The urethra is the final part of the urogenital tract in men and urinary tract in women. As it communicates with the external environment, the urethra is exposed to different types of external agents, which makes it susceptible to irritation, infection, as well as mechanical and chemical damage. Here we discuss some of the most common symptoms originating from the urethral region and their causes.
Urethritis is an inflammation of the urethra which can be caused by bacterial, viral, parasitic, or fungal infections. Microorganisms responsible for urethritis are mainly bacteria, and they include Escherichia coli, Neisseria Gonorrhoeae, Mycoplasma, Ureaplasma, Chlamydia trachomatis, and many others. Candida albicans is the most common fungus in the urinary tract, and Trichomonas is a parasite that can invade the urethra and also cause infection. The herpes simplex virus type 1 and type 2 can both cause urethritis.
Urethritis and urinary infections in general are much more common in women than in men because of the differences in anatomy of the male and female urinary tract.
The most common symptoms of urethritis are pain and itching in the urethral region. Bloody discharge can often be seen and it is usually not a reason to panic. Sometimes, redness of the mucosa can be seen surrounding the ending of the urethra. As these infective agents have a tendency to invade the upper regions of urinary tract, typical symptoms of urethritis can be followed by the signs and symptoms of cystitis (inflammation of the urinary bladder), epididymitis (inflammation of epididymis in males), and even the signs and symptoms of female genital organs (pelvic inflammatory disease). These symptoms include lower abdominal pain, fever, and discharge from the urethra.
Diagnosis of urethritis
Diagnosis of urethritis is usually made only by anamnesis and physical examination. In patients with reoccurring urinary infections, urine tests for different microorganisms are performed. Blood tests are not necessary, but they can give some valuable information if the urine culture returns normal.
Antibiotics and uroantiseptics are used to treat bacterial infections of the urinary tract, and for fungal urethritis, there are antifungal drugs. Of course, good hygiene is necessary to speed up the healing process and recovery.
Mechanical Damage of Urethra
The urethral wall is layered with mucosa from the inside, which can be damaged mechanically by kidney stones and urinary catheters. Kidney stones with a large diameter and sharp edges can cause bleeding from urethra and pain during urination. Urinary catheters can make damage to the urethral wall during placement or removal, but they can also attract infection if left longer than recommended.
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