Drugs for the treatment of urethritis in men. Treatment of all types of urethritis in men Symptoms and signs

Urethritis is a bacterial, fungal, or viral inflammation of the urethra (urethra). It mostly affects men. Accompanied by painful urination, discharge from the urethra. Treatment of urethritis in men with antiviral and antimicrobial drugs quickly destroys the pathogenic flora. To facilitate well-being, symptomatic agents are prescribed - decongestants, painkillers, antihistamines.

Drugs that clear the infection

The basis of conservative treatment of urethritis is etiotropic drugs - medicines that destroy the pathogenic flora. Depending on the cause of inflammation of the urethra, men are prescribed the following groups of drugs:

• antiviral;
• antimycotics (antifungal agents);
• antitrichomonas;
• antibiotics.

The choice of medicines depends on the sensitivity of pathogens to antimicrobials. In 72% of cases, the disease is provoked by bacteria, so it is treated with antibiotics.

Antibiotics

Before treating urethritis in a man, determine the type of infectious agent. With bacterial inflammation of the urethra, antibiotics from the group of macrolides, cephalosporins, tetracyclines are included in the treatment regimen. The most effective tablet preparations include:

• fluoroquinolones - Moxifloxacin, Moximac, Tevalox, Ciprofloxacin;
• macrolides - Clarithromycin, Klamed, Azithromycin, Claricit;
• cephalosporins - Cefix, Lopraks, Vinex, Suprax, Cedex;
• tetracyclines - Doxycycline, Vibramycin D, Unidox, Solutab.

In gonorrheal and chlamydial urethritis, fluoroquinolones and cephalosporins are most effective. Therefore, the treatment regimen includes:

• Ciprofloxacin;
• Aksetin;
• Cefuroxime;
• Bactyl;
• Zinnat.

To destroy the causative agent of Trichomonas urethritis, antiprotozoal agents are prescribed - Nitazol, Trinex, Aminitrazol, Tiberal. Mycoplasma inflammation is eliminated by Doxilan, Tetracycline.

Antiviral

Viral urethritis in men in 94% of cases is caused by herpes viruses, which are transmitted during unprotected intercourse. To treat the infection, antiviral drugs are used in the form of tablets and ointments. The first destroy the pathogenic flora throughout the body, and the second - directly in the lesions.

The most effective antiviral pills include:

• Acivir;
• Viraksa;
• Gepavirin;
• Valaciclovir;
• Acyclovir;
• Viralex;
• Gerpevir;
• Famvir;
• Ribavirin.

If characteristic bubble rashes occur on the glans penis, local antiviral agents are used in the form of creams, gels and ointments - Zovirax, Acyclostad, Agerp, Vratisolin. Treatment is continued until the symptoms of the disease in a man disappear.

Antifungal

Candidal urethritis is caused by yeast of the genus Candida, therefore, systemic and local fungicidal preparations are prescribed. In half of the cases, fungal inflammation occurs after prolonged treatment with antibacterial agents. To destroy the infection in the urethral canal, the following tablets are used:

• Terbinafine;
• Amphotericin B;
• Terbizil;
• Atifan;
• Fluconazole;
• Exifin;
• Pimafucin;
• Nystatin;
• Terbinorm.

Treatment of lesions in the groin area is carried out with antimycotic ointments. The most effective means include imidazole derivatives:

• Clotrimazole;
• Fungisan;
• Kanesten;
• Candide;
• Imazol.

Ointments are applied exclusively to clean skin up to 3 times a day. Complex antimycotic treatment takes at least 7-20 days. With immunodeficiencies, therapy is prolonged.

Antiseptics

In the treatment of genitourinary infections, antiseptic agents are used in the form of:

• powders;
• creams;
• gels;
• ointments;
• candles;
• solutions.

The treatment regimen depends on the characteristics of the course of the disease. In chronic inflammation of the urethra, instillations are performed - drip injection of drugs into the urethra. For disinfection of the urinary tract, solutions of silver nitrate and collargol are used. During the procedure, more than 60% of the pathogenic flora is washed out, which speeds up recovery.

To destroy viruses and microbes in the genital area are used:

• solutions - Chlorhexidine, Betadine, Furacilin, Miramistin;
• ointments - Argosulfan, Dr. Theiss Calendula, Ligenten;
• rectal suppositories - Hexicon, Terzhinan, Miramistin, Osarbon.

Solution preparations are additionally used for washing the inguinal zone. With fungal and bacterial urethritis, the procedure is performed at least 2 times a day.

Other medicines

To cure urethritis, uroseptics are used - drugs with antiseptic and antimicrobial action, the components of which reach the maximum concentration in the urine. They do not have a harmful effect on the entire body, since they act directly in the lesions.

For the treatment of urological diseases in men are used:

• Cinoxacin;
• Nitrofurantoin;
• Furazolidone;
• Trimethoprim;
• Nifurtoinol.

To reduce the drug load on the body, treatment is carried out with herbal uroseptics. Phytolysin, Urolesan, Kanefron are prescribed. Pharmaceutical preparations with thyme, wild rosemary, chamomile, lingonberry, St. John's wort, juniper and goldenrod have pronounced antiseptic properties.

Complementary Therapy

Inflammation of the urethra in men is accompanied by pain and intoxication. Patients complain about:

• burning sensation when urinating;
• pain in the suprapubic area;
• loss of appetite;
• fast fatigue;
• feverish state;
• elevated temperature.

To speed up recovery, the treatment regimen is supplemented with immunomodulating agents. They stimulate the body to fight infection, reduce the likelihood of exacerbations of inflammation.

Immunostimulants

With a recurrent course of urethritis, treatment is carried out with immunostimulating agents. They increase resistance to infections, which shortens the recovery period. In the case of an infectious lesion of the urethra, the following drugs are prescribed:

• Solkourovak;
• Interlock;
• Viferon;
• Genferon;
• Likopid;
• Ribomunil;
• Immunal;
• Pyrogenal;
• Gepon;
• Interferon.

Immunostimulating drugs for urethritis in men are used only on the recommendation of a urologist. People with immunodeficiency states are shown immunostimulating therapy twice a year.

Anti-inflammatory

To combat the symptoms, non-steroidal anti-inflammatory drugs are used in the form of tablets and rectal suppositories. They have a complex effect:

• antipyretic;
• anti-inflammatory;
• painkillers.

In the treatment of bacterial and viral forms of urethritis, the following agents are prescribed:

• ibuprofen;
• Piroxicam;
• Arviprox;
• Gofen;
• Ibunorm;
• Ketorolac;
• Naproxen;
• Ivalgin.

Tablets are used in the treatment of acute inflammation, which is accompanied by fever and fever. Ketalgin, Indomethacin, Ketanov, Emodol have pronounced analgesic properties.

If urethritis occurs against the background of urological diseases (prostatitis, cystitis), rectal suppositories with an anti-inflammatory effect are used:

• Ultraproct;
• Posterisan;
• Indomethacin;
• Proctosedyl.

Suppositories are used 1-2 times a day after defecation. Treated like this until the pain disappears.

vitamins

In half of the cases, urethritis is provoked by opportunistic bacteria. Their activation is associated with immunodeficiencies and vitamin and mineral deficiencies. Therefore, for urethritis in men, fortified preparations are used. They make up for the lack of nutrients, which leads to the strengthening of immune defenses.

In the treatment of urogenital infections, drugs with vitamins of group B, E, C are usually prescribed:

• Active;
• Duovit;
• Complivit;
• Vitrum.

Probiotics

Antimicrobial drugs destroy not only pathogenic, but also beneficial bacteria in the intestines. To prevent dysbacteriosis and beriberi, probiotics are included in the treatment regimen. They contain non-toxic live microorganisms that restore the bioactivity of the intestinal microflora:

• Acipol;
• Enterol;
• Probifor;
• Lactobacterin;
• Enterogermina;
• Bifiform;
• Florin forte;
• Linex.

The course of treatment depends on the duration of antibiotics, therefore it varies from 5 to 20 days.

Antiallergic

Antihistamines are the first-line drugs in the treatment of allergic urethritis. Their action is aimed at combating:

• burning in the urethra;
• swelling of the mucosa;
• itching in the genitals;
• skin rashes;
• redness of the head of the penis.

Third-generation antihistamines are used to relieve symptoms:

• Loratek;
• Telfast;
• Erius;
• Suprastinex;
• Fexofen;
• Desal;
• Zodak Express;
• Allegra;
• Glenset.

Unlike 1st and 2nd generation antiallergic tablets, 3rd generation drugs do not have a harmful effect on the heart. Therefore, they are recommended for the treatment of urethritis in men with cardiovascular pathologies.

Homeopathy

Homeopathic medicine for urethritis is not recognized by official medicine, as it does not have proven therapeutic activity. But drugs in this group are often used in the treatment of chronic urethritis. Most of them do not have a direct antiviral or antimicrobial effect, but have a stimulating effect on the immune system.

Homeopathic remedies for urethritis:

• Sulfur;
• Kantharis;
• Medorrinum;
• Pareyera;
• Argentum nitricum;
• Kopaiva;
• Petroselinum;
• Borax;
• Causticum;
• Equisetum.

Urethritis is an inflammatory lesion of the urethra of an infectious or allergic origin. Late treatment is dangerous due to the penetration of pathogenic flora into other parts of the urinary system - the urea, ureters, kidneys. The basis of therapy is etiotropic drugs that destroy the infection. The course of treatment depends on the nature of the inflammation and takes from 5 to 20 days.

Effective drugs and antibiotics for urethritis, used in accordance with the recommendations of a specialist, become a guarantee of a cure for acute and chronic forms of the disease. Modern medicine is able to offer a large selection of drugs to fight infection and restore the body weakened by the disease.

best remedy for urethritis

The best remedy for urethritis is antibiotic therapy. The following groups of drugs are traditionally used for therapeutic purposes:

1. Fluoroquinolones.
2. Cephalosporins.
3. Uroantiseptics.

The most popular in the treatment of urethritis are second-generation fluoroquinolones - ofloxacin, norfloxacin, enoxacin, ciprofloxacin, lomefloxacin. Of the cephalosporins, ceftriaxone, cefixime and ceftibuten are considered the most effective. Among the macrolides, clarithromycin, azithromycin, erythromycin are in demand.

Uroantiseptics are a type of medicines that have a pronounced antimicrobial effect and minimal systemic effects on the body. Among these drugs there are products of synthetic and natural origin. Treatment of urethritis is carried out using:

• urolesana;
• kanefron;
• furazidin;
• triseptol;
• nitroxoline (5-NOC);
• trimethoprim;
• nitrofurantoin.

The effectiveness of the drugs used largely depends on the patient's compliance with the basic recommendations of the attending physician.

Necessary examinations before prescribing the drug

Before prescribing antibiotics and other drugs, urethritis is diagnosed, consisting of:

1. Collection of anamnesis.
2. General inspection.
3. Laboratory and hardware studies of the patient's biomaterial.

For patients of both sexes, a smear from the urethra, a general analysis of urine and blood, an ultrasound of the pelvic organs, a urine sample according to Nechiporenko, and sowing of the bacterial flora to determine the level of its sensitivity to drugs are required.

In the chronic form of the disease, ureteroscopy will be required, which involves examining the urethra using special medical equipment. An x-ray examination of the urethra and bladder can also be shown by introducing a contrast agent into them (micturation cystourethrography). In the case of the development of nonspecific urethritis, which causes difficulties in making a diagnosis, specialists resort to urethrocystoscopy.

When prescribing medications, factors such as the gender and age of the patient, the presence of concomitant infectious processes in his body, a tendency to allergic reactions to drugs, and pregnancy are taken into account.

Treatment regimens for urethritis and dosage

Depending on the severity of the course of the disease and the stage of its development, various treatment regimens are used.

Treatment of urethritis always involves an integrated approach. The action of antibiotics is enhanced by antiseptic solutions, local remedies in the form of ointments, vaginal and rectal suppositories. All patients are recommended immunostimulating therapy, which ensures the activation of the body's own protective function. Patients are prescribed ribomunil, thymalin, phlogenzym, neovir, benzocaine, aloe extract. Quite often, antihistamines (tavegil, suprastin) are used in the treatment of urethritis.

The course of treatment of acute urethritis in men and women is carried out at home.

In exceptional cases, the patient may be recommended to stay in a hospital. Chronic urethritis requires longer therapy, and often involves several courses.

