Симптомы urethritis у женщин, лечение и осложненияdiseases

Update: October 2018 A disease like urethritis is widely known.
most people, but many unfairly believe that the disease
applies only to men. In fact, the prevalence
diseases одинаково высокая среди обоих полов, но диагностически
urethritis is detected more often and earlier in men than in women. The thing is
that with a disease such as urethritis in women, symptoms can
be a little pronounced or completely absent. This feature
the course of most female urethritis is prognostic
unfavorable circumstance because the delay in the disease is not
leads to nothing but to chronitization of the process.

As noted above, urethritis is a disease with a high
prevalence and almost always associated with some kind of disease
urogenital system of infectious and inflammatory nature.
Any, even the most serious illness, is easier to cure at the initial
stage of development. Это правило касается и urethritis. At the slightest
suspicion of the disease woman must, without delay
consult a doctor.

Concept of urethritis

AT основе urethritis лежит воспаление стенок мочеиспускательного
channel (urethra), caused by some causal factor. Female
the urethra has a short length of about 1-2 cm and
is wide enough. The anatomical structure of the urethra in women
обуславливает легкость проникновения возбудителей diseases в
bladder, as well as the absence of violations of the outflow of urine, even with
significant swelling of the mucous membrane of the urethra.

Urethritis, of course, is not a life-threatening disease,
but delivers very unpleasant sensations, depriving comfort
vital activity, and also dangerous for its complications for the female

У женщин очень часто параллельно протекают два diseases —
urethritis and cystitis, and cystitis is the simplest
осложнением urethritis (см. цистит у женщин — симптомы,
treatment).  ATот почему лечение urethritis должно быть
timely and complete – if you run this inflammatory
process, an ascending infection may develop, the complications of which
dangerous and difficult to treat.

Причины urethritis у женщин

ATедущую роль в возникновении данного воспалительного процесса
the urethra is played by various infections, less
значение в развитии urethritis имеет раздражение уретры
non-infectious factors. ATследствие этого уретрит
classified into non-infectious and infectious. Last in
turn divided into specific and non-specific
infectious urethritis.

Under the nonspecific urethritis understand the classic purulent
inflammation. The symptomatology is similar regardless
what microorganism caused the inflammatory process. More often
в роли возбудителей такого urethritis выступают стрептококки,
staphylococcus and E. coli.

Specific infectious urethritis arises due to
sexually transmitted infections in women. AT таком случае
симптомы urethritis будут варьироваться в зависимости от
infectious agent.

Specific infectious urethritis may be caused by gonococci.
(gonorrheal), trichomonads (trichomonas), candida mushrooms
(candidal), chlamydia (chlamydia), mycoplasmas

ATыделяют также вирусный инфекционный уретрит, основными
whose viruses are herpes viruses and peaked

Non-infectious urethritis can be caused by several
reasons:Уретрит у женщин: симптомы, лечение

  • urolithiasis, in which small go through the urethra
    stones and damage the mucous layer with sharp edges;
  • malignant tumors of the urethra that are accompanied
    inflammatory reactions;
  • injuries of the urethra after cystoscopy, catheterization, due to
    intentional irritation of the urethra with various
  • аллергические diseases;
  • гинекологические diseases;
  • venous congestion in the pelvic vessels;
  • first sexual affinity.

ATыделяют 2 пути заражения уретритом инфекционного происхождения:
genital or hematogenous. Sexual transmission is realized in
time of unprotected intimacy with a sick person, hematogenous – with
contact of the pathogen with blood or lymph from the local focus
chronic inflammation (carious teeth, chronic sinusitis,
tonsillitis, tuberculosis, etc.).

Факторами, способствующими развитию urethritis, являются:

  • Decrease in protective capabilities due to severe
    diseases, malnutrition, diets, avitaminosis;
  • Low hygienic culture, non-compliance
    individual hygiene;
  • The presence of chronic inflammatory processes;
  • Diseases of the genitourinary system;
  • Genital trauma;
  • Hypothermia;
  • Alcoholism;
  • Stress, psycho-emotional overload;
  • Период беременности, when иммунитет ослаблен, а организм
    undergoes serious hormonal changes.

