home remedies can help?
- Drink a lot: It is especially important to drink a lot during the inflammation. In this way, the bacteria can be flushed out of the urethra more easily due to increased urination.
- Keep warm: In addition, it is beneficial to keep the feet warm in particular. This is because blood flow to the feet influences blood flow to the urinary tract via nerve-vascular reflexes. Sufficient blood flow in turn supports the body’s defense mechanisms.
- D-Mannose: According to initial studies, taking mannose seems to reduce the frequency of recurrent urinary tract infections. Mannose binds bacteria to itself, preventing them from adhering to the mucosa. Drugs containing mannose are usually available over the counter in pharmacies or drugstores.
- Limit sexual activity: try to avoid sexual intercourse or masturbation where sex toys might irritate the area around the urethra for the illness period as well.
Home remedies have their limitations. If the symptoms persist for a long period of time, do not get better or even get worse, you should always consult a doctor.
What are the symptoms?
The symptoms of urethritis are similar to the symptoms of urinary bladder infection:
- This often makes urination very painful.
- A glassy, purulent discharge (urethral fluoride) also sometimes occurs from the urethra, which is very unpleasant for many sufferers.
- A reddened urethral outlet at the genital can also sometimes be observed.
Urethritis – Man
Men usually have very severe symptoms, since they have a significantly longer urethra and the inflammation therefore affects a larger mucosal area. In addition, the inflammation sometimes spreads to the prostate and the testicles or epididymis. Therefore, men with urethritis show:
- Mostly very pronounced complaints
- Burning in the urethra (at rest and during urination)
Urethritis – Woman
In women, the symptoms are usually much weaker. Many report only an unpleasant feeling when urinating. As a result, urethritis in women remains undetected for longer. Treated too late, however, in some cases it rises further and spreads to the fallopian tubes and ovaries. This sometimes results in serious consequences such as infertility.
Typical symptoms of urethritis in women are:
- Burning in the urethra (at rest as well as during urination)
- Discharge
- Lower abdominal pain
How does urethritis occur?
In principle, women and men are affected equally often. In most cases, urethritis is due to a bacterial infection after unprotected sexual intercourse. The most common bacterial pathogens of urethritis include:
- Chlamydia (Chlamydia trachomatis) in most cases.
- Gonococci (Neisseria gonorrhoeae)
Most often, the transmission of the bacteria takes place through sexual intercourse. Therefore, the best way to prevent infection is to use condoms during sexual intercourse. Although these do not provide one hundred percent protection, in many cases they prevent infection.
But urethritis is also possible without bacteria or other pathogens. Thus, injury to the urethra after the insertion of sharp objects (for example, through autoerotic practices) also promotes the occurrence of urethritis.
How is urethritis diagnosed?
For further clarification, the doctor usually makes a swab from the urethra. To do this, he takes a sample from the front of the urethra using a cotton swab or a small spatula. The tissue sample is then examined under the microscope.
The establishment of a urine culture has another benefit: If enough bacteria are present, they can be used to test the effectiveness of various antibiotics in advance (antibiogram). If an antibiotic does not help, doctors know through this examination exactly which other antibiotic must help against the specific pathogens.
How is urethritis treated?
The therapy of urethritis always depends on the triggering factor.
- The doctor treats chlamydia with an antibiotic from the macrolide group. These include agents such as erythromycin or clarithromycin.
- For gonococcal infection, an antibiotic from the cephalosporin group is effective.
It is usually also recommended to treat the partner, so that both do not infect each other again and again (“ping-pong effect”).
What is the course of urethritis?
The course of urethritis depends on the cause. In women, urethritis is often milder or even without symptoms. In the case of a bacterial disease, treatment with the right antibiotic leads to a good prognosis. Consequential damage rarely occurs if treatment is timely and consistently completed.
Inflammation of the urethra usually subsides quickly with proper antibiotic therapy.
Possible complications
Nevertheless, complications occasionally occur in the course of urethritis.
- Chlamydia sometimes leads to inflammation of the prostate (prostatitis) or the epididymis (epididymitis) in men in the course of urethritis. Often these inflammations are also accompanied by fever.
- If the infection continues to ascend in women (ascending infection with chlamydia or gonococci), it sometimes causes inflammation of the fallopian tubes (salpingitis) or ovaries (oophoritis). Additional symptoms are then often fever, chills and/or lower abdominal pain.
- Inflammation of the fallopian tubes or ovaries carries the risk of the fallopian tubes becoming blocked and infertility may result.
- The so-called “Reiter’s syndrome” occurs when, in addition to urethritis, conjunctivitis and reactive inflammation of the joints (arthritis) are also present. However, in most cases this disease heals by itself.