Ointments

Ointments used in the treatment of urethritis in patients of both sexes help in getting rid of soreness and discomfort, provide effective prevention of relapse. Many drugs, applied immediately after a doubtful connection, can significantly reduce the risk of infection.

In the process of therapy, antiviral, antifungal and antibacterial agents become relevant:

• viferon;
• zovirax;
• virolex;
• clotrimazole;
• pimafucort;
• levomekol.

According to the instructions, viferon is rubbed into problem areas 3-4 times during the day, zovirax - 2-3 times. The minimum duration of use of each drug is 7 days.

Virolex cream not only has a detrimental effect on the viruses that provoked the development of urethritis, but also serves to strengthen its own immune defenses. This product treats the affected area up to 3 times during the day. The procedures are carried out for 1-2 weeks.

Nystatin is indicated for the elimination of the candidal form of urethritis. The drug is applied to the body in a thin layer, twice a day. Sessions are repeated for 10 days. Similarly, the antifungal agent clotrimazole is used.

Pimafukort exhibits both antimicrobial and antibacterial action. The ointment is applied to the affected areas in men and women from 2 to 4 times a day. To achieve a pronounced effect, the remedy should be used for at least 2-4 weeks.

Levomekol is a popular medication in the form of an ointment that has a destructive effect on gram-positive and gram-negative bacteria. The drug is applied to a sterile cotton swab, then applied to the site of inflammation for 5-10 minutes. The process is repeated up to 3 times a day. The duration of therapy is determined by the attending physician.

The general rules for the use of all types of ointments are the refusal of alcoholic and caffeinated drinks during the treatment period, the transition to a healthy diet, minimizing the amount of sugar in the diet, drinking large amounts of liquid (herbal tea, compotes, fruit drinks), sexual abstinence.

Painkillers

Often with urethritis, the patient develops acute pain. Often it indicates the development of the pathological process in the bladder.

The removal of the syndrome is facilitated by the appointment of antispasmodics and analgesics:

1. But shpy.
2. Drotaverine.
3. Papaverine.

No-shpa is known as an effective and safe remedy for spasms. This remedy is not prescribed if the patient has cardiac disorders, atherosclerosis, pathologies of the liver and kidneys. Non-compliance with the dosage and irregular intake of no-shpa can lead to a decrease in blood pressure, the development of dizziness, and problems with the stool. The daily dose for an adult should be no more than 240 mg, divided into 3 doses. The drug can also be used in injectable form.

Drotaverine with urethritis effectively anesthetizes, is used in tablets or in the form of intramuscular injections. Single dosage for urethritis - 2 tablets of 80 mg. Reception frequency - up to 3 times in 24 hours. Exceeding the recommended doses can lead to a malfunction of the heart, paralysis of the respiratory mechanism.

Papaverine is used in the form of vaginal suppositories for women and rectal suppositories for men. With severe pain, the agent is administered at bedtime, after hygiene procedures and bowel movements.

Pills and antibiotics from urethritis for men

With urethritis in men, tablets are used that reduce the risk of developing allergic reactions, as well as restore the intestinal microflora. In the first case, you can use tavegil, which provides a long-term effect for a long time. The drug is taken twice a day - in the morning and evening.

To normalize the balance in the intestines, yogurt is shown - a tablet product that improves the digestion process and provides prevention of dysbacteriosis. This remedy is taken orally 1.5 hours after the next dose of antibiotic. During the day, it is recommended to take 2-5 tablets. The course of therapy is up to several weeks.

The list of the most popular antibiotics for the treatment of male urethritis includes:

• metronidazole;
• secnidazole;
• doxycycline;
• ofloxacin;
• azithromycin;
• erythromycin.

With gonorrheal urethritis, injections of ceftriaxone are indicated - once a day for 10 days. Additionally, patients are often recommended to take vitamins of group B, PP, nicotinic acid. The use of these drugs helps to speed up recovery and minimize the likelihood of relapses.

During the treatment of urethritis with the listed medicines, it is important to remember that many of them are incompatible with alcohol and various types of medicines.

Preparations for women

The leaders among modern antibiotics prescribed for urethritis in women are:

1. Cephalosporins (cephalexin, cefazolin, ceftriaxone, cefoperazone).
2. Macrolides (clarithromycin, josamycin, ezitromycin).
3. Tetracycline and its analogues.

To relieve the inflammatory process, patients are prescribed sulfonamides from among the less toxic ones - etazol, urosulfan. For local therapy, consisting of douching, washing, baths, inserting tampons into the vagina, furazolidone, furatsilin, furagin are used.

Antiseptic action is provided by miramistin, chlorhexidine, protargol. These drugs are used for instillations of the urethra, irrigation of the external genitalia, the introduction of tampons soaked in the medicine into the vagina.

In order to activate the body's immune system, it is mandatory to take vitamins B, C, E, PP, tinctures of natural origin - ginseng, Chinese magnolia vine. After antibiotic therapy, it will be necessary to conduct a course of restoration of the intestinal and vaginal microflora. For this purpose, bifidumbacterni, lactozhinal, acylact, lactobacterin are prescribed.

Candles for urethritis

For urethritis, vaginal and rectal suppositories are used. Such drugs are divided into several types:

• antibacterial - causing the death of pathogens that caused the pathological process in the urethra;
• anti-inflammatory - relieving inflammation of the urethral mucosa, reducing pain, burning and swelling;
• antispasmodic - effective in relieving acute pain in the urethral canal;
• combined - containing antibiotics and anti-inflammatory components.

For the treatment of female urethritis, vaginal suppositories are used:

1. Polygynax.
2. Hexicon.
3. Terzhinan.
4. Metronidazole.
5. Macmirror complex.
6. Palin.

Diclofenac, genferon, iodovidone are widely used among rectal suppositories. Such drugs are included in the general treatment regimen for urethritis in female and male patients.

The use of any kind of candles lasts for 6-10 days. For greater effectiveness of this dosage form, before the introduction of suppositories into the vagina or anus, it is necessary to carry out a thorough toilet of these parts of the body. The procedure is recommended to be carried out before going to bed - this will avoid the leakage of a large amount of the active substance.

The main advantage of drugs in the form of suppositories is the effect directly on the focus of inflammation, without a negative effect on the digestive tract and other body systems.

Suppositories often have a minimum of contraindications, are compatible with various drugs, and rarely cause side effects.

During pregnancy

In the first trimester, antibiotic therapy for urethritis is completely excluded. To maintain the condition of a pregnant woman is prescribed:

• preparations for the restoration of the vaginal microflora;
• immunomodulators;
• vitamin complexes;
• folk remedies in the form of decoctions, infusions, teas.

In the chronic form of the disease, cauterization of the urethral mucosa with special chemicals can be carried out. At later gestation periods, pregnant women are allowed to drink safe antibiotics:

1. Flemoxin Solutab.
2. Flemoklav Solutab.
3. Ceftriaxone.
4. Cefepime.

The main therapy is supplemented with topical medications (antibacterial gels, creams and ointments), washing the urethra with disinfectant solutions.

Patients are recommended to refuse irritating food, drink plenty of fluids (sour juices, berry fruit drinks), leafy vegetables. To prevent re-infection, therapy is also carried out in the sexual partner of a pregnant woman.

Prices of medicines for urethritis

The estimated cost of the main antibiotics and uroantiseptics used for urethritis is given below.

The price of ointments ranges from $ 1.5-8. The cost of vaginal and rectal suppositories is $1-11 per package.

Any kind of drugs prescribed for urethritis are available for purchase both in conventional and online pharmacies.

Urethritis and the often accompanying vaginitis are caused by a bacterial or fungal infection. The list of antibiotics used to treat urethritis is based on the clinical picture of the disease and the type of pathogen. The effect of using the drug appears after a few days, but if the symptoms persist, a deep diagnosis of the sensitivity of microorganisms to antibiotics of different chemical groups is carried out.

Nonspecific urethritis

A feature is the type of microorganisms that lead to inflammation of the urethra. They belong to the conditionally pathogenic flora, which normally lives in the vagina and on the skin, but under certain conditions acquire pathogenic properties:

• form protrusions of the cell wall, which allow attachment to the mucous membrane;
• produce specific enzymes;
• form bacterial films that make them inaccessible to cells of the immune system.

The main types of bacteria that cause nonspecific urethritis are:

• coli (up to 80% of infections);
• streptococci;
• staphylococci;
• peptococci;
• Proteus;
• klebsiella;
• enterococci.

Separately, among nonspecific urethritis, myco- and ureaplasma are distinguished. For a long time, these microorganisms were considered pathogenic, but later studies showed that they are present in small amounts in healthy women and do not cause inflammation. Mushrooms of the genus Candida are also causative agents of nonspecific urethritis.

Antibiotics prescribed for nonspecific urethritis are selected taking into account the high risk of microflora resistance. Inflammation in this case is not associated with the introduction of infection during intercourse, but with the active reproduction of one's own bacteria. This happens when the immune system is weakened and is usually combined with. Own microflora has already met with antibiotics that a woman has taken throughout her life. Therefore, there is always a risk of multiple resistance and failure of therapy.

A quick and effective recovery is possible if strong broad-spectrum antibiotics are used. The bacteriostatic effect is associated with the suppression of the ability to multiply, but adult cells do not die. Therefore, such drugs lead to the transition of the infection into a chronic form.

• Fosfomycin;
• Nitoxoline;
• Azithromycin;
• Ofloxacin;
• Ciprofloxacin.

Antibiotics prescribed for nonspecific urethritis in women

Fosfomycin

It is a broad-spectrum antibiotic related to first-line drugs. It affects the mechanism of synthesis of the bacterial wall and prevents the adhesion of microbes to the epithelium of the urogenital tract. Pharmacokinetic studies show that after ingestion, after 2-3 hours, maximum concentrations of the active substance are created in the tissues of the kidneys and urine. They keep for 24-48 hours. Therefore, it is enough to prescribe a single dose of Fosfomycin powder at a dose of 3.0 g. Pregnant women are also prescribed this antibiotic, but under the supervision of a physician and taking into account the possible risk to the fetus. At recommended doses, Fosfomycin is not toxic, but animal experiments have shown that teratogenic effects may occur at 9 times the dose.

Nitroxoline

Assign with intolerance to Fosfomycin. The antibiotic is also effective against some pathogens of specific urethritis (gonococci, Trichomonas). Due to the peculiarities of metabolism, high concentrations of the active substance are created in the urine in a short time. Tablets are taken 4 times a day in a course for 2-3 weeks. In some cases, with urethritis and cystitis, a second dose is required with a break of 2 weeks.

Treatment with Nitroxoline has more contraindications. The antibiotic should not be used during pregnancy and lactation, in women with renal and hepatic insufficiency, cataracts and damage to the nervous system. During therapy, urine acquires a rich yellow color.

Azithromycin

In small doses, it inhibits the growth and reproduction of bacteria (bacteriostatic effect), and in high doses it has a bactericidal effect. Large concentrations are created in the tissues of the genitourinary system, so Azithromycin is prescribed for a combination of urethritis and vaginitis. Has a small number of contraindications:

• renal / liver failure;
• individual sensitivity.

Can be used during pregnancy, but not allowed while breastfeeding.

Ofloxacin and Ciprofloxacin

They belong to the group of fluoroquinolones and have a bactericidal effect. They have a wide spectrum of activity, bacterial resistance rarely occurs to them, but sensitivity may decrease with frequent use. If there was an allergic reaction to one of the drugs, then the appointment of another is not possible due to the risk of a recurrence of the allergy. Antibiotics from the group of fluoroquinolones are contraindicated during pregnancy and lactation and are not recommended for damage to the nervous system, epilepsy, arrhythmias, and in elderly patients. But ofloxacin is acceptable for use in pregnant women if the risk to the fetus is less than the possibility of complications from infection.

In pregnant women, treatment of nonspecific urethritis can be carried out with the help of antibiotics of the penicillin series at any gestation period.

Mycoplasma and ureaplasma

In the body of healthy women, mycoplasmas and ureaplasmas can be detected in smears. In the presence of a clinical picture, infertility or habitual, it is necessary to determine the number of copies of DNA. If this figure is greater than 10X4 CFU, antibiotic treatment is required. The exception is pregnant women. They are prescribed antibiotic therapy in the absence of clinical symptoms and a low titer of the pathogen.

