Urethritis is inflammation of the urethra. The most common causative agent is Chlamydia trachomatis. Frequency. Worldwide, 250 million cases are registered annually. Classification

    • infectious
    • Nonspecific (bacterial, viral, caused by mycoplasmas, caused by chlamydia, mycotic)
    • Specific (gonorrheal, trichomonas)
    • Non-infectious
    • Traumatic – urethritis is caused by the introduction of foreign bodies into the urethra, most often masturbation
    • allergic
    • Caused by the presence of diseases of the urethra – strictures, cancer, etc.
    • Metabolic – phosphaturia, oxaluria, uraturia
    • Congestive – due to venous stagnation of blood in the mucous membrane of the urethra. Occur with frequent sexual intercourse, onanism, chronic constipation, hemorrhoids, etc.
    • With the flow
    • Spicy
    • Torpid
    • Chronic
    • By localization
    • Front
    • Total. Risk factors
    • Large number of sexual partners
    • Having a history of sexually transmitted diseases
    • Urolithiasis disease
    • Diabetes
    • Instrumental examination of the urethra and bladder
    • Bladder catheterization.

Clinical picture

    • Acute urethritis – severe subjective disorders: burning and pain during urination, copious discharge from the urethra, sponges of the urethra are bright red, swollen
    • Torpid urethritis – subjective disorders are mild, may be absent: paresthesia, itching in the urethra, scanty discharge
    • Chronic urethritis – with a duration of torpid urethritis for more than 2 months. The clinical picture is similar to that of torpid urethritis.
    • Anterior urethritis – inflammation of the anterior urethra (up to the membranous section)
    • Total urethritis is inflammation of the entire urethra. Dysuric disorders characteristic of prostatitis are added.

Research methods

    • Microscopy of discharge from the urethra. In the absence of discharge – scraping. The presence of more than 5 leukocytes in the field of view indicates the presence of urethritis
    • Sowing discharge or scraping on nutrient media to determine the pathogen and its sensitivity to antibiotic therapy
    • If chlamydial urethritis is suspected, serodiagnosis is performed
    • Urethroscopy (contraindicated in acute urethritis): soft and hard infiltrates, morganitis, littreitis
    • Two glass sample
    • With anterior urethritis, the first portion is cloudy, the second is transparent
    • With total – cloudy urine in both portions
    • Urethrography is necessary for cicatricial strictures of the urethra.


Tactics of conducting

    • Identification and treatment of sexual partners at the same time
    • After the end of the treatment of venereal urethritis, patients are observed and control laboratory tests are carried out (in men for 1-2 months, in women – 3 months).

General recommendations

    • Physical activity: in the acute period: bed rest, then without restrictions, with the exception of abstinence from sexual activity until the end of treatment
    • Diet: spicy, salty foods, beer and other foods that contribute to venous congestion in the mucous membrane of the urethra are contraindicated.

Drug therapy

    • Antibacterial therapy
    • For gonorrheal urethritis, the products of choice are a combination of ceftriaxone 250 mg once a day i.v. day for 7 days).
    • For urethritis caused by Chlamydia trachomatis or Ureaplasma urealiticum, doxycycline hydrochloride 100 mg orally 2 r / day or tetracycline 500 mg orally every 6 hours for at least 7 days, and in case of relapses or complications within 21-28 days. Pregnant women are prescribed erythromycin 500 mg orally 4 times a day for 7 days.
    • With trichomonas urethritis – metronidazole 250 mg orally 2-3 r / day for 7-10 days.
    • With viral urethritis, patients and their sexual partners – tetracycline or erythromycin.
    • With mycotic urethritis – ketoconazole 200 mg orally 2 r / day for 6 days.
    • Local treatment – indicated for chronic urethritis
    • Women – vaginal suppositories with antibacterial products
    • For men – instillations into the urethra with 2% solution of protargol.
    • Immunotherapy
    • Methyluracil 0.5 g 3 times a day for 2 weeks
    • Autohemotherapy.


    • With the development of strictures of the urethra – bougienage, internal or external urethrotomy
    • With the development of prostate abscesses – opening of the abscess.


    • Inguinal lymphadenitis
    • Epididymitis
    • Cuperite
    • Prostatitis, sometimes prostate abscess
    • Cicatricial narrowing of the vas deferens leading to infertility
    • Cicatricial narrowing of the urethra (traditionally the bulbous part)
    • With chlamydial urethra likely development of Reiter’s syndrome
    • Women have pelvic inflammatory disease.

See also Bacterial vulvovaginitis, Vulvovaginitis candida, Pelvic inflammatory disease, Gonococcal infection, Prostatitis, Urogenital chlamydia, Epididymitis


    • A50-A64 Predominantly sexually transmitted infections
    • N34 Urethritis and urethral syndrome

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