Urethritis

Urethritis is inflammation or swelling of the urethra, which is the channel that carries urine from the bladder to the outside of the body. Inflammation of the urethra causes pain or a burning sensation when urinating.

Urethritis can happen to anyone, but this condition is more often experienced by women. This is because the structure of the female urethra is shorter than that of men. As a result, infectious organisms can more easily enter the urethra.

Urethritis is generally caused by a bacterial or viral infection that can be transmitted through sexual contact. However, urethritis can also be caused by non-infectious causes.

This article will limit the discussion to urethritis caused by infection.

Causes of Urethritis

Urethritis or urethral infection occurs when bacteria enter the urinary tract from the skin around the urethral opening or urinary opening. Bacteria that cause infections in the kidneys or bladder can also infect the urethra.

Based on the cause of inflammation, urethritis is divided into two types, namely:

• Gonorrheal urethritis, which is a type of urethritis caused by the bacterium that causes gonorrhea ( Neisseria gonorrhoeae )
• Non-gonorrheal urethritis, which is a type of urethritis caused by other bacteria, such as Chlamydia , Mycoplasma genitalium , and Ureaplasma urealyticum

Urethritis can also be caused by other factors, such as:

• Viruses, including herpes simplex (HSV-1 and HSV-2), human papillomavirus , and cytomegalovirus
• Trichomonas, which is a type of parasite that causes trichomoniasis
• Injury that causes obstruction of the urethra
• Irritation due to the use of spermicide

In addition to the conditions above, there are several factors that can increase a person's risk of urethritis, namely:

• Female sex
• Having unsafe sex, for example by changing partners or not wearing a condom
• Have a history of sexually transmitted infections

Symptoms of Urethritis

The main symptom of urethritis is pain when urinating. Other symptoms that arise can be different in men and women. In men, symptoms include:

• Hematuria
• The penis emits a greenish-yellow thick liquid
• Hot and burning sensation when urinating
• The penis feels itchy, swollen, and painful when touched
• The lymph nodes in the groin area are swollen
• Pain during sexual intercourse or ejaculation

Meanwhile, symptoms of urethritis in women include:

• Stomachache
• Pelvic pain
• Fever and chills
• Burning and discomfort when urinating
• Dyspareunia
• Discharge from the vagina (discharge)

When should you go to the doctor?

As mentioned above, urethritis is transmitted through unprotected sexual intercourse. For this reason, if you experience symptoms of urethritis, especially if you have a history of unsafe sexual relations, immediately check with a doctor .

Diagnosis of Urethritis

As an initial step, the doctor will ask about the patient's symptoms, health history, and sexual history, followed by a physical examination.

In men, a physical examination is performed on the abdomen, bladder, penis, and scrotum. While in women, the doctor will examine the vaginal area, abdomen, and pelvis.

To further confirm the diagnosis, the doctor will perform several supporting tests, namely:

• Blood tests, including a complete blood count and a C-reactive protein test, to detect sexually transmitted infection-causing organisms in the blood
• Urine test (urinalysis) and urine culture, to detect the presence of Neisseria gonorrhoeae or Chlamydia trachomatis bacteria
• Rectal or vaginal swab test , to detect viruses or bacteria that cause urethritis in the anal or vaginal area
• Pregnancy test in female patients
• Pelvic ultrasound , to check the condition of the urinary tract and reproductive organs

Treatment of Urethritis

The treatment of urethritis or urethral infection aims to eliminate the bacteria causing the infection, alleviate the symptoms experienced, and prevent the spread of the infection.

The main method to treat urethritis is by giving antibiotics, among others:

• Azithromycin
• Ceftriaxone
• Cefixime
• Doxycycline
• Erythromycin
• Gemifloxacin
• Gentamicin
• Levofloxacin
• Moxifloxacin
• Ofloxacin

Urethritis caused by trichomonas infection can be treated with the antibiotic metronidazole . However, if urethritis is caused by the herpes simplex virus, then treatment is done with antiviral drugs, such as:

• Acyclovir
• Famciclovir
• Valacyclovir

If the bacteria causing urethritis is difficult to identify, the doctor will give one or more types of antibiotics to overcome the infection. Whereas in urethritis caused by sexually transmitted infections and in married patients, the patient's sexual partner must also undergo examination and treatment.

Other procedures that can be done to treat urethritis are:

• Urethral
  catheterization This procedure is performed by inserting a catheter tube into the bladder through the urethra, to remove urine. In the case of urethral injury, this procedure is performed to prevent urine retention and bleeding in the urethra.
• Cystoscopy
  This procedure is performed by examining the condition of the urethra and bladder using a tube with a camera called a cystoscope. Doctors can also remove bladder stones if there are any. Cystoscopy is performed if urethral catheterization is not possible for the patient.
• Catheterization directly into the bladder
  When the urethra is blocked, the doctor will insert a catheter into the bladder through the lower abdomen. This action is performed if the patient cannot undergo urethral catheterization or cystoscopy.

Complications of Urethritis

Untreated urethritis can cause sores and narrowing of the urethra. The infection can also spread to other parts of the urinary tract, such as the ureters, kidneys, and bladder.

In men, urethritis can cause several complications, namely:

• Testicular infection ( orchitis )
• Bladder infection ( cystitis )
• Prostate infection ( prostatitis )
• Epididymitis
• Reiter's syndrome
• Sterility (infertility)

While in women, complications that can occur due to urethritis include:

• Vaginitis
• Bladder infection ( cystitis )
• Inflammation of the cervix ( cervicitis )
• Pelvic inflammation

Prevention of Urethritis

The main step to prevent urethritis is to have safe sex. In addition, taking care of the health of the urinary tract is also important to reduce the risk of urethritis. Some steps that can be taken are:

• Avoid having sex with multiple partners.
• Always faithful to one partner (monogamy).
• Use a condom every time you have sex.
• Sufficient body fluid needs by drinking a lot.
• Try to urinate every time you finish having sex.
• Avoid exposure to chemicals that can cause irritation to the urethra, such as soap, lotion , or detergent.
• Keep your vagina and penis clean, one of which is to change your underwear regularly.
• Do regular reproductive organ health checks.