The goal of treatment of nonspecific urethritis caused by mycoplasma is to eliminate the clinical manifestations of the disease and laboratory signs of inflammation. Both sexual partners should take antibiotics.

Due to the stability of ureaplasmas, the following drugs are not used for treatment:

• penicillins (Amoxicillin, Ampicillin);
• cephalosporins (Ceftriaxone, Cefotaxime);
• nalidixic acid preparations (Nevigramone).

Antibiotics for the treatment of urethritis caused by mycoplasma or ureaplasma belong to the following groups:

• tetracyclines;
• macrolides;
• fluoroquinolones (except nalidixic acid).

Antibiotics in the treatment of mycoplasma and ureaplasma urethritis

Josamycin

It is the main drug for urethritis, to which sensitivity remains in 95% of cases. It is a broad spectrum antibiotic with a bactericidal effect. It is well tolerated, has practically no contraindications and can be used to treat pregnant and lactating women. But in case of severe violations of liver function, allergies to drugs of this group, macrolides are not prescribed. The course of therapy with Josamycin for an infection caused by ureaplasma is 10 days. If laboratory signs and clinical symptoms persist, another alternative agent is selected.

Doxycycline

It is effective in 93-97% of cases, but is not used in pregnant women due to a violation of the formation of the fetal bone skeleton. It belongs to the tetracycline group of antibiotics, acts bacteriostatically. The course of therapy is 10 days, if necessary, it is extended or replaced by an alternative regimen.

Azithromycin

Used for ureaplasma urethritis. The scheme of application differs from traditional therapy. On the first day of treatment, 500 mg is prescribed to create a high concentration in the blood. After that, 4 days take 250 mg of Azithromycin.

The effectiveness of treatment is checked 4 weeks after the end of the course. If there is no decrease in the titer of the pathogen in the PCR analysis, then the scheme is repeated or another drug is used.

candida

Urethritis caused by fungi of the genus Candida in women is always combined with vaginitis. But treatment with local remedies is impossible, it will only lead to the suppression of Candida activity in the vagina and will not affect the condition of the urethra. Antibiotics are not effective in treating fungal infections. Special antifungal drugs are used:

• Fluconazole;
• Itraconazole;
• Ketoconazole.

A fungal infection in the vagina and urethra indicates a decrease in overall immunity, so it is necessary to look for and eliminate the underlying cause of the disease.

Antifungal drugs

Fluconazole is the main drug recommended by the CDC, IUSTI/WHO association for systemic use. Resistance of fungi of the genus Candida to it rarely develops. Uncomplicated acute urethritis is treated with a single dose of 150 mg fluconazole. On sale this drug is under different trade names:

• Flucostat;
• Difluzol;
• Diflucan;
• Mycosist;
• Flunol.

If frequent recurrences of candidal urethritis and vaginitis occur, a chronic infection is diagnosed. Her treatment is different. At the initial stage, Fluconazole is prescribed with an interval of 72 hours three times. After that, they switch to anti-relapse therapy. To do this, for 6 months, once a week, drink 150 mg of Fluconazole.

A fungal infection requires not only special treatment, but lifestyle changes. Women are advised to carefully observe intimate hygiene, wear natural underwear, reduce the amount of sweet and starchy foods in the diet, and increase the amount of fermented milk products.

Itraconazole is an alternative antifungal agent. Its use during pregnancy is allowed if the benefit to the mother outweighs the risk to the fetus. But breastfeeding Itraconazole is contraindicated. Women who are undergoing treatment of candidal urethritis with Itraconazole are advised to choose a reliable method of contraception and use it until the onset of menstruation after the end of the course.

Specific urethritis

Which antibiotic to drink for urethritis of a specific nature depends on the type of pathogen. Often a specific infection is combined with a non-specific one. The treatment regimen includes strong broad-spectrum antibiotics that act against most pathogens. Before prescribing treatment, an accurate diagnosis is necessary. A smear is enough to confirm gonorrheal or trichomonas urethritis, chlamydial infection is not always detected by bacterioscopy, so PCR diagnostics may be required.

Gonococcal

The lower parts of the urogenital tract, in the absence of correct and timely treatment, passes to the higher genital organs, causes impaired patency of the fallopian tubes and infertility. Treatment is prescribed to all sexual partners at the same time, and sexual contacts are excluded for the period of antibiotic therapy and control.

The sensitivity of the microorganism depends on which antibiotic to treat gonorrheal urethritis. The main one is Ceftriaxone. It is prescribed once intramuscularly. Ceftriaxone is the drug of choice in pregnant women, they are treated regardless of the gestational age. Delaying treatment increases the risk of miscarriage, intrauterine infection, and severe fetal malformations. Spectinomycin, which is administered intramuscularly once, is also safe for the fetus.

With fresh gonorrhea (no more than 2 months have passed since the infection), other antibiotics can be used:

• Azithromycin 2.0 g once;
• Ciprofloxacin 500 mg once;
• Cefixime 400 mg once.

If for some reason these drugs cannot be used, treatment is selected based on alternative means:

• Ofloxacin 400 mg;
• Cefodizim 500 mg intramuscularly;
• Kanamycin 2.0 g;
• Trimethoprim and Sulfamethoxazole 10 tablets orally once a day for 3 consecutive days.

When choosing an alternative regimen, it is necessary to control the sensitivity of gonococci to antibiotics in order to exclude the emergence of resistant strains. Sometimes a deep examination for other sexually transmitted infections is necessary. For example, chlamydia often co-occurs with chronic gonorrhea. Therefore, gonococci get the opportunity to hide from the immune system or go into the phase of incomplete phagocytosis. When combined with chlamydial infection, Josamycin, Doxycycline or Azithromycin are added to the therapy regimen.

Antibiotics for the treatment of gonococcal urethritis

In the treatment of complicated gonorrhea of ​​the urogenital tract, one injection or taking pills is not enough. The drugs are prescribed several times, the amount is selected individually. The main requirement is that after the disappearance of symptoms, it is necessary to continue taking the drug for the next 48 hours.

Antibiotic therapy for gonorrheal urethritis can be supplemented with immunotherapy. For it, a gonococcal vaccine (specific treatment) or non-specific immunomodulators (Pyrogenal, Prodigiosan) is used. To reduce local symptoms, baths with antiseptic solutions, chamomile decoction are used. It is impossible to be limited only to local treatment without the use of antibiotics.

Trichomonas

Trichomonas due to structural features are insensitive to conventional antibiotics. For treatment apply:

• Metronidazole;
• Tinidazole;
• Ornidazole.

The first line drug is Metronidazole. It is rapidly absorbed, penetrates well into all tissues of the body, high concentrations are found in urine, vaginal secretions. It crosses the placenta, so it is used with caution during pregnancy. It is not prescribed in the 1st trimester, but treatment of Trichomonas urethritis in the 2nd and 3rd trimester of gestation is allowed. Pregnant women are prescribed a single dose of 2.0 g of Metronidazole, less often they use a small dose regimen for 7 days.

Drugs for the treatment of trichomonas urethritis

In lactating women, antibiotic concentrations are found in milk, similar to those in blood plasma. Milk acquires a bitter taste. After taking a single dose, it is necessary to express for 2 days, and feed the child with an artificial mixture.

Metronidazole is incompatible with alcohol. With simultaneous use, a disulfiram-like reaction occurs:

• spasmodic abdominal pain;
• vomiting, nausea;
• dizziness and headache.

In young girls under 18 years of age, Metronidazole should not be combined with Amoxicillin.

With trichomonas lesions of the urogenital tract, one should not be limited only to the local use of vaginal tablets. The disease after such treatment will not disappear, and can also cause a relapse of vaginitis.

Ornidazole, like Metronidazole, is a derivative of 5-nitromidazole. It acts not only against Trichomonas, but also some non-specific pathogens. Available under several trade names:

• Tiberal;
• Dazolik;
• Gyro;
• Quinizol;
• Ornisid;
• Ornidazole.

I prescribe the medicine once or use a prolonged dose for 5 days twice a day. According to a similar scheme, Tinidazole is prescribed.

For the treatment of trichomonas urethritis and vaginitis, it is impossible to use other schemes. In case of allergy to the listed drugs, desensitization therapy is first carried out under the guidance of an immunologist or an allergist.

Chlamydial

When chlamydia is detected, treatment is prescribed regardless of the titer of the pathogen and the clinical picture. In most women, the disease proceeds secretly. The only sign of it can be long-term infertility. Chlamydia refers to STIs and leads to severe complications from the reproductive system.

The choice of antibiotic depends on the course of the disease. The first line drug is Azithromycin. It is prescribed once for uncomplicated infection. If complicated chlamydia is diagnosed, it is necessary to take 500 mg 2 times a day for 7-10 days.

Among other means:

• doxycycline;
• Josamycin;
• Clarithromycin;
• Roxithromycin;
• Ofloxacin.

Antibiotics for the treatment of chlamydial urethritis

The course of therapy with any of the listed drugs is 7 days. But with complicated forms of infection, it is extended to 14-21 days. Josamycin and Azithromycin are the main drugs for the treatment of pregnant women.

• Clarithromycin belongs to the macrolide group of antibiotics. Effective against intracellular microorganisms (mycoplasma, ureaplasma, legionella), fights many representatives of opportunistic microflora that may accompany specific urethritis. Clarithromycin is contraindicated only in case of individual intolerance, it is not recommended for pregnant women and during lactation. Against the background of therapy, subject to the dosage and duration of administration, side effects rarely occur. With prolonged diarrhea after the course, you should consult a doctor to exclude the development of pseudomembranous colitis.
• Roxithromycin also belongs to the group of macrolides, has a bactericidal effect. Its action is similar to other antibiotics of this type.
• Alternative drugs are Erythromyfin and Lomefloxacin. They are used when standard treatment regimens are ineffective or impossible to apply.

In the therapeutic regimen, a combination of several drugs can be used if mycoplasma, Trichomonas or another pathogen is diagnosed. The main side effect after antibiotic therapy is candidiasis of the urogenital tract. To avoid this, a single dose of Fluconazole is preemptively prescribed.

Antibiotics are not the only drugs used to treat urethritis in women. They act against the causative agent of the disease, and they are supplemented by drugs that eliminate concomitant symptoms. To reduce pain, inflammatory reactions, non-steroidal anti-inflammatory drugs are used in a short course. Herbal preparations with lingonberries, cranberry juice help to change the acidity of urine. Baths with decoctions of herbs fight against itching and burning.

Urethritis in men is an inflammatory disease of the wall of the urethra, which is often caused by various infectious factors: bacteria, viruses, fungi or protozoa.

In addition to infectious causes, inflammation can be caused by allergies, chemical or traumatic exposure. Urethritis is accompanied by itching, discharge from the urethra, burning and pain. Without timely treatment, the disease leads to the development of cystitis, prostatitis or inflammation of the testicle and its appendages, and in some cases, untreated urethritis can result in narrowing of the urethra.

That is why, at the first symptoms of an infection, it is necessary to consult a specialist in order to prevent its progression.

Features of the disease in men

In men and women, the disease has different manifestations, which is associated with the characteristics of their genitourinary system. And if female urethritis goes away with virtually no symptoms, then inflammation of the urethra in men is accompanied by various unpleasant sensations.

General practitioner Elena Vasilievna Malysheva and cardiologist German Shayevich Gandelman will talk about the features and symptoms of the disease:

The reason for the activation of the inflammatory process, according to doctors, is mainly genital infections. The first manifestation of the disease is the weakness of the body. A man can feel her already a few hours after a pathogen enters the body. There are also non-infectious causes of the development of the disease (injury, allergic reaction, malnutrition or personal hygiene, etc.), but they are quite rare.

It is very important to start treatment of inflammation at the initial stage of its development, since urethritis can lead to the development of pathologies of the genitourinary system and impaired reproductive function.

Treatment methods

Treatment of urethritis in men does not require hospitalization and is successfully carried out on an outpatient basis. The choice of drugs depends on the form of the disease and the result of bakposev. The main group of therapy used is antibiotics. Methods of administration vary and are agreed between doctor and patient. Medicines can be taken in tablet form, administered as intramuscular or intravenous injections, or delivered directly to the site using a catheter. Consider drugs for the treatment of urethritis in men, depending on the identified pathogen.

