The urethra or urethra is an organ that looks like a hollow tube and is designed to drain urine from the bladder to the outside. The structure of the urethra has pronounced sex differences.
The length of the urethra in women is approximately 3.0 - 3.5 cm. It starts from the bladder and is a hollow, slightly curved tube that envelopes the pubic symphysis behind and below. The posterior wall of the urethra in women is quite closely connected to the anterior wall of the vagina. Outside of the period of passage of urine through this channel, its walls are tightly adjacent to each other, thereby preventing infection from entering the bladder cavity. However, the walls of the female urethra have good extensibility, and its lumen can be stretched up to 10 mm.
In men, the urethra is not only an organ of the urinary system, but also the reproductive system. In this regard, the urethra in men has a more complex structure. Its length is 20 - 25 cm and three parts are distinguished in it:
1. Prostate - starts from the inner opening of the bladder and penetrates the prostate. Its length is about 4 cm. On the sides of this part of the urethra in men are the mouths of the ejaculatory ducts;
2. The membranous part is the shortest and narrowest part of the male urethra. Its length does not exceed 2.0 cm;
3. Spongy part - the longest part of the urethra in men, having a length of 17 to 20 cm. The ducts of the bulbourethral glands open into the posterior wall of the spongy part of the urethra.
Throughout the entire length of the urethra, there are numerous longitudinal folds of the mucous membrane, causing an increase in the lumen of the canal at the time of urination and ejaculation.
Inflammation of the urethra
Inflammation of the urethra is called urethritis. Urethritis is classified as infectious and non-infectious. Infectious inflammation of the urethra is caused by specific (gardnerella, chlamydia, gonococcus, etc.) and nonspecific (streptococci, E. coli, staphylococcus, etc.) microflora. Urethritis of a non-infectious nature develops as a result of traumatic damage to the walls of the urethra during the passage of urinary calculi or when performing catheterization, cystoscopy. Other reasons for the development of non-infectious inflammation of the urethra may be allergies and congestion in the pelvic area.
The first sign of urethritis is a burning sensation in the urethra, which sharply increases at the time of urination. In addition, discharge from the urethra appears, which are mucopurulent. The symptoms of urethritis are more pronounced in men, and in women, the disease proceeds with mild symptoms, and often generally asymptomatic.
Discharge from the urethra
In many people, at the time of pronounced sexual arousal, a small amount of colorless mucus may appear from the urethra. Such discharge from the urethra is considered one of the normal options. The appearance of all other secretions is one of the symptoms of diseases of the genitourinary system:
- Purulent discharge - usually observed with infectious urethritis and accompanied by a burning sensation in the urethra. The appearance and amount of these secretions are largely determined by the type of pathogen. With gonorrheal urethritis, the discharge is creamy, greenish-yellow in color and quite abundant. With trichomoniasis, the discharge is usually frothy and scanty.
- Urethrorrhagia - discharge from the urethra outside the urination of blood. Most often it occurs as a result of mechanical trauma to the urethra, but it can also be one of the symptoms of malignant neoplasms of the genitourinary system.
- Spermatorrhea - the release of a small amount of sperm at the end of the act of defecation or urination in the absence of an erection and orgasm. Spermatorrhea is a symptom of diseases such as colliculitis and vesiculitis (inflammation of the seminal tubercle and seminal vesicles). In severe spinal cord injuries and in meningitis, spermatorrhea can be permanent.
- Prostatorrhea - the release of prostate juice at the end of bowel movements or urination and is not accompanied by a burning sensation in the urethra. By its appearance, prostate juice is similar to sperm, and they can only be distinguished by laboratory methods. Prostatorrhea is observed in chronic prostatitis and inflammation of the excretory ducts of the prostate gland.
Urethra (urethra) - it is part of the urinary system of a woman and the urinary and reproductive systems of a man.
In men, the urethra, 20 cm long, is located both in the pelvis and inside the penis, and opens with an external opening on the head. Anatomically, the following sections of the male urethra are distinguished:
(1) outer hole;
(2) scaphoid fossa;
(3) penile;
(4) bulbous;
(5) membranous;
(6) prostatic (proximal and distal).
Figure taken from www.urologyhealth.org
The prostatic urethra passes through the prostate and divides into proximal and distal portions at the level of the seminal tubercle. In the proximal part of the prostatic urethra, along the posterolateral surfaces, the excretory ducts of the prostatic glands open with the mouths. On the sides of the seminal tubercle are the mouths of the right and left ejaculatory ducts, through which sperm enters the lumen of the urethra from the seminal vesicles and vas deferens. Elements of the urethral sphincter are located in the distal section of the prostatic section and in the membranous section of the urethra. Starting with the bulbar section, the urethra runs inside the corpus spongiosum of the penis. The bulbar section is located inside the bulb of the spongy body. In the membranous and bulbar regions, the urethra bends anteriorly upward. In the penile section, the urethra is located medially along the ventral surface of the penis downward from the cavernous bodies. The capitate part of the urethra is located inside the glans penis. The inner surface of the male and female urethra is covered with a mucous membrane (transitional epithelium, with the exception of a non-extended area near the outer opening, where there is a squamous non-keratinizing epithelium).
