By itself, a diagnosis of urethritis, as a rule, is an experienced special difficulties, because many of the symptoms of the pathological process are characteristic. The difficulty to diagnose are those forms of the disease that occur atypically or without any symptoms (draft).
Because what infectious agent caused the disease (bacteria, viruses, fungi, parasites), will depend on its nosological variant (gonorrheal, herpetic urethritis, etc.).
Symptoms with urethritis do not only depend on the type of pathogen, but also the patient’s age, the protective properties of the organism, presence of comorbidities and complications. Below we describe the distinctive features of different forms of pathological process, as well as the main diagnostic methods, with which you can identify those or other infectious agents.
The disease can be transmitted sexually (for example, Trichomonas or gonorrheal urethritis), or have non-infectious nature of their origin (allergic, traumatic urethritis, and others).
According to the severity of symptoms of urethritis clinically, there are several forms:
- Acute process starts suddenly and is characterized by a vivid picture of the disease: violation of urination, pain while emptying the bladder, copious unpleasant discharge from the urethra which dry up and cause the sticking. If the affected posterior urethra, discharge becomes less frequent but the urge to going to the toilet, the pain appears at the end of the act, in the urine is possible to detect traces of blood.
- Chronic process is characterized by less severe clinical picture, often the symptoms of urethritis do not exist at all. Often there is discomfort and transient itching in the genital area, periodic nagging or aching pain in the lower abdomen. Some girls say unpleasant sensations during sexual intercourse. As a rule, changing the emotional background of patients, deteriorating mood, and reduced overall interest in life.
- Torpid process has the same symptoms as the chronic form of urethritis. Talking about him when disease duration is less than 2 months. At the end of this period, the patient exhibited diagnosis of chronic forms of urethritis.
With the defeat of the calving front of the urethra, the pain usually very strong, they occur at the beginning of the emptying of the bladder, the patient concerned about copious
The symptoms of bacterial processes
First and foremost, patient has subjective complaints of unpleasant and uncomfortable feelings in the urethra, which increases with the desire to go to the toilet, especially if there is delayed emptying of the bladder.
The first signs of the disease, which often go to the doctor, become yellowish-gray, or purulent discharge from the urethra, bringing inconvenience and discomfort to the patient
Changing the natural color of urine it becomes turbid, it appear in long white strands that are visible to the naked eye.
At the beginning of urination patient feels a sharp pain, radiating to the perineum or thighs. If the inflammatory process captured the outer sphincter of the urethra, appear uncontrollable urge to urinate. When pain syndrome arises at the end of emptying the bladder, we can talk about the defeat of the posterior urethra.
As a rule, the desire to urinate becomes unbearable, breaks down the process of erection, and in the urinary sediment, there are traces of blood. In the propagation of inflammation in the mucosa of the bladder there is a reduction in abnormal discharge.
Diagnosis of gonorrheal infection
The disease can be diagnosed through the following methods:
- microscopy of the secretions obtained from the lumen of the urethra (visualized gram-negative diplococci);
- seeding of the substrate on the nutrient medium (grows pure culture of the pathogen).
As a rule, the majority of patients are not even aware of the presence in the organism of this species that is accidental finding during the examination (for example, women who have got registered for pregnancy in female consultation). In spite of this disease should be treated, even in patients in a “position” because there is a risk of activating pathogenic properties of the pathogen.
Some patients may experience scanty discharge from the urethra, they appear in the morning (after waking up) and have a mucous or Muco-purulent. Dysuric disorders occur only with the active form of the process, which threatens early complications (hemorrhagic cystitis, epididymitis, acute prostatitis, and others).
When “active” chlamydia, the patient may experience pathological processes of different localization
Diagnosis of chlamydial infection
Most often to detect the pathogen resort to the methods of serological and immunological diagnostics, which in the body is easy to detect the DNA of chlamydia, as well as antibodies generated against their antigens.
Main symptoms of the disease appear after a few days of infection. Unfortunately, they are not specific. Patients may complain of periodic discharge from the urethra, most often, they are scarce, but have an extremely unpleasant smell (fish). There is discomfort in the genitals, increasing during sexual intercourse.
The pathological process is recorded as among adult women and among girls in the younger age groups, due to the imperfection of the protective properties of their natural microflora of the vagina.
Diagnosis gardnerellas infection
To establish an accurate view of agent used:
- microscopic examination of native preparations and painted with special dyes (pathognomonic sign is “peppered with” the appearance of the squamous cells, which are tightly attached to the pathogen);
- seeding of the substrate in a nutrient medium;
Mycoplasma and Ureaplasma urethritis
Unfortunately, the symptoms of these types of urethritis are very scarce or missing entirely, making it difficult to process their timely treatment.
Some patients may present a complaint to a small dysuric disorders (burning sensation in the urethra, frequent urination, scant mucous discharge from the lumen of the urethra and others), which disappeared spontaneously without any specific therapy.
Sometimes patients go to the doctor with symptoms of prostatitis or vesiculitis, which is a common complication ureaplasmosis.
Diagnosis of Mycoplasma and Ureaplasma infection
Resort to the following methods:
- sowed discharge or smears from the urethra;
The symptoms of viral processes
The disease is characterized by a very bright clinical picture that occurs a few days after the previous sexual contact with an infected partner.
When genital herpes on the genitals (inner surface of the foreskin, in the lumen of the urethra, the glans penis) pop the bubbles that itch and break open to form ulcers and crusts
Selection are of a slimy nature, they often appear early in the morning in the form of several drops. While there is a moderate burning sensation or tingling. If you join a bacterial infection, the discharge becomes purulent.
The disease is 1-2 weeks, even without treatment. Very often, patients present recurrence of the pathological process, a clinical picture which is less pronounced.
Diagnosis of herpes infection
To establish the infectious agent carried out the following diagnostic procedures:
- the scrapings from herpes lesions and their study with a microscope;
- serological diagnostic methods (PCR), direct immunofluorescence reaction.
Fungal (mycotic) urethritis
Onset is usually torpid, that is, subacute. Discharge from the lumen of the urethra is scarce, their appearance may be preceded by unpleasant sensations of itching, burning, or paresthesia (sensitivity).
As a rule, the walls of the urethra appears cheesy plaque, it becomes erythematous and edematous. Changing the color of the urinary sediment, it becomes cloudy.
Women very often there is a combination of the disease with bacterial vaginosis, which exacerbates their health.
Diagnosis of fungal infection
The causative agent of the process is very easy to identify through microscopic examination (determined by long filaments pseudomycelium). For this purpose, material from the urethra and also from the areas affected mucous tissues.
Trichomonas infection can occur acutely and immediately diagnosed in the chronic form. It depends on the pathogenic properties of the pathogen and protective properties of the organism-carrier.
The symptoms of urethritis are characterized by subjective complaints: severe itching of the mucous membranes of the urinary organs, burning sensation, sensitivity.
From the lumen of the urethra appear copious grayish-white color. During the act of urination experiencing pain and frequent urge to emptying of the bladder.
If the process is not treated, the disease becomes torpid course, there are different kinds of complications (eg, inflammation of the prostate)
Diagnosis of Trichomonas infection
To identify infectious agent widely used methods of PCR diagnosis, ELISA, RPG and others.
Infectious processes of the urinary tract, particularly sexually transmitted infections, represent a topical problem not only for patients but also for doctors involved in their treatment.
Unfortunately, currently there is a trend to increase the percentage of patients with sexually transmitted form of cancer that requires a long and not always effective treatment of all sexual partners.
To avoid any complications and unpleasant consequences of the disease, it is necessary to consult a specialist and carry out the necessary treatment of the disease.