Gonococcal and bacterial inflammation

In 40% of cases, monotherapy with cephalosporin antibiotics is performed. In a chronic process, a tetracycline group is more often prescribed: doxycycline, kanamycin. Complicated gonorrheal urethritis in men is treated with a combination of several groups of drugs, for example, Gentamicin and Sumamed. Antibacterial therapy requires prophylactic administration of antimycotic drugs: Nystatin, Levorin. Without fail, immunomodulators and vitamins are prescribed. To control the effectiveness of treatment, it is necessary to take an analysis three times, with a certain time interval, to detect gonococcus.

Trichomonas inflammation

For the treatment of this type, the time-tested metronidazole is used as a course or once in the maximum possible dose. The intake of immunostimulating agents and fortified supplements is shown.

The defeat of chlamydia

How to treat chlamydial infection is determined by the doctor based on the result of bacterial culture. The least effective is a single dose of the maximum dose of Azithromycin. The best result is given by course treatment with Josamycin or an antibiotic of the tetracycline group - Doxycycline. Together with antibacterial hormone therapy is prescribed.

fungal infection

Detection of a fungal infection in the urethra in men requires antimycotic therapy: Levorin, Pimafucin, Fluconazole are taken in the form of tablets. Antifungal ointments are used locally, for example, Clotrimazole. Great importance is attached to immunostimulating therapy.

Viral defeat

The most common infection with the herpes virus types 1 and 2. In this case, urethritis in men is treated with antiviral drugs: Acyclovir, Ribavirin. There is an opinion that it is not possible to completely recover from the herpes virus, but stable remission can be achieved.

Inflammation of unknown etiology

In 30 - 40% of cases, the infectious agent cannot be established, however, the ongoing antibiotic therapy gives good results. How to cure urethritis in men with an unspecified diagnosis? Antibiotics of a wide range of several groups are prescribed: Azithromycin, Doxycycline, Metronidazole. Additionally, antifungal drugs and general strengthening are introduced. The scheme may change at the discretion of the attending physician.

Therapy for an inflamed bladder

The infectious process often goes beyond the urethra, so consider how to treat cystitis in combination with urethritis. The main causative agent is the bacterial microflora. Her treatment is trusted with macrolide antibiotics, fluoroquinols or tetracyclines. In addition, preventive antifungal therapy and multivitamin intake are prescribed.

The reasons

The main reasons that cause the development of urethritis in men, doctors include:

1. Diseases that can be transmitted as a result of sexual intercourse without a condom (herpes, HPV, gonococci, trichomonas, ureaplasma, chlamydia, etc.). Basically, inflammation in the urethra becomes just a sign of such infections.
2. Violation of metabolic processes (especially in the pelvic area).
3. The impact on the body of various toxic substances.

1. Stagnant processes occurring in the pelvic area. This leads to the development of congestive urethritis. The occurrence of venous blood stagnation is preceded by constipation, hemorrhoids, the practice of coitus interruptus.
2. Allergies that can be caused by food, personal care products, or certain medications.
3. A large amount of acidic and salty foods with a lot of spices in the diet, which can irritate the mucous membranes.

The following factors can provoke the inflammatory process:

• Hypothermia of the body.
• Chaotic sex life.
• Stress.

• Physical or psycho-emotional fatigue.
• Eating disorder.
• Damage to the walls of the urethra as a result of mechanical action (medical manipulations, etc.).

Treatment with folk remedies

• Cranberry. The juice from this plant will help the body fight inflammation, prevent the formation of stones, which is useful for urethritis in men caused by urolithiasis.
• Black currant. Three tablespoons of the leaves of the plant must be poured with two cups of boiling water, insist. Take twice or thrice throughout the day. It is useful to make decoctions, compotes from the berries of this plant.
• Parsley seeds. Pour a teaspoon of seeds with one liter of cool water, strain after eight hours. Tincture should be consumed three times a day, three tablespoons.

Classification of urethritis

According to the primacy of the development of inflammation, the disease is:

1. Primary - the infection develops directly in the urethra.
2. Secondary - other organs become the focus of infection. Together with the bloodstream, pathogens are able to enter the urethra.

Table 1. Classification of urethritis by type of pathogen

Classification

Depending on the cause, urethritis in men is divided into infectious and non-infectious, and infectious, in turn, into gonococcal and non-gonococcal.

Non-gonococcal urethritis is divided into types depending on the pathogen:

• bacterial (caused by conditionally pathogenic microflora);
• chlamydial;
• trichomonas;
• mycotic (candidiasis, fungal);
• viral;
• tuberculosis;
• ureaplasmic;
• mycoplasma;
• gardnerella;
• mixed.

Non-infectious urethritis in men is of the following types:

• allergic;
• traumatic;
• stagnant (congestive).

According to the duration of the course of the disease, fresh (acute, subacute and torpid) and chronic urethritis are distinguished.

Depending on the localization of the pathological process:

• anterior urethritis - in the anterior urethra, i.e., located closer to the outlet on the glans penis;
• posterior - in the posterior urethra, i.e., it is located closer to the bladder.

According to the primacy of the development of the inflammatory process, the following types of urethritis in men are distinguished:

• primary - when an infectious disease develops in the urethra;
• secondary - when the infection enters the urinary tract from neighboring organs that are the focus of infection.

Most often, infectious agents enter the urethra from the bladder and prostate gland, where an inflammatory process develops.

Urethritis and cystitis

These two diseases very often accompany each other, so patients often confuse them, mistaking one for the other. But it turns out they have significant differences.

In this article, we will talk about the symptoms and treatment of cystitis in men.

Firstly, this is the place where the inflammatory process occurs. With urethritis, the mucous membrane of the urethra becomes inflamed, and during cystitis, the walls of the bladder are exposed to this.

There are differences between urethritis and cystitis in the symptoms of diseases. With cystitis, the urine has an unpleasant odor and becomes cloudy. In contrast, in men with urethritis, there is no general weakness of the body.

Symptoms and signs

Attentive attention to the symptoms of the disease will help to avoid long-term treatment, to prevent its development. Main features:

• Itching, sharp pain during the release of urine, burning.
• Discharges that are mostly foul-smelling.
• Hyperthermia is occasionally observed.

The incubation period after which the symptoms of the disease appear depends on the type of disease and ranges from several hours (allergic) to several years (tuberculous). An experienced specialist will prescribe the necessary tests to determine which species struck the man’s body and provide the necessary treatment.

Diagnostic methods:

• Blood analysis.
• Urinalysis for leukocytes.
• Research on venereal diseases.
• Determination of the sensitivity of the pathogen to antibiotics.
• Ultrasound of the pelvic organs.

Symptoms

The very first signs of urethritis in a man can occur at different times: after a few hours (with an allergic form of the disease), after 3-21 days (if the cause is pathogenic microorganisms, depending on the type of pathogen), after a few months (viral urethritis) or even several years (tuberculous urethritis).

Dermatovenereologist, urologist Sergei Gennadievich Lenkin tells more about the causes and symptoms of the trichomonas form of the disease:

The characteristic manifestations of the disease are:

• Painful urination.
• Discharge from the urethra (the nature of which is associated with the types of pathogen).
• Burning sensation and itching of the penis.

When the pathology becomes chronic, the symptoms may disappear completely, with the exception of a slight discomfort in the groin.

Table 2. Symptoms of urethritis, based on the type of disease

Stages of the disease

Fresh (acute) urethritis occurs in three stages:

1. The incubation period is the time from the moment of infection to the onset of the disease, lasting from 1-2 days to 2 weeks.
2. period of severe symptoms.
3. The period of convalescence - complete recovery under favorable conditions (treatment) or chronicization of the process, i.e., the transition of the disease to a chronic form in an unfavorable variant.

A consequence of gonococcal urethritis in men can be a stricture (narrowing) of the urethra. Chlamydial urethritis can cause the development of Reiter's syndrome.

In the clinical picture of chronic urethritis, three alternating periods are also distinguished:

1. Exacerbation (symptoms are pronounced).
2. Remission (asymptomatic, but the inflammatory process is not resolved, it continues in an implicit form).
3. Unstable remission (poor clinical manifestations).

Complications

If any signs of inflammation of the urethra appear, it is important for a man to undergo a full course of treatment. If left unattended, the disease can lead to serious consequences. This is expressed in the fact that the inflammatory process can spread to the testicles, scrotum and prostate gland.

One of the complications of the disease is prostatitis.

The main complications of urethritis in men include: prostatitis, orchitis, epididymitis, funiculitis. Prolonged lack of treatment often leads to disruption of the reproductive system.

How to treat urethritis?

At home, the treatment of urethritis in men should be comprehensive. All procedures are carried out on an outpatient basis, medicines are selected by a specialist. The patient must scrupulously carry out all appointments and follow certain recommendations during the treatment period. These include:

• temporary refusal of sexual intercourse;
• strict adherence to hygiene standards;
• implementation of all medical recommendations regarding the duration of the course of treatment and medication;
• giving up bad habits (alcohol, smoking);

It is mandatory to adjust the diet, aimed at eliminating fatty, fried, spicy foods, smoked meats, marinades, pickles, carbonated drinks, in a word, all foods that can increase the severity of the inflammatory process. The patient is advised to drink more fluids, observe the daily routine, avoid hypothermia, stress and the influence of other negative factors.

On average, the treatment of almost any form of urethritis takes several weeks. In no case should treatment be abandoned when signs of improvement and subsidence of the clinical picture of the disease appear. At the end of treatment, a control swab is taken from the urethral canal to confirm recovery.

Diagnostics

Having noticed any symptoms of urethritis, a man should definitely visit a doctor who will prescribe the necessary examination and be able to make an accurate diagnosis. It is on the basis of diagnostic data that the treatment of urethritis will be prescribed.

During the examination, the urologist will feel the urethra for thickening and pain, and check the inguinal lymph nodes. In addition, he will examine the discharge and determine if there is swelling.

To make an accurate diagnosis, a man will have to undergo some examinations and take tests:

1. A smear taken on the walls of the urethra.
2. Analysis of urine and blood.
3. Bacteriological culture for detection of sensitivity to antibiotics.

1. Urethroscopy.
2. PCR (analysis makes it possible to identify a specific pathogen, which is especially important for treatment).
3. Testing for syphilis and HIV.

Read how to recognize the first symptoms of HIV in men.

Phytopreparations

One of the ways to solve the problem with infectious inflammation of the genitourinary system is herbal medicine. Medicines based on active plant ingredients have found wide application in the field of urology.

For example, lovage root has antibacterial and anti-inflammatory properties because it contains falcarinol and essential oils. The components of the essential oil of pine, sage, mint and citrus have a similar effect.

Plants such as goldenrod, knotweed, medicinal chamomile and cranberries have a pronounced anti-inflammatory and antimicrobial effect.

Some plants used in pharmacology for the manufacture of herbal remedies acquire poisonous properties if combined incorrectly. Therefore, for the treatment of urethritis, it is more expedient to use factory-made pharmaceutical products that have passed laboratory and biological control.

Among the combined herbal remedies that meet all the necessary requirements, the following are popular:

• Shed;
• Kanefron;
• Phytolysin;
• Cytotransit.

Treatment

Before prescribing certain drugs for the treatment of urethritis in men, the doctor will draw the patient's attention to the fact that sex must be completely excluded for the entire period of therapy. This applies not only to classic sexual intercourse, but also to oral sex and even masturbation. If an infection that can be sexually transmitted has led to the development of the disease, then the partner of the man is also subject to mandatory treatment.

It is also important to follow a certain diet. During this period, spices, marinades, fatty, salty and spicy foods should be completely excluded from their diet. It is forbidden to consume alcoholic beverages. To speed up the healing process, during treatment you need to observe the drinking regimen. At the same time, you need to drink at least 2 liters of clean water without gas daily.

Antibacterial therapy

The treatment regimen for urethritis is always based on the use of antibiotics, without which it is impossible to cure the disease. The name of the drug and its dosage should be determined by the doctor based on the results of the tests. Each of the possible pathogens has its own sensitivity to antibacterial drugs, so general antibiotics for urethritis are not suitable for treatment. The doctor may prescribe:

• The gonococcal type of the disease responds well to treatment with Azithromycin or Ceftriaxone.
• The Trichomonas species is better affected by "Metronidazole" or "Trinidazole".
• "Monural" for urethritis is considered the most effective if the disease is of an infectious type or a purulent form of the pathology is diagnosed.