The main functions of the urethra in men
- carrying urine out of the bladder;
- carrying sperm out during ejaculation (ejaculation);
- participation in the mechanism of urinary retention.
The most common diseases of the urethra
- Urethritis (inflammation of the urethra) is often due to sexually transmitted infections (gonococcus, chlamydia, ureoplasma, etc.);
- Strictures (narrowing of the lumen) of the urethra in its various parts (due to the formation: congenital, traumatic and inflammatory origin);
- Anomalies in the development of the urethra: the most common is hypospadias (the location of the external opening of the urethra on the ventral surface of the penis is more proximal than the apex of the head).
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The urethra is a tubular organ that is the distal part of the lower urinary tract, which, in addition to the urethra, includes the bladder with all its structures. The urethra begins just behind the bladder outlet, i.e. bladder neck. Thus, the bladder neck is not part of the urethra.
The border between them is well defined during endoscopy:when the urethrocystoscope is removed from the bladder, passes the cervix and moves distally, one can observe the closure of the cervix - just distal to the cervix, the urethra begins.
The endpoint of the urethra is the external opening (meatus), which has a slit-like vertical shape and opens at the apex of the glans penis. (If there is a displacement of this point, then there is a meatus dystopia.)
According to the International Anatomical Classification, the urethra is divided into three segments:
1.prostatic (prostate), passing through the prostate;
2. membranous (membranous), surrounded by the urogenital diaphragm;
3.spongy (spongy), from the urogenital diaphragm to the meatus.
Picture
From the point of view of normal anatomy, this classification is correct. However, from the standpoint of studying the pathology of strictures of various parts of the urethra, the features of surgical tactics and treatment techniques, in our opinion, it is advisable to use a more detailed classification, which is shown in Fig. one.
Urethral divisions
Each of these departments differs in structural features and functions performed, which determines the specific features of reconstruction and plastic restoration of various segments of the urethra with its strictures. Let's consider each of the departments in more detail.1. Prostatic department:
- length ~ 40 mm (borders: from the neck of the bladder to the distal end of the seminal tubercle);
- diameter - 10-15 mm;
- lined with transitional epithelium (like the bladder), does not contain its own smooth muscle membrane, although individual bundles of smooth muscles pass from the neck of the bladder into the subepithelial connective tissue, which is in close contact with the prostate tissue without significant boundaries.
The unfavorable consequences of surgical intervention in this area may be due to the following features of the anatomy:
- violation of urinary continence, since the bladder neck and prostate smooth muscle tissue play an important role in the mechanisms of retention;
- impaired fertility due to obstruction of the mouth of the ejaculatory ducts;
- the development of infections and inflammation of the prostate, seminal vesicles and epididymis due to obstruction of the prostate ducts and ejaculatory ducts;
- dysfunction of erectile function due to electric shock during endoscopic or open surgical interventions of neurovascular bundles that go to the penis along the posterolateral surface of the prostate and are especially close to the urethra in the apex of the prostate.
- length - 1.5-2 cm (borders: from the apex of the prostate, i.e., the distal point of the seminal tubercle, to the distal border of the urethral sphincter, well defined during endoscopy of the urethra in the form of a point with the folds of the mucosa converging radially to it and opening with further cranial promotion of the instrument);
- diameter ~ 9 mm;
- lined with transitional epithelium, under which a thin layer of connective tissue is surrounded by striated muscle fibers emanating from several muscles: the levator of the anus, the deep transverse muscle of the perineum.
- violation of urinary retention up to total incontinence due to damage to the sphincter by electric current during endoscopy or damage during open surgical intervention;
- violation of erectile function due to damage to the neurovascular bundle by electric current during endoscopic interventions.
- length ~ 50-60 mm (boundaries: oturethral sphincter to the zone of fusion of the legs of the penis into its trunk);
- diameter - 10-12 mm;
- covered with a cylindrical epithelium, the mucosa contains connective tissue rich in elastic fibers oriented longitudinally to the length of the urethra. The mucous membrane is surrounded by the spongy (spongy) body of the urethra, the structure of which is different from the cavernous body of the penis, although outwardly, i.e. macroscopically, they are similar. The scarring of the tissue of the spongy body is due to the fact that it (tissue) is an array of venous vessels adjacent to each other and oriented along the urethra. Therefore, on the transverse section of the bulb, there is a kind of cellularity of the tissue, but these are the gaps of the veins. The bulbose urethra has an eccentrically located lumen, displaced dorsally (Fig. 2).