Общие симптомы urethritis

Urethritis in women very rarely occurs with vivid symptoms.
Как и для многих болезней, для urethritis характерен период инкубации
lasting from several minutes to one or two months, when
no manifestations of the disease are observed. However, after
this latent period urethritis can develop without development
каких-либо специфических проявлений – около половины cases
женского urethritis протекает бессимптомно. This kind of chronic
urethritis in women does not give symptoms, but it is
contagious and easily transmitted by sexual intimacy, and still dangerous
complications that arise against the background of seemingly utter

Read also on the topic:

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  • Review of 15 Cystitis Tablets
  • Cranberries for cystitis helps
  • Thrush in women – symptoms
  • How to take antibiotics
  • Chlamydia in women: symptoms and treatment
  • Itching in the vagina: causes, treatment
  • Overview of the top 10 candles from thrush
  • Everything a woman needs to know about douching?
  • Causes of frequent urination in women
  • Lower abdominal pain in women – causes
  • Symptoms of cystitis in women
  • Pain and burning when urinating in women
  • Pyelonephritis: symptoms, treatment

Specific and non-specific urethritis varies by clinical

ATыделяют общие признаки, характерные для острого urethritis, как
specific and non-specific:

  • itching and various discomfort during urination
    (pulling, constricting feeling);
  • recurring soreness of the whining character, pain in the region
  • discharge of a different nature from the urethra, up to
  • blood impurities in the urine;
  • the feeling of “glued” urethra in the morning

These symptoms are not necessarily present at the same time,
rather, some of them, by expressiveness, will prevail over
by others. Еще одной отличительной особенностью течения urethritis
is the absence of common symptoms, such as hyperthermia
(fever), weakness, etc.

Хроническое течение urethritis характеризуется отсутствием
any signs, and only when the process is aggravated
certain manifestations of pathology.

Специфика симптомов в зависимости от возбудителя urethritis

Specific infectious urethritis caused by one or another
infectious pathogen, has a number of symptoms, the manifestation of which
allows you to suspect the presence in the body of a specific
etiological agent.

Gonorrhea Gonorrheal urethritis in the acute stage of the course provokes pain with
rezu during urination – a symptom occurs after a few
weeks after infection. The hallmark of this type
urethritis является: болезненность и дискомфорт в уретре при долгой
urinary retention. It is extremely important to see a doctor.
it is at the stage of overt symptomatology, since when the infection passes into
chronic course these symptoms are absent.
Trichomonas If there is a trichomonas urethritis in women symptoms
develop after a few weeks from the moment of infection, while
около трети cases diseases протекают без специфических
manifestations. For the disease are characterized by: itching and burning sensation in the area
urethra, as well as in the area of ​​the external genitalia. Chronitization
трихомонадного urethritis приводит к исчезновению symptomatology.
Candidiasis Candida urethritis does not cause symptoms in women
within 10-20 days from the moment of infection. Then the woman starts
disturb soreness, burning sensation and discomfort when urinating.
In addition, there are discharge from the urethra whitish-pink
shade, viscous and even thick consistency. All symptoms have
moderate severity.
Mycoplasma Mycoplasma уретрит начинается подостро, без ярко выраженной
symptomatology. The woman is worried about slight itching and discomfort,
accompanied urination process. Today to mycoplasmal
infections, doctors’ attitudes have changed somewhat, since the defeat
мочеполовой системы этими инфекционными agents происходит крайне
rarely, and their presence may be a variant of the norm, when detected
Mycoplasma treatment is not indicated in all cases.
Chlamydia Chlamydia urethritis is asymptomatic in the first 2-3 weeks
after infection. Symptoms in women are very mild itching and
slight pain when urinating, discharge
various nature, up to purulent, from the urethra.
Urogenital tuberculosis In addition to these infections with similar symptoms proceeds
and tuberculosis that can affect any organ of the human
organism – genitals, kidneys, bladder and urethra, including
including For extrapulmonary tuberculosis, the presence of
long subfebrile temperature, weakness, high
sweating. Tuberculous urethritis usually appears on the background
туберкулеза почек, when поражается и мочевой пузырь, и уретра,
sometimes it is combined with female genital tuberculosis. AT
In recent years, the incidence of tuberculosis has increased,
и его внелегочных форм тоже (то есть when у пациента
radiography of the lungs is normal).