Azithromycin is a semi-synthetic antibiotic used for infectious and inflammatory diseases. Price in pharmacies from 32 rubles

Antiseptics

To reduce pain, men are prescribed antiseptic drugs. These can be both medicines in the form of tablets, and local remedies, such as Furacilin, Chlorhexidine or Miramistin.

Candles and ointments

Local preparations, which are used in combination with antibacterial therapy, help speed up the treatment process. Acyclovir ointment, which is prescribed for the treatment of viral urethritis, has a good antiviral effect.

Rectal suppositories are comparable in their effectiveness to injections. Therefore, the course of treatment is often supplemented with Hexicon, Cifran, Indomethacin or Metronidazole suppositories.

Immunomodulators

To restore the body's defenses, the urologist will prescribe immunomodulators to the patient. They are always included in the main course of treatment, since it is the decrease in immunity that is considered one of the main causes of the development of the disease. They must be taken in addition to antibacterial drugs to support the immune system. The most effective means for treatment include: "Myelopid" or "Timalin".

An interesting report by Doctor of Medical Sciences Tatyana Germanovna Fedoskova on the topic "Immunomodulators in clinical practice: the role in anti-infective therapy and prevention":

vitamin therapy

During the treatment of urethritis, it is important for a man to eliminate the deficiency of vitamins and trace elements. Therefore, the doctor may prescribe medications (multivitamin preparations with a high content of vitamins A, C, D and E (“Pikovit”, “Bio-max”, etc.). A balanced diet and enrichment of the diet with fresh fruits helps to replenish the supply of vitamins in the body and vegetables.

It is important to understand that it is impossible to completely cure the disease with folk remedies. However, their use along with drug treatment helps to avoid relapse and speed up recovery. For this, decoctions and infusions of medicinal herbs can be used, which can be prepared at home:

1. An infusion prepared from blackcurrant leaves. This remedy has an antiseptic effect and helps to enrich the body with vitamins. To prepare it, 3 tablespoons of dried leaves are poured into 250 ml of boiling water and infused until completely cooled. After that, the infusion is filtered and taken 15 minutes before meals three times a day.
2. Decoction of oak bark. This remedy eliminates the soreness and burning sensation that appear at the time of urination. To prepare it, 1 tablespoon of raw materials is poured with 250 ml of boiling water and kept in a water bath for about 20 minutes. After cooling, the broth is filtered and taken 1 tablespoon before each meal. You can also use the decoction for sitz baths.
3. Infusion of cornflower. To prepare the infusion, 1 teaspoon of dried flowers is poured into 250 ml of boiling water and infused for at least 1 hour. After that, the agent is filtered and taken three times a day before meals, 2 tablespoons. The medicine helps to relieve inflammation and normalize the microflora.

Watch a video about the treatment of the disease with folk remedies:

Complementary Therapies

Along with drug therapy, physiotherapy is prescribed for the treatment of chronic urethritis. According to patients' reviews, magnetotherapy, electrophoresis, laser therapy, UHF have a good effect. During the period of exacerbation, they are contraindicated.

How to treat

Timely treatment will help to avoid possible complications. It is carried out with the help of various drugs - antibiotics, antiseptics, antioxidants, immunotherapy, vitamins, immunomodulators, topical agents. The dosage is prescribed by the doctor. It is important to observe proper nutrition, give up alcohol and cigarettes.

Antibiotics

A course of antibiotic therapy is prescribed after examinations: external examination, blood, urine, smear. Then the type of urethritis, the pathogen that provoked it, is determined. In the treatment, the use of common antibiotics is excluded, since the sensitivity of the bacterium to the drug depends on its strain. What antibiotics are used for treatment?

Antibiotics of the nitroimidazole group:

• Metronidazole. An antimicrobial agent that promotes the destruction of protozoan cells disrupts the synthesis of DNA of microorganisms, which contributes to their death. The drug is effective for trichomonas urethritis, is available as a solution for injection, in the form of suppositories, tablets. Adverse reactions are possible: nausea, abdominal pain, headache, diarrhea, allergic reactions, anorexia, unpleasant taste in the mouth, dryness, urinary incontinence, change in its color.

• Self-treatment of prostatitis at home
• Symptoms of prostatitis and its treatment in men: means and methods
• The incubation period and the first manifestations of trichomoniasis in men - symptoms and drug treatment regimen

The drug is contraindicated in leukopenia, organic lesions of the nervous system, with renal failure, allergies to the components that make up the composition.

• Secnidazole. It provokes the death of the pathogen cells, is effective in the fight against Trichomonas bacteria. Available in the form of granules, which must be dissolved before oral administration. May cause side effects: nausea, diarrhea, bad taste in the mouth, stomatitis, leukopenia, allergic reactions, dizziness, ataxia. Contraindicated in blood diseases, CNS lesions, allergies to the drug.

Tetracycline groups:

• Doxycycline. Suppresses protein synthesis by microorganisms. Helps in the treatment of gonococcal and non-gonococcal urethritis. Release form: capsules, tablets, injection solution, oral solution. May cause digestive disorders, as well as anemia, thrombocytopenia, allergic reactions.

Fluoroquinolones:

• Moxifloxacin. Suppresses the activity of microorganisms, effective against a variety of pathogens. It is prescribed for a wide range of diseases, as well as during the treatment of male urethritis. Exists in the form of a solution for infusion and tablets. Common adverse reactions: abdominal pain, dyspepsia, dizziness, headache, change in taste. Contraindications: epilepsy, hypersensitivity, severe diarrhea, age under eighteen.
• Ofloxacin. Destabilizes the DNA of infectious pathogens, affects many bacteria. The drug is prescribed during the treatment of any type of urethritis. The dosage form is a capsule. Possible side effects: disorders of the digestive, nervous system, taste, hearing, smell, allergic reactions. Contraindicated in children under 18, during epilepsy, after traumatic brain injury, stroke, if there is an allergy to the drug.
• Levofloxacin. Suppresses DNA synthesis of many microbes. Release form: tablets, solution for infusion. Possible unpleasant reactions: disorders of the digestive system, decreased pressure, hypoglycemia, disorders of the nervous system, disturbances in the functioning of the senses. Contraindications: epilepsy, age under 18, tendon damage after treatment with quinolones.

Triazoles:

• Fluconazole. An agent that destroys the fungus helps during the treatment of candidal urethritis. Release form: capsules, tablets, solution for oral administration and infusion, syrup. Side effects: nausea, flatulence, taste changes, dizziness, headache. Learn more about how to take fluconazole.

Contraindicated when taken simultaneously with terfenadine, astemizole.

Quinoxalines:

• Dioxidine. An antibacterial agent that helps when other medicines are ineffective. Available as an ointment, aerosol, solution for injection, external, intracavitary use. Reactions are possible: allergy, after intravenous or intracavitary exposure, disorders of the digestive system, fever may occur, after topical application - dermatitis. Contraindications: adrenal insufficiency, allergy to the drug.

Macrolides:

• Erythromycin. The antibiotic blocks the synthesis of proteins of microorganisms, which leads to their destruction. One of the safest and most effective remedies that is used during the treatment of male urethritis. It is taken intravenously and orally. Side effects - digestive disorders, tinnitus or hearing loss. Contraindicated if the patient has a significant hearing loss, as well as when used together with terfenadine, astemizole.
• Clarithromycin. An antibiotic derived from erythromycin with a stronger antibacterial effect. It is taken orally. Side effects: disorders of the digestive system, systems. Contraindicated in children under 12 years of age, with allergic reactions to the drug.

Azalides (macrolide derivatives):

• Azithromycin. Suppresses protein synthesis of pathogens, has cellular and extracellular effects. Helps during the treatment of gonorrheal, non-gonorrheal urethritis. Common side effects: digestive system disorders - diarrhea, nausea, abdominal pain. Contraindications: hepatic, renal failure, hypersensitivity.

At the moment, macrolides are used to treat various types of urethritis - one of the safest means. Previously, antibiotics of the penicillin group, for example, bicillin, were often prescribed, but due to the development of resistance to it by many microorganisms, it is prescribed in exceptional cases.

Tablets

Antihistamines will help to avoid allergic reactions, remove possible side effects:

• Tavegil. Has a long lasting effect. Helps with various types of allergic reactions of the body. You need to drink the drug twice a day - in the morning and in the evening. Possible side effects: nausea, headache, dry mouth. Contraindicated in children under one year old, when taking MAO inhibitors.

Medicines that restore the gastrointestinal tract are also useful:

• "Yogurt". It normalizes the intestinal microflora, improves the digestion process, and is useful for the prevention of dysbacteriosis. It is taken simultaneously with antibiotics, which negatively affect the body. You need to consume two to five tablets per day, with food, for several weeks. In order not to reduce the effectiveness of the antibiotic, the breaks between doses should be at least one and a half hours.

Vitamins:

• Vitamin B, the drug "B Complex" from "Biotek". Improves cellular metabolism, useful in the complex therapy of urethritis in women and men. Take one tablet daily with food.
• Vitamin PP or nicotinic acid. Helps in the treatment of infectious diseases. It should not be taken by hypertensive patients, allergy sufferers, and diabetics.

Other medicines

With urethritis, complex therapy is used, therefore, during treatment, as a rule, several types of drugs are prescribed at once.

Immunomodulators:

• Polyoxidonium for injections. It helps the body cope with infectious diseases. It is prescribed as injections of 6 mg daily for three days, then a day break, and again taking the drug. From five to ten injections of the drug are carried out.

Antiseptics for washing:

• methylene blue. The disinfectant is used as a 0.02% solution with water.
• Hydrocortisone. If the entire urethra is affected, installations with this drug are used.

Antiviral ointment:

• Acyclovir. Topical ointment, which will be especially effective in treating if a man suffers from herpes urethritis. Apply to the affected area five times a day, take from five to ten days.

Observance of preventive measures will help to avoid such serious treatment - reducing the frequency of sexual intercourse with unverified partners, using condoms, constant thorough hygiene, a diet that excludes food that irritates the mucous membrane, drinking at least one liter of water during the day.

Urethritis in children

Inflammation of the urethra can affect not only adults. Urethritis in children is no less common. Both infectious and non-infectious factors can lead to its appearance. Infectious diseases include the entry of bacteria, viruses, gonococci, trichomonads, mycoplasmas, and ureaplasma into the urethra. Among non-infectious factors, injuries (passage of stones through the urethra or medical manipulations), allergic reactions and congestive processes in the pelvic area predominate. In addition, narrowing of the urethra can lead to its appearance.

Read more about Trichomonas bacteria in men.

Symptoms in children are always related to gender. For boys, burning during urination, itching of the penis, discharge (white or with an admixture of mucus) and the presence of traces of blood in the urine are more characteristic. In girls, the disease is manifested by increased urge to urinate and pain in the lower abdomen.

Normal indicators of bacteriological analysis of urine

For diagnosis, bacterioscopic and bacteriological analyzes of urine and urethral discharge are used. If the doctor suspects a chronic form of the disease, the child will undergo a ureteroscopy.

Treatment is carried out depending on the form of the disease. In the case of the acute phase of urethritis, antibiotics are used that are suitable for a particular age group. In the case of diagnosing a chronic form, in addition to the use of antibiotics, the patient is prescribed drugs to maintain immunity and the introduction of drugs into the urethra.

After the end of treatment, the child must be re-examined. Along with drug treatment, the child needs a special diet (excluding smoked, spicy and salty) and compliance with the drinking regimen.

If left untreated at the initial stage of the disease, urethritis in a child can become chronic, when it becomes much more difficult to cure it.

Physiotherapy

Significantly accelerate the process of recovery from urethritis using physiotherapy methods.

For this disease, apply:

• laser therapy, involving the treatment of the urethra with infrared radiation;
• UHF therapy aimed at relieving spasm of the muscles of the genital organs;
• magnetotherapy, carried out with the aim of sanitizing the urogenital area and warming up areas of inflammation;
• ozone therapy, with which it is possible to quickly destroy harmful bacteria and viruses;
• electrophoresis;
• galvanotherapy.

All of the above methods contribute to the activation of the body's defenses.