Figure 2. Cross section of the bulbous urethra. A, B, C - the ratio of the lumen of the urethra to the corpus spongiosum at different levels
Bulbous urethra is distinguished by the curvature of its course - concavity on the distal side. Its appearance through the perineal wound is not the same in different areas. In the proximal third, it has the greatest wall thickness, the diameter of the urethra reaches 20-25 mm, and the course is caudal-cranial, i.e. parallel to the plane of the operating table in the lithotomy position of the patient.
The median third has a diameter of ~ 18-20 mm, and the course of the urethra is parallel to the skin of the perineum. The diameter of the distal third of the bulbous urethra is up to 10-12 mm (significantly reduced), and the lumen is located more centrally. Thus, the thickness of the dorsal wall of the bulbose urethra is about 2.0-2.5 mm, and the thickness of the ventral wall along the midline in the proximal third is 20-22 mm, and in the distal one - 4.0-5.0 mm.
Possible adverse consequences of surgery in this area due to the peculiarities of the anatomy:
- violation of ejaculatory function, namely, weakened ejaculate ejection due to damage to the periurethral muscles (bulbocavernosus);
- postmictic urine dripping due to weakness of the periurethral muscles;
- shortening of the penis and / or reduction in the erection angle due to resection\u003e 2.0-2.5 cm of the bulbose urethra.
- length in a relaxed state of the penis ~ 7-8 cm, in an erect state ~ 11-12 cm. The length has a fairly wide range of individual fluctuations (boundaries: from the zone of confluence of the legs of the corpora cavernosa to the coronal groove);
- diameter ~ 9-10 mm;
- wall thickness along the median line on the dorsal surface is 1.0-1.5 mm, on the ventral surface - about 3.0-4.0 mm;
- the inner surface is lined with a cylindrical epithelium, under which a thin layer of connective tissue is located; the mucosa is surrounded by the spongy body of the urethra. The lumen of the urethra is somewhat eccentric due to the different thickness of the walls of the corpus spongiosum. Outside, the corpus spongiosum is covered with an adventitia membrane, clearly delimiting it from the surrounding deep fascial sheath of the penis (Fig. 3).
Figure 3. Cross-section of the shaft of the penis
The most common adverse effect of surgery in this area in practice is the shortening of the penis, its curvature due to the shortening of the urethra\u003e 1.0 cm, or a decrease in its elasticity, or the development of periurethral cicatricial adhesions with the corpora cavernosa and skin.
5. Glandular (capitate) department:
- length ~ 1.0-2.0 cm (borders: from the coronal sulcus to the meatus);
- diameter ~ 10-11 mm in the area of \u200b\u200bthe scaphoid fossa and 7-9 mm in the area of \u200b\u200bthe external opening;
- the inner surface of the mucosa is lined with a flat multilayer epithelium, under which a thin layer of connective tissue is in thin contact with the tissue of the glans penis;
- in the scaphoid fossa there is a fold of mucous membrane more or less pronounced along the dorsal wall - Guerin's flap, which sometimes interferes with the unhindered passage of the instrument along the urethra.
- splashing a stream of urine due to the unevenness of the walls of the scaphoid fossa, which forms the cylindrical shape of the stream;
- curvature of the glans penis - its deviation downward due to scarring of the wall, shortening of the capitate urethra;
- poor cosmetic result, retraction of the meatus due to insufficient tenderness of the wall of the capitate urethra. Bulbous, penile and capitate
- departments of the urethra have and common to them
- structures:
- the mucous membrane of the urethra contains many mucous glands of Littre (mainly along the dorsal wall and to a lesser extent along the lateral), and the ducts of two Cooper's glands located in the depth of the deep transverse muscle flow into the bulbo urethra (proximal third). The secretions of the glands cover the surface of the mucous membrane to make it non-wetting for urine and thereby reduce the loss of energy in the flow of urine as it passes through the urethra. It is generally accepted that inflammation of the mucous membrane, affecting the glands, reduces the production of secretions, which will disrupt the wettability of the mucous membrane, as well as its protection from the chemical and other negative effects of urine (theoretically, as a result, the urine flow should deteriorate);
- the mucous membrane of these parts of the urethra contains many lacunae, i.e. small pseudodiverticula. This apparent excess of mucous membrane is actually its reserve, which is necessary for lengthening the urethra during an erection. Due to the presence of such a "reserve" mucous membrane and a large number of elastic fibers in the submucosal layer, resection of the urethra with a tension-free anastomosis is possible;
- corpus spongiosum - an original structure not only as part of the urethra, but also as a whole of the penis. It plays an important role in the function of urination, as well as erectile and ejaculatory functions.
It is quite clear that the increase in the volume of the corpus spongiosum during erection is a hemodynamic effect. Is it the same as in the corpora cavernosa? Or how can a spongy body structure provide a similar effect? To understand the structure and function of the corpus spongiosum, it is necessary to have a correct understanding of its arterial and venous systems.
Arterial system of the spongy body
The arterial system of the corpus spongiosum is an integral part of the arterial system of the penis (Fig. 4).