Based on the foregoing, it becomes clear that even
specific infectious urethritis does not differ any stormy
symptomatology, and differential diagnosis between the described
infections are carried out only by doctors.

Диагностика urethritis

ATо the time of examination by a doctor can be detected hyperemia of the external
openings of the urethra and adjacent tissues, pain on palpation and
discharge from the urethra. Without fail
appointed by:

  • General urine and blood test.
  • As well as an extended urine test according to Nichiporenko.
  • Bacteriological examination of urine allows you to accurately determine
    etiological agent of urethritis; parallel test
    sensitivity of the identified infectious agent to
  • The study of biological material (scraping of the urethra)
    PCR is the most accurate diagnostic technique
    since the biopsy is taken directly from the area
  • Urinalysis for mycobacterium tuberculosis (the result is expected in
    within 10-12 weeks)

From instrumental diagnostic methods can be conducted
urethroscopy – endoscopic examination of the mucous membrane
urethra with the ability to perform additional manipulations –
biopsy sampling, elimination of strictures and scars. When urethrocystoscopy
(varieties of urethroscopy) examines the urethra and bladder.
Ultrasound diagnosis of the pelvic organs allows you to fully assess
condition of the genitourinary system.

Urethritis Complications

Urethritis Complications чаще всего развиваются при длительном,
hidden course of the disease or in the absence of treatment. Primary
a complication of urethritis is most often cystitis. Often
Vaginitis and vulvovaginitis are diagnosed. More serious
female genital inflammation, such as colpitis,
adnexitis (see inflammation of the appendages – symptoms, treatment),
endometritis, occur with the spread of the infection process
sexual ways ascending. Worst case outcome
urethritis is female infertility (see the uterus on

Treatment of acute urethritis

Treatment of uncomplicated urethritis does not require hospitalization and
going on at home. Women need to clearly fulfill appointments
physician and periodically visit the clinic for the implementation
control over the course of treatment.

  • Drug therapy

The main and most effective treatment for urethritis is
women and men is antibiotic therapy (with the exception of the disease
with viral and fungal etiology). The choice of antibiotic is very important
for the effectiveness and usefulness of treatment – identified pathogen
urethritis should be highly sensitive to the selected

Неспецифический  уретрит In non-specific urethritis, broad antibiotics are indicated.
spectrum of action: cephalosporins (cefazolin, cefotaxime,
ceftriaxone); sulfonamides (sulfazole, urosulfan); macrolides
(azithromycin, clarithromycin); fluoroquinolones (clinafloxacin).
Gonococcal При гонорейном уретрите показаны антибиотики: эритромицин,
spectinomycin, oletetrin, ceftriaxone, cefuroxime, rifampicin,
cefakor and pr.te.e. those that are detrimental to chlamydia. But
in each case, the drug is selected individually (see gonorrhea in
women – symptoms, treatment).
Trichomonas При трихомонадном происхождении urethritis appointed by:
antimicrobial drug metronidazole (trichopol), as well as drugs
of choice – benzydamine, imrazol, ornidazole, chlorhexidine, suppositories
Candidiasis Candidiasisный уретрит требует применения противогрибковых
drugs: levorin, nystatin, natamycin, amphoglucamine,
clotrimazole (see antifungal drugs in pills).
Mycoplasma Mycoplasma уретрит лечат антибиотиками из группы
tetracycline (doxycycline, tetracycline).
Chlamydia When chlamydial urethritis is well established
tetracycline antibiotics (tetracycline, doxycycline),
erythromycin, clarithromycin, azithromycin, clinafloxacin (see
Chlamydia – treatment regimens, drugs).
Viral In case of viral origin of urethritis treatment is indicated.
antiviral drugs – ganciclovir, acyclovir,
ribavirin, famciclovir, penciclovir, etc.