Prevention

Any disease, including urethritis, is easier to avoid than to deal with its consequences. For this, it is important for a man to follow certain preventive rules:

• Strictly follow the rules of personal hygiene.
• Wear underwear made from natural materials.
• Avoid using other people's personal items (towels, linen, etc.). Thus, you can become infected with various infections and fungi.
• Avoid promiscuity. Have a permanent partner. In case of contact with a casual partner, it is important to use barrier methods of contraception (condom).
• Regularly (at least 2 times a year) a man needs to undergo a preventive examination by a urologist. This must be done even if nothing bothers him, because many infections can not manifest themselves in any way, but at the same time cause irreparable harm to the body of a man.
• Carry out timely treatment of any genital infections and diseases that are caused by fungi. This is due to the fact that they are able to give complications to the urethra, causing the development of urethritis.
• Avoid hypothermia, especially in the genital area.

• Protect the genitals from possible injury.
• Avoid excessive physical and psycho-emotional overwork.
• Provide yourself with proper nutrition, with enough vitamins and trace elements in foods.
• Observe the drinking regime and drink at least 2 liters of clean water without gas during the day.
• Get rid of bad habits or minimize them.
• Avoid urinary retention and empty the bladder completely at the first urge.
• Temper the body and use vitamins to support immunity.

Every year, a large number of men are faced with such a diagnosis as urethritis. A number of reasons can lead to an inflammatory process in the urethra. The most common of these are sexually transmitted infections. In addition, allergic and traumatic urethritis are distinguished, which are not associated with the entry of pathogens into the urethra.

Regardless of what caused the inflammatory process, the disease requires mandatory treatment, which can only be prescribed by a doctor after a comprehensive diagnosis and identification of the pathogen. All medical recommendations must be strictly observed by the patient. This is due to the fact that urethritis is difficult to treat and if the therapeutic course is not completed to the end, a relapse, the transition of urethritis to a chronic form or the development of complications is possible.

Complications and prognosis

In the male understanding, it is a shame to consult a doctor with a similar problem, but untimely or incorrect treatment threatens with many complications. The infection can spread to surrounding organs, causing cystitis, pyelonephritis, prostatitis. As a result, there is a violation of sexual functions and infertility. Chlamydial infection is manifested by subsequent damage to the articular tissue and systematic conjunctivitis. Purulent urethritis leads to structural changes in the mucous membrane of the urinary canal, its growth and narrowing of the lumen. With proper treatment, it is possible to quickly and completely get rid of the problem, the prognosis in this case is favorable.

Inflammation of the urethra: when antibiotics are not needed

When antibiotics are not needed to treat urethritis, only the patient's attending physician can decide. It's important to listen to your doctor. Since antibacterial agents have serious side effects, it is not recommended to use them just like that. Naturally, recommendations are given individually.

It must be understood that if there is no bacterial pathology in the patient's body, there is no point in taking antibiotics. After all, these substances destroy only pathogenic or conditionally pathogenic microorganisms. If they are absent in the body, antibiotics have nothing to act on. For example, urolithiasis may not require the use of antibacterial agents, as well as tumor diseases.

You can refuse these drugs with a fungal infection. The need to refuse antibacterial agents in each case is decided individually. Naturally, it all depends on the cause of the pathology.

If the patient simply does not want to be treated with antibiotics because he considers these drugs dangerous or more harmful than inflammation in the urethra, the doctor's task is to convince him.

Antiseptics

Antiseptics are another group of drugs often used for inflammatory processes in the urethra. These medicines do not destroy those bacteria that are already in the tissues. But they can get rid of pathogenic microorganisms and viruses located superficially.

They are used not only in the treatment of diseases in order to speed up the healing process. But even if the patient needs prophylaxis.

Washing the urethra with inflammation with antiseptics helps not only get rid of superficially located bacteria.

But also prevent secondary infection. The fact is that the inflammatory mucosa becomes more vulnerable to negative external influences.

The likelihood of contracting STDs with urethritis is much higher than in normal conditions. To influence this likelihood, doctors recommend washing with antiseptics. Even if the pathology is not bacterial in nature. You can use, for example, Miramistin or Chlorhexidine.

Immunomodulators for inflammation of the urethra

Immunomodulators are another drugs that can help treat inflammation of the urethra in men. Today they are mainly used in the event that a representative of the stronger sex has any STD.

The task of drugs is simple. With their help, they strengthen the immune defense of the body, help the body defend itself against bacteria more effectively. As a result, it is possible to reduce the time of antibacterial treatment, improve the general condition.

Immunomodulators are used mainly in the form of tablets. Means based on interferons, Viferon, Cycloferon, etc. are used.

Other remedies for treating inflammation of the urethra

In the fight against urethral disease, the stronger sex and women can be helped not only by antibiotics, antiseptics and immunostimulants. Often, doctors additionally recommend various ointments for treating affected skin from the outside, candles for the fair sex.

The composition of ointments and suppositories may also include antibacterial drugs. The task of which is to accelerate the destruction of bacteria. In addition, it has been proven that topical antibiotics have a lesser negative effect on the body.

Additionally, physiotherapy, herbal medicine can also be used. The optimal treatment program for each patient is selected based on the cause of the disease, as well as its individual characteristics.

How to diagnose a disease?

Inflammation of the urethra in men can cause serious health consequences. Therefore, when the first signs of a problem appear, you should immediately consult a doctor. Only a specialist can make an accurate diagnosis. The following methods are used for confirmation:

• A urogenital smear is taken, which is then sent to the laboratory for examination. This can be bacteriological culture or PCR.
• General urine analysis. This analysis helps to determine the degree of damage to the urinary tract.
• Blood test for inflammation.
• Urethroscopy - examination of the urethra using a special probe. It can be carried out only after acute urethritis in men has receded.
• Ultrasound procedure. Allows you to study pathological changes in the bladder, prostate and other nearby organs.
• Urethrography is an X-ray examination of the urethra. To obtain a clearer picture, a contrast agent is injected into the patient's blood. Such an examination can be carried out only if there is a suspicion of chronic urethritis.

Only after conducting a full medical examination, the doctor can draw a conclusion about the nature of the disease and its severity. After the pathogen is identified, it is possible to proceed to the development of a specific treatment method.

Treatment of mycoplasmal and ureaplasmic urethritis

Mycoplasmas and ureaplasmas are among the possible causative agents of the disease. They cause urethritis. It rarely spreads to other organs. However, these pathologies need to be treated.

In women, they are dangerous during pregnancy.

In men, it often leads to the development of Reiter's disease. This is a complex of symptoms caused by reactive inflammation of the joints, eyes, skin, and sometimes internal organs.

With mycoplasmal urethritis, drug treatment can be carried out for a long time. These microorganisms are difficult to eradicate. The course is scheduled for at least 10 days. Often it is extended up to 2-3 weeks.

It is especially important to carefully treat couples planning a pregnancy. Because after the conception of a child, the infection can worsen and cause serious complications. Including it leads to spontaneous abortions and premature births.

Drugs for the treatment of the disease

The cause of urethritis in men is a pathogenic agent, therefore, when prescribing drugs, the doctor must take into account the test data. For the period of therapy, the patient is recommended to completely exclude alcoholic beverages, give up sexual activity, delete harmful and fatty foods from his diet. Only timely treatment of the symptoms of urethritis in men can guarantee a quick recovery of the patient and the absence of negative consequences of such a pathology - the development of prostatitis and other complications. For effective therapy of this disease, the following groups of drugs are used.

Antibiotics

Antibacterial drugs are the basis for the treatment of diseases of the urethra. There are a huge number of different drugs that are used to destroy harmful bacteria in inflammation of the urethra. What antibiotics should be used to treat urethritis in men? In such a situation, patients are prescribed tetracycline, fluoroquinolone, penicillin drugs, as well as drugs from the macrolide group.

If the symptoms of this disease are caused by a sexual infection - chlamydia or gonococci, then the use of Gentamicin, Erythromycin, Azithromycin and Tetracycline is advised. When pathology occurs due to infection with ureaplasmas and mycoplasmas, Tetracycline and Doxycycline are used to treat urethritis in men. If the causative agent of the disease is Trichomonas, therapy is carried out by taking medications - Metronidazole, Azithromycin. To eliminate conditionally pathogenic flora, Enoxacin, Lomaday, Norfloxacin are used. They have a pronounced effectiveness in infection with staphylococci, Escherichia coli, Escherichia.

Antibacterial tablets for the treatment of inflammation of the urethra should be taken only under the supervision of a specialist, as there is a risk of side effects. Some of these drugs are poorly tolerated by the patient's body and cause migraine, vomiting and nausea, dizziness. The question of how to treat urethritis in men is decided only by a qualified specialist. The result of the therapy depends on the correct choice of drugs. After completing the course of treatment, the patient retakes a smear containing discharge from the urethra, which should confirm the absence of pathogenic microflora. If the chosen method of therapy turned out to be ineffective, the treatment of inflammation of the urethra in men is repeated, using antibiotics of another group.

Important! The most safe and effective antibacterial drugs at the moment are the macrolide group drugs. They are considered a worthy replacement for penicillin-type drugs, which have lost their effectiveness as a result of improvements in the defense system of many bacteria.

Antifungals

Chronic urethritis caused by fungal microorganisms can be treated with systemic antifungal medications. Drugs for the treatment of urethritis in men, prescribed for fungal infection, are Clotrimazole, Fluconazole, Pimafucin, Nystatin. Taking medication with an internal method of use is recommended to be combined with external antifungal agents. Creams and gels with fungicidal action, as well as systemic preparations, must be applied within 7 days.

Acute urethritis in men with fungal infection of the mucosa can become recurrent. In this case, the therapeutic measures described above should be supplemented with systematic washing of the urinary canal with disinfectant solutions. Such a procedure disinfects the mucous membrane of the urethra damaged by fungi and significantly accelerates the regeneration of its tissues.

Attention! Preparations for candidal urethritis in men are selected individually. Treatment of the disease must be carried out in both partners at once, since the fungal flora enters the human genitourinary organs as a result of unprotected sexual contacts.

Antiviral therapy

How to treat urethritis in men if its symptoms are caused by a virus? At the initial stage of development, this form of the disease does not cause specific sensations in the patient. The characteristic signs of viral urethritis appear only in the case of activation of the pathogen. With the progression of this pathology, a man also has general symptoms of inflammation - loss of appetite, fever, sleep disturbance, lethargy, and poor health. You can cure acute and chronic urethritis (in the stage of exacerbation of the disease) using the following drug names:

• Gerpevir - the drug exists in the form of an ointment, tablets for internal use and powder for injection. The tool is not recommended for use in case of intolerance to active substances, in case of violations of the kidneys or liver. The course of taking such medications is prescribed for a period of 8 to 10 days.
• Acyclovir - the drug is produced in the form of tablets and cream. For internal use, it is advised to use 400 mg of the drug no more than 2-3 times a day. The duration of treatment of the inflammatory process of the urethra with this remedy does not exceed 10 days. Adverse reactions occur in the form of difficulty breathing, allergies, dizziness, hallucinations, increased excitability of the nervous system. The use of Acyclovir is strictly prohibited for patients who have intolerance to the main components of the drug.
• Riboferin - the drug has the ability to stop the synthesis of viral particles, their reproduction and development. Taking the drug is unacceptable if the patient has pathologies of the kidneys and liver, severe types of anemia, heart failure, depressive states.
• Valacyclovir - this medication is produced in Russia and is an excellent analogue of the popular Acyclovir. The tool is successfully used to treat urethritis, which occurs after infection with a viral microflora (herpes). The list of adverse reactions in the drug is small, this should include heart rhythm disturbances, migraine, increased blood pressure, vasculitis.

In the case when, after the course of therapy, the signs of the disease appear again, it is necessary to continue antiviral treatment. These medicines should only be taken under the supervision of a healthcare professional.

Antihistamine medicines

As mentioned earlier, the cause of urethritis in men is not always infection with harmful microorganisms. Typical symptoms of this disease are often manifested by the body's allergy to the action of various foods, household chemical or hygiene products, and drugs.

That is why, with urethritis in men, treatment is carried out not only with antibacterial drugs, but also with antihistamines - Cetrizin, Suprastin, Tavegil. The appointment of these pharmacological agents helps to quickly eliminate inflammation that spreads through the urinary canal, as well as alleviate the patient's condition as a whole.

Vitamin complexes and immunostimulants

Penetrating into the human body, the infectious pathogen weakens the immune system, as a result of which the body's defense system loses the ability to neutralize harmful microbes. To increase the reactivity of immunity throughout the entire period of the disease, it is necessary to use immunomodulating agents - Gepon, Cycloferon, Duovit, Phlogenzym and Timalin. Also, with urethritis in men, the treatment of the disease should include taking vitamin preparations and antioxidants.