Figure 4. Diagram of the arterial system of the penis
Penile artery- terminal branch of the internal genital artery. In the proximal third from the artery of the penis a. bulbaris, and in the distal third, before entering the cavernous bodies, the artery gives off another branch - a. uretralis. Thus, in the bulbus and the spongy body of the urethra, two a. bulbaris and two a. uretralis. They are located at 3 and 9 o'clock of the spongy body (Fig. 5).
Figure 5. Cross section of the spongy urethra: A - in the middle third of the bulbose section; B - in the penile department
If the blood flow through the penile arteries is preserved, the transverse dissection of the bulbose urethra in the middle and, especially, the proximal third leads to gushing arterial bleeding (the penile arteries can be damaged by fractures of the pubic bones). It usually stops after short-term pressing of the bulb with a tampon.
The urethral arteries go up to and penetrate the glans penis. This also includes two deep and two dorsal penile arteries. Thus, the head has an arterial network fed by six arteries. It is known that all like and opposite arteries of the penis are extensively anastomosed to each other. This is clearly seen when the dorsal surface of the corpus spongiosum is separated from the ventral surface of the corpora cavernosa, i.e. from the urethral sulcus, when the perforating arteries intersect and arterial bleeding occurs, requiring coagulation.
Figure 6. Artery of the corpus spongiosum of the penial urethra. The muscular layer includes individual muscle bundles parallel to the lumen of the artery
The urethral arteries in the penile urethra have an unusual structure (Fig. 6). Their muscle layer consists of individual muscle bundles oriented parallel to the blood flow in the artery. Such arteries have a good ability to expand, but most importantly, to lengthen, which is important for an erection.
Venous system of the corpus spongiosum
As already emphasized earlier, the bulk of the bulbose part of the corpus spongiosum is made up of veins, which originate at the cranial end of the corpus spongiosum. The venous trunks are oriented longitudinally around the mucous membrane and go along the penile urethra and enter, without interruption, into the head, where they form an intricate plexus.Thus, the glans is an important component of the corpus spongiosum of the penis, there is no border between the corpus spongiosum and the glans - they function as a whole.
The studies that we carried out with colleagues made it possible to establish that the bulbous part of the corpus spongiosum contains a large number of sinuses. Most of them are in the proximal third of the bulb, and their number gradually decreases towards its distal third (Fig. 8).
Figure 8. Bulbous part of the corpus spongiosum: A - a section of the proximal part of the corpus spongiosum, containing a large number of veins and sinuses; B - the same section with a higher magnification: vein and sinus; (A, C, D - staining with hematoxylin and eosin, increase Ok.:W-PI Yx / 23; Ob .: A-Plan 20x / 0.25; B - staining with hematoxylin and eosin, magnification approx .: W-PI 10x / 23; Ob.A-Plan 40x / 0.25)
In the penile urethra, there are practically no sinuses, as in the glans penis. The sinuses of the bulbus differ in structure from the sinuses of the corpora cavernosa in that they have almost no folding and therefore may not increase their volumes so significantly (Fig. 9). The sinus scan shows the orifices of small arterioles.
Figure 9. Scanogram (electron microscope, x1000): A - the sine of the bulb has a slight folding; B - sinus of the cavernous body, which has a highly folded surface
Apparently, blood from small arterioles in the bulbus enters the sinuses, causing them to dilate, and only then goes into the veins originating from the sinuses (Fig. 10).
Figure 10. Diagram of blood flow in the bulb (arteries - red, sinuses - green, veins - blue)
In the proximal third of the bulb, the arteries are densely surrounded by a huge number of sinuses, and here the veins originate (Fig. 11).
Figure 11. Proximal third of the bulb. Large and small arteries are surrounded by multiple sinuses, a small number of veins. Staining with hematoxylin and eosin, increase Ok.:W-PI 10x / 23; Rev .: A-Plan 10x / 0.25
The veins of the penile urethra are oriented strictly longitudinally, like a "bundle of brushwood", around the lumen (Fig. 12).
Figure 12. Cross-section of the cancellous urethra in the middle third of the penile shaft, multiple venous lumens oriented along the urethral lumen. Van Gieson staining, magnification Ok.:W-PI 10x / 23; Ob .: A-Plan 10x / 0.25
Veins have "pillows" with a bundle of smooth muscle fibers in the center, which, apparently, play an important hemodynamic role, namely: they form the direction of blood flow "periphery - center" and maintain a pressure gradient (Fig. 13).
Figure 13. Vein of the corpus spongiosum in the middle third of the shaft of the penis. The arrow points to the muscle cushion. Staining with azure and eosin, magnification Ok.:W-PI 10x / 23; Rev .: A-Plan 10x / 0.25
Of course, the veins of the bulbose and penile urethra have not only multiple anastomoses between themselves, but also connections with non-spongy veins, namely with the circumflex veins of the cavernous bodies, and, therefore, with the deep dorsal and superficial veins of the penis.