When urethritis is initially prescribed antibacterial drugs,
having a wide spectrum of action. This is done in order not to
lose time and do not run the infection because bacteriological
the study and the installation of sensitivity bacteria occupy
certain time.

Antibiotics may be prescribed as:

  • tablets for oral administration in 81.3% of cases of acute
  • injections – intravenous 0.2% and intramuscular 18.five%
  • Intravaginal suppositories and installations – antibiotic infusion into
    urethra through catheter
  • monotherapy – that is, the use of 1 antibiotic in 41%
  • combination of 2 drugs in 41%
  • 3 antibiotics in 13%
  • 4 препаратов в five% cases

The most commonly used drugs for acute urethritis are
women who are appointed according to the pathogen
diseases are presented in the table.

Urethritis of unspecified etiology  Non-GI urethritis caused by atypical

 Gonococcal + атипичные патогенные микроорганизмы
(mixed urethritis)

Azithromycin 2four% Azithromycin 3five% Azithromycin 29%
Doxycycline 1eight% Fluconazole 2four% Doxycycline 2five%
Metronidazole 1eight% Ofloxacin 12% Fluconazole 2four%
Ceftriaxone ten% Doxycillin 12% Secnidazole 1five%
Fluconazole 9% Metronidozole 6% Ornidazole 1four%
Josamycin four% Josamycin five% Ceftriaxone eight%
Secnidazole four% Clarithromycin 3% Josamycin 6%
Ciprofloxacin 3% Secnidazole 3%
Nimorazole 3%
Clarithromycin 3%
Tinidazole 3%
Trichomonas уретрит + атипичные агенты Gonococcal
 Metronidazole 36% Ceftriaxone 61%
 Doxycycline 21% Azithromycin 1five%
 Azithromycin 9% Metronidazole ten%
 Josamycin 6% Ciprofloxacin four%
Ornidazole 6% Doxycycline 3%
  •   Diet therapy

A woman with a urethritis is advised to limit
eating fatty, sour, spicy, salted foods. Sure to
it is required to normalize the drinking regime and drink at least one and a half
liters of free fluid (in addition to the liquid in the dishes) per day.

  • General recommendations

During the period of treatment should:

  • avoid hypothermia;
  • refrain from sexual intercourse (even with a condom)
    up to complete recovery;
  • strictly follow the rules of individual hygiene.

Лечение хронического urethritis

Chronic urethritis requires long and comprehensive treatment,
which includes:

  • antibiotic therapy, taking into account the sensitivity of the pathogen;
  • antiseptic washing urethra;
  • vitamin and mineral therapy.

In chronic urethritis gonococcal etiology are held
installation of an antibacterial drug in the urethra. If available
granulation, then installation of a collargol and silver solution is performed
в уретру, а также бужирование и прижигание уретры ten% – 20%
silver nitrate solution (with a pronounced contraction).

In chronic trichomonas urethritis, installations are carried out in
urethra solution of trichomonacid 1%.

In chronic chlamydial urethritis in addition to antibiotics
additionally appointed immunomodulators, drugs
интерферона, пробиотики (см. список аналогов Линекса),
enzyme therapy, vitamin therapy, hepatoprotectors (see list
таблеток для печени), антиоксиданты  (см. схемы лечения

Народные способы лечения urethritis

Лечение urethritis народными средствами дает неплохие результаты,
as an addition to the main anti-bacterial treatment:

  • infusion of parsley leaves (1 tablespoon crushed leaves per 500 ml
    cold water, insist overnight) is applied inside by 3
    st.l. every two hours;
  • an infusion of green grass yellow (1 tsp herbs per 200 ml of boiling water,
    insist 12 hours) is applied inside of 1 cup twice in
  • infusion of black currant leaves (3 tsp herbs per half liter
    boiling water) is used as a tea.
  • infusion of blue cornflower flowers (flowers without baskets pour 200
    мл кипятка) применяется по 2 st.l. twice a day before meals.

Every second woman faces urethritis during life
and this is a reason for heightened vigilance
own health.

Автор: врач-гигиенист, эпидемиолог

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