Properly selected medications are the key to successful therapy. The consequences of an inflammatory disease of the urethra in men occur in the case of untimely treatment or its complete absence. Complications appear in the form of orchitis, balanitis, prostatitis, vesiculitis, balanoposthitis, colliculitis, the development of a purulent or chronic form of pathology.

Treatment and prevention of fungal urethritis in men

Candida fungi enter the urethra of a man during unprotected sex. A provoking factor in the development of fungal inflammation is a long-term uncontrolled intake of antibacterial agents or a decrease in immunity. Fungal urethritis is manifested by itching, burning in the urethra, pain during urination and specific white discharge. Fungal urethritis, which is not treated with antifungal agents, often turns into chronic urethritis. Treatment and prevention of candidiasis are carried out with the following medicines:

• Fluconazole (Diflucan, Flucostat, Mikosist);
• Itraconazole (Orungal, Irunin).

The drugs belong to the group of triazole antifungals, which suppress fungal infection. Their metabolism occurs in the liver with the participation of microsomal enzymes, which affects the pharmacological effect of other drugs that are biotransformed by these same enzymes. Therefore, it is undesirable to carry out the simultaneous administration of antifungal tablets with certain antibiotics (Erythromycin, Rifampicin), diuretics (Hydrochlorothiazide), antidepressants (Amitriptyline) and other antifungal agents (Amphotericin B).

Contraindications: hypersensitivity, severe liver disease, heart block.

Side effects: dyspepsia (nausea, vomiting), headache and dizziness, increased levels of liver enzymes in a biochemical blood test, a decrease in the level of potassium in the blood, allergic reactions, a decrease in blood cells (leukocytes, erythrocytes, platelets).

Inflammation of the urethra: possible complications of pathology

If the symptoms of inflammation of the urethra are not treated, in the future a representative of the stronger sex or a woman may face serious complications.

In men, the testicles and prostate are mainly affected. After all, pathogenic microorganisms can migrate to these areas, exerting their destructive effect on them. Naturally, the symptoms of urethritis in this case will be supplemented by other complaints.

In a woman, urethritis often ends with damage to the kidneys and bladder. This is due to the peculiarities of the structure of the genitourinary system. After all, the fair sex is the owner of a short and rather wide urethra. Through which inflammation easily migrates to the organs located above.

Acute urethritis

The main thing with acute urethritis is a quickly started treatment. In men, acute urethritis is often treated with a ten-day course of doxycycline. This is due to its activity against a significant number of microorganisms and bacteria. The use of azithromycin is also effective. This course of treatment lasts from one to five days. This short course of taking the drug has fewer side effects, but is ineffective in infectious processes in the prostate.

In acute urethritis, a painful manifestation of symptoms is characteristic, therefore, painkillers (No-shpa, Baralgin) are included in the therapy. Bed rest will also ease the patient's condition.

For patients with urethritis, it is mandatory to be screened for the presence of sexually transmitted diseases.

Kinds

In clinical practice, several classifications of urethritis are used. It is called primary if the infection occurred from the outside (after contact with a sick person). The secondary form of the disease occurs if the primary source of infection is in the patient's body (genitourinary system, pelvic organs and any other localization). It usually develops against the background of immunosuppression (taking cytostatics, courses of radiation therapy, hematological pathologies, HIV, congenital diseases of the immune system).

Depending on the pathogen that caused the disease, there are nonspecific and specific forms. Nonspecific urethritis is caused by microorganisms that are conditionally pathogenic flora, and they can be isolated from healthy patients (streptococci, staphylococci, Escherichia coli, Proteus, Candida).

Specific urethritis is caused by pathogenic pathogens that are predominantly sexually transmitted (chlamydia, trochomonas, gonococcus, ureaplasma, mycoplasma).

Separately, non-infectious urethritis is isolated, which occurs due to irritation or damage to the mucous membrane (allergic reagents, drugs, ionizing radiation). But in half the cases, it goes into a bacterial form.

Depending on the duration of the course of urethritis, it is divided into 2 large groups:

• acute form - the disease lasts up to 3 months;
• chronic - the symptoms of urethritis bother the patient (possibly with periods of remission and relapse) for more than 3 months.

Prevention of urethritis disease

• examination by a urologist every six months;
• timely treatment of diseases;
• intimate hygiene;
• one verified intimate partner;
• protected sex if the partner is fickle;
• proper nutrition and water balance;
• exclusion of hypothermia;
• avoid overwork and heavy physical exertion;
• refusal of alcohol and tobacco;
• use of cotton intimate underwear, towels (only your own);
• should not be nervous;
• urinate at the first urge;
• take vitamins.

Prevention and general daily routine

Proper treatment of the disease is its prevention. To avoid complications of urethritis, as well as minimize the likelihood of occurrence, adhere to the following measures:

• Use a condom, avoid sexual contact with a full bladder, wear loose underwear, and practice good hygiene.
• Do not abuse alcohol and cigarettes.
• Monitor the state of health, treat after infection, sanitize foci of chronic infection, undergo preventive examinations once a year.
• Adhere to a healthy lifestyle - proper nutrition and moderate exercise will strengthen the immune system.
• Normalize the mode of work and rest, sleep and wakefulness.
• Avoid hypothermia, traumatic and stressful situations.

Epidemiology

According to epidemiological data, urethritis is ubiquitous and is more common in young sexually active men from 18 to 35 years. The rapid increase in the incidence is facilitated by modern features of sexual behavior: the absence of a permanent sexual partner, improper use of condoms, the onset of sexual activity in adolescence.
World incidence of gonococcal urethritis, according to "British Medical Journal"

is 42 cases per 100,000 population, non-specific urethritis 217 cases per 100,000 population. In the Russian Federation, according to the Central Research Institute of Organization and Informatization of Healthcare, about 350,000 patients with nonspecific urethritis are registered annually.

What tests are needed to treat urethritis

Therapy is not given at random. First, the doctor examines the patient. He evaluates clinical symptoms and takes tests.

The basic study is a smear on the flora. It allows you to fix the fact of the presence of an inflammatory process in the urethra.

A large number of leukocytes speaks of urethritis.

Microscopy can reveal some pathogens of infectious diseases:

• trichomonas
• gonococci
• candida

If a sexually transmitted infection is suspected, PCR is performed. Examine the smear for all common STDs. Not only bacterial, but also viral, fungal (candidiasis), protozoal (trichomoniasis).

After establishing the type of microorganism, a therapy is selected aimed at eradicating the pathogenic flora. To identify venereal and nonspecific inflammation of the urethra, a tank seeding is performed.

This research makes it possible:

• identify the type of pathogen
• determine the number of bacteria (in colony forming units)
• choose the best antibiotics for the treatment of urethritis

After sowing, when colonies grow, various antibacterial substances are added to the medium. In the course of the study, it is estimated which of them inhibit the growth of microflora to a greater extent. Those that affect the colonies more strongly are recognized as the most effective for the treatment of this infection.

Some antibiotics do not inhibit the growth of microflora at all or do so minimally. Such drugs for etiotropic therapy are not used.

Often the doctor prescribes treatment even before the culture tank has received the results. But after receiving them, the doctor has the opportunity, if necessary, to change the scheme to a potentially more effective one.

Complications in the absence of therapy

Among the possible consequences of urethritis are the following diseases: cystitis, orchitis, prostatitis. However, with an untreated infection, the inflammatory process rises to the kidneys, in which case there is the development of pyelonephritis and urolithiasis.

Inflammatory disease of the urethra - urethritis, often occurs among young men. Symptoms that do not take long to wait sharply spoil the quality of life of people and create extremely uncomfortable sensations. With timely access to a doctor and correct identification of the pathogen, urethritis is treatable.

Causes

Urethritis in a man can be triggered by several reasons. As already mentioned, the most common are venereal diseases. But inflammation of the urethra can occur if a man ignores the rules of personal hygiene, because dirt quickly collects on the genitals and pathogenic bacteria multiply.

E. coli, which remains on the surface of the intimate zone after bowel movement, very actively increases its population on the skin. When it gets deep into the urethra, signs of the development of urethritis immediately appear. Pathogenic microbes that affect the urethra include:

• staphylococci;
• streptococci;
• coli.

Urolithiasis can also cause the development of urethritis. Stones that are in the kidneys, under certain conditions, can end up in the urethra of a man, causing inflammation. Medical interventions also often cause inflammation, since microscopic abrasions very quickly become infected with an infection in the body, and then become inflamed.

Antibiotic treatment

The use of antibiotics for the treatment of urethritis is based on the results of the diagnosis, taking into account the identified pathogen. Also take into account the age of the man, the presence of chronic diseases and the cause of the development of urethritis. Antibiotics are started as early as possible, observing the norms and regimen of taking the drug. More popular because of the convenient use of tablet preparations. The purpose of antimicrobial drugs depends on the type of bacterial urethritis, so they are most often used:

At Trichomonas urethritis Metronidazole, Doxycycline.

• Metronidazole- has an antibacterial, trichomonacid and antiulcer effect. It is rapidly absorbed by the body creating bactericidal concentrations. Not recommended for men with liver disease. Mandatory simultaneous treatment of sexual partners.
• Doxycycline- a broad-spectrum antibiotic. Must be taken with a meal and plenty of fluids. It is recommended to avoid sun exposure while taking.

At gonococcal urethritis appoint Cefalexin, Azithromycin, Metronidazole.

• Cefalexin- a broad-spectrum antibiotic. It is highly concentrated in the kidneys, so it is often prescribed for diseases of the genitourinary system.
• Azithromycin- creates high concentrations in the foci of inflammation, providing a bactericidal effect. The advantage of this drug is the preservation of bactericidal properties for 5-7 days after administration, this made it possible to prescribe short courses of treatment (from three to five days).

At non-gonococcal urethritis helps Azithromycin, Fluconazole, Ofloxacin.

• Fluconazole- has a pronounced antifungal effect, is used to treat infections caused by fungal microorganisms. Has good tolerance. Can be taken with or without food. Use with caution in renal failure.
• Ofloxacin- effective against microorganisms resistant to most antibiotics. It is used for urethritis due to its ability to be excreted by 80% in the urine and stays in it for up to 24 hours. While taking the drug, it is not recommended to use agents that reduce the acidity of the stomach, which contributes to a decrease in the effectiveness of therapy.

At urethritis of unknown cause appoint Azithromycin, Metronidazole, Doxycycline, Cefalexin.

Home treatment: is it possible?

The main tasks in the treatment of urethritis are to eliminate the causative agent of the disease and restore the tissues of the urethra. Only a doctor of the appropriate qualification can cope with a venereal or tuberculosis infection. The issue of hospitalization is discussed on an individual basis, depending on the condition of the patients, the stage of the disease and a number of other reasons.

Urethritis of the infectious group is treated on an outpatient basis, the patient receives a course of antibiotics in tablets or injections. The drugs are able to destroy pathogenic bacteria, eliminate inflammation and prevent recurrence of the disease.

You cannot self-medicate. With the wrong selection of drugs, the acute phase can turn into a chronic one, which requires a longer and more complex treatment.

The doctor selects the necessary funds, he also calculates the course and dosage.

For a successful recovery, a complex of means is needed, including oral preparations and means for external exposure.

Therefore, before treating urethritis at home, a consultation with a specialist is required!

You can use them at home, it is important to be on time for examinations and strictly follow the doctor's instructions. If necessary, the specialist will supplement the therapeutic regimen, replace an ineffective drug or a drug that gives negative side effects.

Diagnostic methods

Diagnosis of the disease is not difficult. The examination begins with a thorough history of life and anamnesis of the disease. They will find out from the patient what he was ill with, how he was treated, whether he had unprotected sexual intercourse. They also carefully listen to the patient's complaints, clarifying and analyzing them.

Then proceed to the inspection. Carefully examine the mouth of the urethra, pay attention to the swelling of the sponges and their adhesion, discharge from the urethra. Palpation and percussion (tapping) of the urethra can be painful.

Laboratory studies - play a huge role in the diagnosis.

Blood tests. They take a general blood test, where they find signs of inflammation (leukocytes are increased, the number of stab neutrophils is increased, the erythrocyte sedimentation rate is accelerated). They also conduct a blood test for sexually transmitted infections (gonorrhea, trichomoniasis, chlamydia, ureoplasmosis).