So, the spongy body of the urethra and the head of the penis are actively involved in the erection of the penis, and this important circumstance should be taken into account when surgery on the spongy urethra.
Anatomical terms that are inappropriate to use:
- “Anterior” and “posterior” urethra are old and familiar terms for us, but from the point of view of today's surgery, in my opinion, they have lost their meaning.
- "Anterior" was considered to be the part of the urethra from the meatus to the membranous section. A natural question arises: "front" in relation to whom or to what? In relation to the urologist, who introduces the instrument into it, it is the front, and in relation to the urine stream, it turns out to be the "last" part.
- The terms "hanging", "scrotal", "perineal" urethra have also lost their clear anatomical and functional sound, especially since some of them are rather dissonant.
Few people know what the urethra is in women. The urethra is the urethra, the last link in the urine excretion system. It has its own structural features:
- small length (about 3-5 cm);
- wide diameter at the moment of stretching;
- narrowed areas;
- one enlargement near the bladder;
- secreting glands.
The urethra is located in front of the vagina and runs through the muscles located in the pelvic floor. The muscle corset at the exit from the urethra is slightly weakened.
The urethra performs the following functions:
- withdrawal of accumulated urine from urea;
- toning muscles to create a reservoir;
- erogenous zone.
Many people think that this is a simple pipe and do not take it seriously. This is an erroneous opinion, since diseases of the urethra in women can lead to a disorder of the reflex functioning system, which can significantly affect the intimate life in a negative way.
Why does urethral disease occur?
Urethritis is divided into 2 main types:
- non-infectious origin;
- caused by pathogens.
Diseases of non-infectious origin arise:
- with mechanical damage to the integrity of the mucous membrane by calculi, the movement of which is characterized by urolithiasis;
- trauma by a cystoscope, catheter, etc.;
- allergies;
- tumors of a malignant nature;
- diseases of the genital organs;
- venous stasis in the pelvic organs.
Diseases of an infectious nature arise as a result of pathogens entering the body through sexual contact:
- gonococci;
- chlamydia;
- mycoplasma;
- herpes viruses.
Factors contributing to the development of urethritis
It is clear that the disease develops for certain reasons and in connection with some pathogens, but there are a number of factors that contribute to the development of this disease:
- strong overloading of the body;
- injuries of the reproductive system;
- constant stress and the transfer of serious illnesses;
- poor nutrition;
- bad habits, especially alcohol abuse;
- lack of vitamins;
- chronic form of diseases of the respiratory tract, organs of the reproductive system and oral cavity;
- diseases of the urinary system;
- period of pregnancy or menopause;
- neglect of hygiene rules.
Infection routes
There are 3 ways in which infectious pathogens enter the urethra:
- contact, which occurs during the transport of urine by the body from the kidney, where the epicenter of the infection is located, to the bladder;
- sexual - in the process of intimacy with a sick partner;
- hematogenous - the infection comes from the inflammatory foci of chronic diseases through the blood circulation.
Urethritis is classified according to the nature of its spread:
- primary - develops if an infectious bacterium enters the area of \u200b\u200bthe urethra;
- secondary - pathogenic microbes enter the blood circulation from the pelvic organs, intestines or other location of the chronic focus.
The main symptoms of the disease
Signs of the development of the disease can be very diverse. The clinical picture of the disease is presented by acute and chronic forms.
The acute form manifests itself when the incubation period passes from the moment the pathogen enters.
The following sensations arise:
- the appearance of sharp pain at the time of urination;
- the occurrence of burning and itching at the exit from the urethra;
- the appearance of secretions with a mucous or purulent structure;
- bad smell.
When allergic, in parallel with the above symptoms, the following are observed:
- difficulty breathing due to nasal congestion
- rash on the skin;
- lacrimation;
- shortness of breath.
On examination, the urologist can detect a low degree of swelling of the mucous membrane, redness of all tissues that surround the urethra.
Diagnosis
In order to diagnose the disease, it is necessary to conduct a urine test. This is done by the three-glass sample method. Morning urine is collected in turn in 3 sterile containers. It is important to remember that the presence of a disease such as urethritis is determined by 1 portion of urine.
Typically, the following result is achieved:
- The first portion of urine is cloudy. It contains a large number of leukocytes, since there is an inflammatory process in the cavity of the urethra.
- The second serving contains much fewer white blood cells.
- In the third serving, they are completely absent.
The material obtained from the urethra for research is analyzed by bacterial culture, and the degree of sensitivity of the flora to antibiotics is also established. If a difficult case, then specialists use polymerase chain reaction (PCR). With its help, it is possible to determine the type of pathogen by DNA, even with a latent course of the disease. For analysis with a probe, a tissue sample is taken from the wall of the urinary tract. This is a very difficult procedure because the female urethra is very small. This method is necessary in order to detect herpetic or chlamydial urethritis.
