What is urethritis?
The urethra is part of the urinary tract. Urine flows from the bladder to the outside through them. In urethritis, the mucous membrane that lines the inside of the urethra becomes inflamed. The most common cause is pathogens that enter the urethra from outside and multiply there.
Urethritis often occurs as part of a sexually transmitted disease (STD). These are diseases that are mainly transmitted through unprotected sexual intercourse. Women in particular often do not notice urethritis, as the symptoms are only very mild.
Age and frequency
Urethritis can occur at any age. However, those affected most frequently fall ill between the ages of 20 and 30 – in other words, at a time when many people are very sexually active.
Urethritis: causes and risk factors
Urethritis can have various triggers. Experts distinguish between different forms of the disease.
- Specific or gonorrheal urethritis: This is caused by an infection with gonococcal bacteria. Gonorrhea is a sexually transmitted disease and is also known as gonorrhea. It is one of the most common triggers for urethritis.
- Non-specific or non-gonorrheal urethritis: This is most commonly caused by a bacterial infection with chlamydia, mycoplasma and intestinal bacteria such as Escherichia coli or enterococci. Sometimes viruses (such as herpes viruses), fungi (Candida albicans) or other microorganisms such as trichomonads also cause non-specific urethritis.
Risk factors for urethritis
In addition to unprotected sexual intercourse, other factors can also promote urethritis. These include mechanical irritation of the urethra, for example from a urinary catheter. This is used when a person can no longer urinate independently. The thin plastic tube is inserted via the urethra to drain urine from the bladder to the outside.
Furthermore, a so-called self-infection often occurs, especially in women. As the urethral opening is close to the anus, intestinal bacteria can enter the urethra after using the toilet, for example, if the wrong cleaning technique is used. Fragrances in soaps or panty liners and excessive hygiene can also irritate the urethra and promote inflammation.
Symptoms: Men often suffer more from symptoms
A common sign of urethritis is pain when urinating. In women, these sometimes radiate into the entire lower abdomen. Unpleasant itching often occurs at the same time. A whitish to greenish discharge from the urethra is also typical. In men, a drop of pus (bonjour drip) often comes out of the urethra in the morning before the first urination.
Some sufferers do not feel any symptoms at all. Women in particular often only notice urethritis very late. This is because the symptoms of urethritis are generally more pronounced in men than in women. This is due to an anatomical difference: the urethra is significantly longer in men than in women. This also provides more mucosal surface area, which can become inflamed and cause problems.
Diagnosis of urethritis
At the beginning of the examination, we will have a detailed discussion with you (anamnesis). You should describe your symptoms as precisely as possible. You may also have to answer uncomfortable questions, such as whether you have had unprotected sex or sex with more than one person. This is followed by a physical examination. Here we can determine whether external signs of inflammation (e.g. redness, discharge) of the urethra are visible.
Urine sample for urethritis
To confirm a suspected urethritis, you will usually have to give a urine sample. We can have these examined in the laboratory for pathogens and signs of inflammation (e.g. an increased number of white blood cells).
Smear
In rare cases it is necessary to take a smear from the urethra. To do this, we insert a thin cotton swab into the urethra. This can sometimes be a little uncomfortable. The secretion and tissue sample is then examined in the laboratory to identify a specific pathogen beyond doubt.
Urethritis: prevention, early detection, prognosis
Women in particular often only have very mild symptoms and do not even feel that they are suffering from urethritis. Early detection is therefore difficult. If your partner suffers from urethritis, you should definitely have an examination – even if you have no symptoms. This is because germs can be transmitted very easily during unprotected sexual intercourse. One of the best means of prevention is therefore to use condoms. There are also other helpful measures that can prevent urethritis:
- Drink a lot: If you drink a lot, you also need to urinate often. This can help to flush pathogens out of the urethra before they settle in the mucous membrane and cause inflammation.
- Proper hygiene: After using the toilet, women should always make sure to clean the anus from front to back. This reduces the risk of wiping intestinal germs into the urethral opening. It is also important not to irritate the intimate area with soaps or intimate sprays. This can also promote urethritis. Warm water is usually sufficient for washing.
Course and prognosis (urethritis)
As a rule, urethritis heals well without causing any long-term consequences – especially if the right treatment is given as early as possible. However, as many sufferers often feel no or only very mild symptoms, urethritis often remains undetected. In this case, the pathogens can spread further from the urethra. In men, for example, the prostate or epididymis can become inflamed, and in women the uterus, fallopian tubes or ovaries. In the worst case, this can lead to infertility in the person affected. Sometimes the inflammation can also spread to the joints and conjunctiva. Experts refer to this as Reiter’s syndrome. In most cases, however, the autoimmune disease heals without consequences with the right treatment.
Urethritis: Treatment also always affects the sexual partner
The most important thing in the treatment of urethritis is to identify the causative pathogen and treat it specifically with medication.
Details of the treatments