Urinalysis is very informative. A general urine test will show the presence of inflammation (leukocytes in the urine are increased, bacteria will appear). A three-cup test is carried out, the essence of which is that the patient urinates into three containers, the first container from the urethra, the second and third from the bladder. In the first glass, bacteriological examination will reveal the maximum number of bacteria.

Examine the discharge from the urethra (smear), determine the pathogen and immediately its sensitivity to antibiotics.

Instrumental diagnostic methods for urethritis are rarely used. They are necessary in order to find the cause of the disease or developed complications. An ultrasound of the prostate, testicles, seminal vesicles, bladder, kidneys is performed. Endoscopic methods are not shown.

Nonspecific urethritis

In cases of non-specific forms of urethritis, the urethra is "attacked" by microbes that are constantly in our bodies (streptococci, E. coli, staphylococci, fungi). High immunity prevents their reproduction, so the main treatment is aimed at increasing the protective properties of the body. Start treatment with immunostimulating drugs(Cycloferon, Uro-Vakson, Phlogenzym, Gepon). After immunomodulators appoint antibiotics, which are selected depending on the course of the disease and the complications that have arisen in the process of progression.

Antibacterial therapy it is also applied topically in the form of urethral lavages (instillations). Using instillations microorganisms are washed out of the urethra, but this procedure is often not recommended, since the microflora of the mucosa is disturbed.

In the chronic course of nonspecific urethritis is effective physiotherapy(electrophoresis, UHF, laser therapy). In cases of acute course of the disease, physiotherapy is undesirable. Treatment of non-specific urethritis does not require treatment of the partner.

In addition to drug treatment, it is also necessary to adhere to the general rules:

• Refrain from sexual intercourse.
• Follow a diet (limit spicy, sour, salty foods, and alcohol).
• Adhere to a therapeutic drinking regimen (drink at least 2 - 2.5 liters of water per day, include fruit drinks and herbal diuretic teas in the diet).
• Eliminate the systematic ingestion of toxic substances (tobacco, alcohol, drugs, chemicals) into the body.

Preparations

In the treatment program for urethritis in men, the following medications are needed:

• Oral antibiotics(Doxycycline, Azithromycin, Ceftriaxone, Metronidazole). Necessary to fight bacteria that contributed to the development of urethritis.

• Antibacterial drugs for topical use(Miramistin, Potassium Permanganate, Protargol). To flush out infection from the urethra. When using a urethral flush with these drugs, up to 80% of bacteria die.
• Antivirals(Acyclovir, Riboverin, Gerpevir). With a viral cause of the disease. Note!

The use of antibiotics for viral infections is impractical because they do not affect viruses.

• Antihistamines(Suprastin, Loratadin, Cetirizine). Help with allergic form of cystitis. Probiotics (Linex, Bifidumbacterin). It is important to take them along with antibiotics to restore the microflora.
• Immunomodulators(Cycloferon, Uro-Vakson, Phlogenzym, Gepon). Increase the protective capabilities of the body, which contributes to a speedy recovery, and reduce the likelihood of recurrence of the disease.
• Vitamin and multivitamin complexes(Vitrum, Duovit, Multitabs). Necessary for the body with a deficiency of nutrients in the diet.
• Phytopreparations(Gentos, Cyston, Kanefron-N). Used for uncomplicated forms of cystitis or as concomitant therapy.

The result of treatment directly depends on the selection of drugs. If pathogens are found in the analyzes after the therapy, repeated treatment is prescribed with the appointment of antibiotics of a different series.

Urethritis

This disease affects not only men, but also women, and the percentage of lesions is almost the same.

Symptoms of urethritis

Its causes are varied, it can be:

• hypothermia;
• prolonged use of the catheter, as a result of which the urethra is affected by pathogenic bacteria;
• transmission from a sexual partner in case of unprotected contact;
• gonorrheal urethritis occurs due to gonorrhea that occurs due to the sharing of personal items or through sexual contact;
• inflammation of an infectious nature that is already present in the genitourinary system;
• lack of personal hygiene;
• the candidal variety of the disease occurs due to infection with a fungus, but this can happen due to weakened immune system, taking antibiotics or due to sexual infection;
• defeat by chlamydia infection or other sexually transmitted diseases, resulting in chronic urethritis in patients.

As for men, their clinical picture may be slightly different from women:

• the presence of blood in semen or urine;
• high sensitivity of the penis;
• the presence of pain during sexual intercourse;
• urge to urinate.

And in women, the symptoms will be as follows:

• itching during menstruation;
• discharge of pus, which may differ in color;
• redness.

prostatitis in men

An interesting fact is that in women, the disease is not so pronounced, but this fact is due to a different structure of the genitourinary system.

Treatment of urethritis with urolithiasis

By themselves, kidney stones are not a source of inflammation. But they increase the risk of bacterial infection.

Calculi disrupt the parietal circulation in the organs where they are located. They damage the mucous membrane with their sharp edges. Therefore, they violate protective barriers, creating an entrance gate for infection.

Nonspecific inflammatory processes often join. In the treatment of urethritis in women, different drugs are used against the background of urolithiasis. Necessary not only sanitation of the urinary system. Removal of the stones themselves is also required.

For this apply:

• antispasmodics- relax the muscles of the urinary tract, facilitate the removal of stones
• citrates- dissolve urate and sometimes oxalate stones formed in acidic urine
• lithotripsy– for crushing stones with ultrasound
• surgical intervention- to remove stones

Urethritis and cystitis itself also require drug treatment. Broad-spectrum antibiotics are prescribed.

Preventive actions

By understanding the causes of urethritis and what it is, it is easy to identify preventive measures:

• exclude dubious sexual relations;
• use condoms as a means of protection;
• adhere to the rules of hygiene;
• pay attention to your health, in case of doubtful symptoms, immediately consult a doctor;
• during the period of enhanced psycho-physical stress, take vitamin complexes;
• avoid hypothermia;
• adhere to a balanced diet, do not get involved in harmful foods;
• strengthen the immune system.

Acute inflammation brings many unpleasant symptoms, but a neglected, uncured process is much worse for its long-term consequences. About 40% of men of retirement age suffer from prostatitis, and this is a direct consequence of chronic urethritis. The sadder the statistics, since inflammation of the urinary canal is completely treatable if all recommendations are followed.

Doxycycline

This pharmacological agent belongs to the group of semi-synthetic drugs with a fairly wide range of effects on pathogenic bacteria. This drug is especially effective in the fight against various strains of gram-positive bacterial pathogens - streptococcal, staphylococcal, chlamydial, gonorrheal type of infection and others.

The active substances of this drug are absorbed by the digestive system almost in full. Eating does not have any effect on the absorption of doxycycline. The maximum content of the drug in the patient's blood is reached after 2 hours after the use of the drug. The active effect of the drug lasts for 15-24 hours from the moment of administration. The medicine is available in the form of capsules intended for oral administration. Doxycycline is recommended to be taken after meals with plenty of water. The daily dose of medication for adult patients is 1 capsule.

In the treatment of symptoms of urethritis in men on the first day of the disease, the patient is advised to use the maximum amount of medication. Then, during the entire course of therapy, the patient takes smaller doses of medication, which are prescribed by a specialist, depending on the form and severity of the course of this pathology. The duration of treatment with Doxycycline is from 10 to 13-14 days. It is not recommended to interrupt therapy even in case of a noticeable improvement and disappearance of the symptoms of the disease.

The drug has a number of contraindications. This drug should not be taken by patients suffering from the following diseases:

• leukopenia;
• lactase deficiency;
• severe form of renal or hepatic insufficiency;
• allergy to lactose;
• porphyria;
• individual intolerance to drugs of the tetracycline group.

Doxycycline is able to slow down the reaction, therefore, during the period of its use, men should stop driving a car and operating complex mechanisms.

Forecast

Urethritis is a benign disease. With proper treatment and timely use of antibacterial drugs, a man recovers completely in 98% of cases. The problem of the correct selection of antibiotics has arisen due to the growth of antibiotic resistance (especially in gonococci, chlamydia and staphylococci). Therefore, all patients who seek medical help are taken from the urethra with bacteriological examination.

There are factors that can contribute to the chronicity of the disease:

• interrupted course of treatment (immediately after the disappearance of symptoms);
• diabetes;
• congenital malformations of the urinary system;
• diseases of the immune system;
• uncompensated comorbidities.

Treatment of nonspecific bacterial urethritis

Not all cases of inflammation are caused by genital infections. Sometimes the cause is conditionally pathogenic microflora. Bacterial urethritis is treated with antibiotics.

Which antibiotics for urethritis will be prescribed depends on:

• clinical symptoms
• history data
• laboratory research

Various drugs may be used. It can be cephalosporins, macrolides, penicillins. Local antiseptics are also used.

How is gonorrheal urethritis treated?

How is relapse treated?

In the Soviet period, gonorrheal urethritis was given the apt name "eye sexual disease", because, having become infected through sexual contact, men soon cried from pain during urination, they were not at all in the mood for jokes. The symptoms of today's gonococcal inflammation of the urethra have become milder, and the pathogen itself is more resistant to drugs.

How is gonorrheal urethritis treated?

This is not the most common infection of the urinary system of Russians, more relevant non-specific urethritis, caused by a wide variety of representatives of the microflora. Despite occasional reports of super-antibiotic-resistant gonorrhea, in most cases it is no more difficult to cure than non-specific inflammation of the urethra.

Today, short courses of antibiotics of the 3rd generation cephalosporin group are used, both in injections and tablets. A properly selected drug in the right dose eliminates the pathogen on the second day.

The fluoroquinolone antibiotic ciprofloxacin has lost its leadership in effectiveness today, in addition, its adverse effect on tendons and ligaments has been discovered. However, with insufficient effectiveness of cephalosporins, it is also used, as well as alternative drugs of the levofloxacin and ofloxacin group.

An improperly selected drug and self-medication guarantee a relapse of the disease, before the manifestation of which the patient is a source of infection for all sexual partners. Do not rely on "maybe" and the recommendations of "experienced", seek help from the Center for Urology and Andrology. Anonymity is our professional credo.

Is antibiotics enough for urethritis?

Often the gonococcus lives in conjunction with chlamydia, this condition is called gonococcal chlamydial urethritis, so chlamydia is treated simultaneously with doxycycline or erythromycin.

Trichomonas is successfully treated with metronidazole and similar drugs, it is also often a companion of these infectious agents.

It is possible to use local antiseptics, which are introduced into the urethra only by a specialist in order to avoid mechanical damage and burns of the inflamed mucosa.

In women, antibacterial drugs greatly change the microflora of the genital tract, so fungi easily attach, and there is no visible improvement, therefore antifungal drugs of general and local action are immediately introduced into the combination.

What is the treatment for nonspecific urethritis?

An acute infection is treated with antibiotics until the specific pathogen is identified, which may take several days. Empiric therapy is used - a broad-spectrum drug is prescribed, that is, it kills most possible infectious agents. After bacteriological analysis, the treatment is adjusted - the drug is injected, to which the highest sensitivity is revealed.

Often, mycoplasma and ureaplasma seed the mucous membrane of the urinary canal, and the absence of a cell wall in the simplest microorganisms makes them very resistant to drugs, so not one, but a combination of drugs is required, each of which has its own contraindications and complications.

The sensitivity of the causative agents of European and American urethritis is not at all identical to the reaction of Russian strains, and American standards of therapy do not always help Russian patients.

The specialists of the Medicine 24/7 clinic strictly follow the clinical guidelines, taking into account the specific characteristics of the "Russian" infectious agents and their "national" response to treatment, which allows achieving expert results in the cure.

How is relapse treated?

In every tenth patient, acute urethritis returns within 30 to 90 days - this is a persistent infection or a relapse of the disease. Genital mycoplasma is often found in chronic infections, but optimal recommendations for therapy have not yet been created.

How this category of patients is examined and treated has not been determined by the world medical community, because there have not been sufficient and serious clinical studies. In most cases, there is a need for combined antibiotic therapy. In this situation, the personal clinical experience of the specialist and the ability of the clinic to perform accurate and complex analyzes for the detection of a wide range of pathogens play an important role.

The Medicine 24/7 clinic has developed a coherent diagnostic program and alternative therapy for recurrent infections, minimizing the likelihood of chronicity of the pathological process and the development of complications. If you are tired of malaise and sluggish pathological manifestations, seek help from a specialist at the Center for Urology and Andrology.