For ureteroscopy, local anesthesia is used.
Often, specialists will prescribe antibiotics a week before the procedure to prevent further spread of the infection.
With the help of an ultrasound examination, cystitis can be determined, a disease in the pelvic organs can be detected.
There is also a radiopaque examination by the method of voiding cystourethrography. The introduction of a contrast agent into the urea cavity makes it possible to take pictures. With the help of these images, you can find poor patency, neoplasms, adhesions and the like. Women must be examined by a gynecologist without fail. This is necessary to exclude diseases of the inflammatory nature of the cervix, genitals.
Applied treatment
Despite the fact that it brings a woman very uncomfortable and painful sensations, there is no need for treatment in a hospital. The disease is mild and treated on an outpatient basis.
Initially, you should undergo an examination, which is prescribed by a specialist. During the examination, you can determine the cause of the disease, the type of pathogen, select the most suitable, effective anti-inflammatory agent. When infection occurs through sexual contact, not only the woman should be treated, but also her sexual partner.
- it is important to give up intimacy until complete recovery;
- limit physical activity as much as possible;
- prevent hypothermia of the legs;
- eat right, or rather: exclude salty, spicy, smoked foods and, of course, alcoholic beverages from the diet;
- regulate the amount of fluid consumed: during the day you need to drink about two liters of water in the absence of diseases associated with fluid retention in the body;
- eat sour milk daily, more fruits and vegetables.
With regard to drug treatment, doctors prescribe the use of a wide variety of drugs that have anti-inflammatory effects, prescribe injections, tablets, vaginal suppositories, douching, etc.
The antibiotic should be drunk for 5 to 10 days. The exact dosage is determined by the doctor, taking into account the degree of the inflammatory process, body weight, age of the patient.
In no case should you self-medicate. It is especially contraindicated to use antibiotics longer than the prescribed period, since microorganisms develop resistance to the drug, and then the drug does not have the desired effect.
Treatment tactics are determined by the type of pathogen:
- for a disease caused by a fungus, antifungal drugs are prescribed;
- if the ailment appeared due to mycoplasmas - drugs of the imidazole group.
To enhance the effect of drugs, experts recommend using them in the form of suppositories. Due to the fact that the suppositories are injected directly into the area of \u200b\u200binflammation, their composition is completely absorbed by the vessels of the small pelvis. Thus, there is an anti-inflammatory effect on organs located nearby.
In addition to potassium permanganate, you can use a decoction of herbs that have anti-inflammatory effects. Douching with antiseptic agents is recommended.
Treatment of urethritis with alternative methods
Traditional methods do not have the required effectiveness in. That is why experts insist on the medication type of therapy. Despite this, there are some herbs that complement the action of the drugs, and such a complex treatment can be successful. For this purpose, herbs and plants are used that have a diuretic, antimicrobial, antispasmodic effect.
The following should be consumed with food:
- lingonberry, carrot or cranberry juice, free of sugar and preservatives;
- from fresh herbs - parsley, as well as beets;
- decoction of parsley, linden, cornflowers, black currant.
Ways to prevent the disease
That will take a lot of time and effort. It is also important to say that this disease brings very unpleasant painful sensations. In order to avoid this, you need to take preventive measures. In the process of prevention, all possible sources of the pathogen entering the body are completely excluded. In this way:
- It is important to pay attention to the health of your sexual partner, to avoid unprotected sex.
- It is necessary to strictly follow all the rules of personal hygiene, to constantly wash off using light disinfectants.
- You should not use hygiene products containing alcohol, soap, as well as components that lead to severe irritation of the urethra.
- Exclude from the diet all foods that irritate the urinary organs. Such products include smoked meats, spicy and salty dishes.
- You should dress warmly (for the weather) to prevent hypothermia of the body, especially the legs. It is necessary to wear clothes that do not constrain the waist and abdomen, as this leads to slow blood circulation in the pelvic area.
- All emerging diseases should be treated with the utmost seriousness and treated in a timely manner in order to prevent their transition to a chronic form.
Despite the fact that a disease such as urethritis is not considered a fatal ailment, it can greatly affect a woman's health, seriously undermining it. The constant discomfort associated with itching and painful sensations causes severe irritability, insomnia, and negatively affects the ability to work. It is better to do everything in a timely manner to prevent the disease than to experience the whole negative of urethritis and treat it for a long time. When the first signs of the disease appear, you need to seek help from a specialist as soon as possible.
The urethra in men is much smaller than in women. But this is the same urethra, although it has significant differences in structure in different sexes. There are features in the diagnosis of this organ, for example,.
The urethra in women is a straight tube that resembles the membranous part of the male urethra, but is much wider and shorter. Its length varies from 3 to 5 cm. The urethra is located, starting from the neck of the bladder (internal opening), then runs parallel to the vagina, and ends between the entrance to the vagina and the clitoris (external opening). The end of the urethra in a woman has the shape of a slit-like star, 0.3 to 0.6 mm in diameter. Most often, the form is closed. The entire urethra tube has the same fixed diameter along its entire length. It is between 1 and 1.6 mm.
Due to the fact that the female urethra is very short, bacteria quite often enter the urogenital system itself above. That is why in women, inflammatory processes of the urinary system are observed several times more often than in men. Women are prone to inflammation, kidney and bladder dysfunctions because of this.
The urethra has an opening that helps empty the bladder. The female urethra is not involved in reproductive activity, this is the main difference from the male.
After childbirth and in old age, one of the functions of the urethra - the retention of urine in the bladder - loses its properties, which affects the patient's condition and sensations. This is a reason to visit a doctor, since it is impossible to return the former functions on your own.
In the female body, the urethra has nothing to do with the reproductive system, and the difference from the male
The structure of the male urethra
The male urethra is a tubular organ with a length of 15 to 25 cm.The average size is 19 cm.The urethra in a man begins at the neck of the bladder, passes through the prostate gland, enters the pelvic diaphragm, passes through the entire penis and ends at the end heads with a vertical slit hole with a diameter of 5 to 8 mm. This organ in men has not only the function of urination, but also participates in reproductive activity, namely, in the release of seminal fluid. The health of this tube is extremely important for a man, however, due to its location and size, the urethra in men is often subjected to mechanical stress and injury. Most common.
The peculiarity of the structure of the urethra in men is peculiar, due to the location and length of the urethra. In the stronger sex, the anterior and posterior urethra stand out.
The sections of the male urethra are divided into 3 parts. The canal has a prostate, membranous and spongy part. In general, a man's urethra is curved and similar to the Latin letter S, there are narrowings and extensions along the entire length of the organ. Width varies depending on the part of the organ. The largest diameter (middle of the urethra) is 15 mm, and the smallest is 5 mm (in the outer opening). The urethra in men is located in the place of accumulation of a large number of veins and arteries, which is why it has an increased blood supply.
What is the Urethra - Anatomical Location
What are its functions in the body becomes clear even from the second name of the organ - the urethra. Even children know where this channel is. From an early age, a person understands how his genitals are located. Girls are interested in their bodies at an earlier age, men turn to this a little later, but the interest that arises is usually due to puberty.
The process of formation of the urethra occurs even in utero, and this is influenced by a huge number of different factors, including the mother's alcohol consumption, drugs, smoking in all its forms. Statistics note that in recent years, ultrasound studies have increasingly revealed various malformations of the urinary system in the fetus. Experts associate this with the fascination of expectant mothers with bad habits and their abuse. It is not uncommon for children to be born with such phenomena as hermaphroditism and intersexuality. As a result, the child has a similarity between the male and female urinary organs. Timely diagnostics helps to find a way out of such situations. They take tests from the baby and determine which hormones prevail in the body, after which therapy begins, leveling the type to which the baby is predisposed. Sometimes this requires surgery.
Distinctive features of urination
Physically, urination in women is quite different from that of men, since the urethra is located in a special way and women cannot control the flow of urine during the process. The urethra is located entirely in the pelvic perineum, and the opening for urine to exit is formed just below the vagina. Such anatomical factors force girls from an early age to learn to go to the toilet while sitting.
A man's urethra is located outside the pelvis, so it is more convenient for men to urinate while standing, and there is the possibility of controlling the stream. When the penis is raised to the abdominal cavity, the S-shaped bend is transformed into one common one, which allows urine to exit in a single stream. However, in men, the stages of increasing the jet and weakening are distinguished, in addition, the process of urination ends with intermittent jerks, due to the contraction of the surrounding muscles.
Features of microflora
At the moment of a person's birth, his microflora is formed. Germs and microorganisms get inside, where they create a certain environment. From birth, it is formed from bifidobacteria and lactobacilli, and as the girl grows up, the coccal flora is gradually formed.
In men, the flora does not change from birth, it contains staphylococci, streptococci and corynebacteria. In the urethra, a neutral-alkaline environment is formed, this is important for the formation of sperm. An important component for the flora of the male body is the presence of such bacteria:
- commensal;
- rod-shaped bacteria;
- ureaplasma;
- neisseria.
When the flora of the urethra changes in men, pathological complications can develop that affect the ability to bear children. Other bacteria are sexually transmitted.
Possible anomalies and pathologies
Internal secretions and urine help to remove harmful substances. Therefore, the urethra in men and women plays a vital role. However, quite often patients turn to a gynecologist and urologist with problems of the urethra. Depending on the cause of the occurrence, ailments are divided into the following categories:
- congenital anomalies, when the urinary canal is located on top, or the external slit is closed or not in place;
- inflammations of an infectious nature, the most common - urethritis, vulvitis, postitis, balanitis;
- allergic reactions;
- trauma;
- neoplasms, tumors;
- sexually transmitted diseases.
Congenital developmental anomalies are easily determined during a woman's pregnancy, which doctors notify the expectant mother about. There are pathologies incompatible with life, there are abnormalities that are corrected from birth with the help of an operation. Hypospadias is a violation of the urethra, characteristic of the male sex. Channel disorders, when the female and male urethra also develop abnormally - this is epispadias characteristic of boys and girls.
Urethritis - inflammation in the urethra, in which the epithelium in the tubular urethra is affected. Mostly found in men. It is characterized by painful sensations during intimacy and during urination. Women suffer from such symptoms less often, too active symptoms do not appear.
Women can develop vulvitis due to violation or non-compliance with hygiene rules. It affects not only the urethra, but also the vagina and external genitalia.
A man's urethra can also become inflamed, while in parallel there is an inflammatory process covering the head of the penis - it can be balanitis, postitis and balanoposthitis. In addition, STDs (sexually transmitted diseases) can also affect the function of the urethra:
- gonorrhea;
- chlamydia;
- staphylococcal infections;
- trichomoniasis, ureaplasmosis.
If you delay with treatment, then negative consequences are inevitable. Usually sexually transmitted diseases are complicated or become chronic.
A urethral cyst in women is an uncommon occurrence, however, it is a rather serious condition that requires surgery. During any surgery, a catheter is inserted into the urethra so that urine is excreted from the body. After operations, this device remains in the body for some time, which can lead to mechanical damage to the epithelium, and this entails suppuration, inflammatory processes. It is important that all manipulations are carried out by a doctor, including removal of the catheter.
Paraurethral glands can also become inflamed; they are located on the back wall of the urethra. Both men and women are susceptible to this, and early medical care is very important. Otherwise, an abscess may develop.
Symptoms of diseases
The disease can manifest itself at any time, regardless of the alleged cause of infection, due to the fact that the incubation period for individual diseases is characterized by different time lengths. Sometimes it is a couple of days, and sometimes it is several months.
Symptoms vary significantly between men and women. A woman may not feel any signs, and only an examination shows the clinical picture, while in men, the symptoms appear more clearly and clearly, sometimes an examination by a urologist or venereologist is enough.
Symptoms manifested in a man:
- itching and burning during urination;
- gluing the outer lumen;
- discharge of pus;
- bloody issues;
- retention of urine.
Typically, these symptoms are accompanied by a high fever.
Symptoms for women:
- pain in the lower abdomen, especially when urinating;
- pain when going to the toilet;
- bloody issues;
- purulent discharge;
- redness, inflammation in the urethra:
Urethral diseases in women are also accompanied by an increase in temperature to 39-40 ° C.
Damage to the urethra can be both mechanical and bacterial, which occurs due to sexually transmitted diseases
Causes of urethral diseases
The main causative agents of diseases of the urethra are most often infections. Less common are allergic and toxic lesions of the urethra. The anatomy of the female body is such that diseases in the weaker sex are much more common than in men.
Depending on the type of infectious agent, ailments are divided into 2 types: specific and non-specific.
The first type includes sexually transmitted diseases:
- trichomonas;
- chlamydia;
- ureaplasma;
- gonococci;
- mycoplasma.
The second group includes:
- staphylococci;
- streptococci;
- fungi;
- colibacilli.
Despite the different nature of the origin, these diseases are treated in almost the same way.
Another reason for inflammation of the urethra may be the patient's reduced immunity. As a result of the general weakening of the body, the tone of the walls of the urethra weakens, and the infection easily makes its way inside. And the urethra is at risk every now and then, since the infection constantly passes through the urine and enters the body during unprotected sexual intercourse.
Mechanical influences, bruises, injuries - unsuccessful falls, the use of intimate toys are also provocateurs of urethral ailments. The list of causes of diseases of the urethra is continued by unhealthy diet, bad habits, hypothermia, kidney stones, in the bladder, inflammatory processes in the body that develop into a chronic form, manipulations performed incorrectly (taking a smear, installing a catheter). They account for 76% of all cases of mechanical organ trauma.
Another, but rather rare, cause is a hereditary factor. These changes appear either in utero or immediately after birth.
Unfortunately, the urethra is a very vulnerable organ of the human body, which is why it is quite often prone to inflammatory processes. It is worth remembering that for a healthy person, 5-7 urinations is an absolute norm. If you have frequent or less frequent urination - a reason to go to a urologist, nephrologist, gynecologist. In order to avoid significant changes and pathological functions in the tissues, with any violations of the urethra, or with pain and changes, it is important to urgently seek medical help. No less important is prevention in the form of strengthening the immune system, as well as maintaining a healthy lifestyle. You should be very careful about choosing a sexual partner and avoid promiscuous unprotected relationships. Human hygiene also plays an important role - the easiest and most affordable way to maintain your own health. Together with this publication, another diagnostic method is often read, hysteroscopy, this information is useful for girls:
