Genital herpes - symptoms, treatment. Features of the course of urethritis depending on the pathogen How to treat urethral herpes

Herpetic urethritis is a disease characterized by a vivid clinical picture, capable of becoming chronic over time. Pathology is becoming more and more common today. Therefore, it is necessary to know exactly what symptoms it manifests itself and how to treat it.

What are the causes of herpetic urethritis, patients are often interested in their doctors, and how to recognize the disease in a timely manner.

What pills to drink with this disease, and how can you protect yourself from this disease?

Herpetic urethritis: causes of pathology

The main cause of the pathology is herpes type 1 and type 2 with herpetic urethritis. Herpes simplex virus infects a large number of people today, and the prevalence of infection continues to grow. But why someone develops a disease, and someone lives all his life, not even knowing that he is sick, patients are interested.

The role of immunity in the development of the disease cannot be overstated. The fact is that herpes is an infection that can be in the patient's body for a long time without showing itself.

For the first time, a pathogenic microorganism usually makes itself felt if, for some reason, the body's immune defenses are reduced. A drop in the level of immunity inevitably leads to the manifestation of clinical symptoms.

Today, doctors identify the following factors that contribute to the onset of symptoms of the disease:

• frequent, prolonged in duration and high in intensity stressful effects that adversely affect the immune system;
• the rhythm of life, leading to disruption of sleep and wakefulness, due to which the immune system cannot fully recover;
• malnutrition, abuse of harmful products that adversely affect the general condition of the body;
• contact with respiratory viruses that cause a sharp drop in immunity;
• the presence of congenital or acquired immunodeficiency (for example, herpetic urethritis is diagnosed as one of the manifestations of an immunodeficiency state);
• hormonal shakes, which are especially characteristic of women during the period of bearing a child, menopause, and also monthly before menstruation;
• chronic diseases of the liver, lungs, heart and other organs and systems, which have a debilitating effect on the human body, can contribute to the development of symptoms of the disease.

The appearance of symptoms of herpetic urethritis in most cases indicates that the patient's immunity has suffered serious damage for some reason. In healthy people, signs of the disease are not detected.

Symptoms of herpetic urethritis

The herpes simplex virus that causes the disease can be contracted in a variety of ways.

In the first place in terms of implementation is sexual contact, especially if it is not protected by barrier contraceptives.

Sex can be dangerous even if people use a condom. Since the virus can, among other things, be transmitted by touch, and not only through body fluids. In addition to the sexual way, the contact-household way is often realized. In this case, transmission occurs through shared hygiene items such as towels. It is also possible to infect a small child during childbirth.

Symptoms of herpetic urethritis are usually pronounced, especially if the clinical picture develops for the first time. The patient complains about:

• the appearance of a rash in the genital area, causing significant inconvenience;
• strong, which is accompanied by every urination;
• an increase in body temperature to subfebrile values, and sometimes even higher;
• a sharp deterioration in general well-being, complaints of fatigue, decreased performance;
• apathetic mood, lack of interest in things that previously aroused interest;
• a feeling that is episodic (often patients describe the pain as unbearable, acute);
• frequent urge to empty the bladder, which may not always end in the release of urine;
• complaints of a feeling of fullness in the bladder, even if the patient has just gone to relieve himself.

Herpetic urethritis in women and men may differ in localization.

In the fair sex, the presence of pathological formations on the external genital organs is usually not noted. All of them are located exclusively in the urethra. With men, the situation is different.

In the representatives of the stronger sex, rashes can cover not only the inner part of the urethra, invisible to the eye, but also the penis itself. As a result, rashes can be injured by rubbing against clothing while walking or making other movements. Therefore, herpetic urethritis in men may be accompanied by a small discharge of blood.

Classification of herpetic urethritis

The infection is divided by doctors into 4 main forms. The division into forms is based on the severity of the symptoms of the disease.

• Light form

The first episode is easy. The patient may complain of a small number of rashes localized intimately, but there are no complaints of fever and deterioration in general well-being, indicating general intoxication. Pathology recurs no more than 4 times a year.

The first episode is a bit more difficult. The rash is characterized as more widespread, very thick, conspicuous. Localization is possible not only in the genital area, but also in other places. Fever, deterioration of health and other symptoms of viral intoxication are still absent. Relapses occur 5 or more times a year.

• Severe form

If the infection is severe, the initial episode is considered severe. A thick, numerous eruption is found in the urethra, causing the patient great discomfort, which is difficult or impossible to ignore. The rash may spread to other parts of the body. There are complaints about the symptoms of general intoxication, although mild. The patient draws the doctor's attention to an increase in temperature, a deterioration in general well-being.

• very severe form

A very severe form is characterized by frequent relapses that are difficult to control even with medication. The patient complains of a pronounced spread of the rash, which is easily noticed by the doctor during the examination. Also, you can not ignore the high temperature and severe symptoms of intoxication. The frequency of recurrence of the disease directly depends on the form of the disease and the characteristics of the patient's immunity.

Herpetic urethritis: approaches to diagnosis

How to take tests for herpetic urethritis, many patients are interested in their attending physicians. In most cases, smear and blood tests are performed for herpetic urethritis. If it is decided to conduct a study using a smear, then it is recommended to take it in the area of ​​​​localization of the rash. A scraping may also be performed there.

With a pronounced course of infection, good results are also obtained by assessing the blood that is taken from a vein, as in a classic study. Further, the patient can undergo three diagnostic options:

• ELISA is the most common and cheapest option, during which antibodies secreted by the body to fight viral particles are detected or excreted;
• PCR is a more expensive, but also more reliable method, in which pathogen DNA is isolated even in the smallest concentrations;
• Antigen highlighting, in which blood treated with special reagents is highlighted, and pathogenic parts are highlighted in a special color.

The immunogram and the role of the immunologist in herpetic urethritis, if it often recurs, are enormous. With the help of an immunogram, it is possible to determine whether there are any violations in the activity of immunity. And the immunologist will help decipher the data of the immunogram and will treat the patient if the immunity is somehow impaired.

Treatment methods for herpetic urethritis

Treatment is selected by the doctor in each case individually. The choice of drugs, their dosages and features of use depends on the severity of the infection, the general health of the patient and a number of other features. Most often, the following treatment regimen is possible:

As an alternative to Acyclovir, Famciclovir or Valaciclovir can be used. The first drug is drunk 5-6 times a day for the same period, and the second is used twice a day in the same course. The drugs are similar, the differences in them are explained only by different excipients.

An alternative to Acyclovir in the form of an ointment can be Zovirax, which has similar effects. It is important to remember that if a patient has concomitant infectious diseases, therapy should be aimed not only at eliminating the herpes simplex virus.

Which doctor to contact many patients ask. First of all, it is recommended to visit a urologist or dermatovenereologist. Which will be able to diagnose and choose the right therapy. Additionally, a visit to an infectious disease specialist, immunologist-allergist may be recommended.

Fundamentals of prevention of herpetic urethritis

Prevention of the disease is very simple, although non-specific. First of all, it is necessary to exclude sexual and domestic infection with herpetic urethritis. For this it is recommended:

• observe safety rules when having sex, using barrier contraceptives, especially if the partner is unreliable;
• observe simple rules of personal hygiene;
• refuse to use common hygiene items such as towels, washcloths, etc.;
• lead a healthy lifestyle, normalizing sleep and wakefulness, giving preference to wholesome food;
• regularly undergo preventive examinations with a urologist or gynecologist;
• do not delay contacting a doctor if any alarming symptoms appear.

Compliance with preventive measures will help to significantly reduce the likelihood of contracting this unpleasant infection. However, unfortunately, it will not completely rule it out.

If symptoms appear that may indicate an infection with a pathology, one should not hesitate to contact a doctor. Herpetic urethritis is dangerous for both men and women. In the representatives of the stronger sex, a neglected disease leads to a decrease in sexual activity, infertility. And women, in addition to infertility, with severely neglected pathology, may encounter fusion of the labia minora.

If you suspect herpetic urethritis, contact a competent venereologist.

Herpetic urethritis is a viral disease, which is characterized by an extensive clinical picture. In recent years, the disease has been actively spreading, so you should understand how to treat it.

Why do people get herpetic urethritis?

The causative agent of ordinary herpetic urethritis is considered to be the second type of herpes virus, which is secreted mainly when the human genital organs are affected. Infection usually occurs as a result of close contact, especially intimate.

You can become infected with herpetic urethritis from a man or woman whose body is already infected and has symptoms of the disease. Also, sometimes there are no pronounced symptoms, but the virus is present in a dormant state. During the initial infection, the symptoms are usually pronounced, and then the virus switches to a latent state. The next exacerbation of urethritis from herpes occurs in four out of five infected people, so the disappearance of symptoms does not indicate recovery.

What are the symptoms of the disease?

In men, herpes urethritis with its characteristic symptoms appears several days after contact with the carrier. Erythema and vesicles form on the penis and inside the urinary canal, which eventually rupture and form ulcers with a red border in their place.

Herpetic urethritis is accompanied by rashes in the navicular fossa that do not exit the urinary canal. They look like multiple erosions, merging into large inflamed spots. In this case, the patient experiences pain, he is overcome by fever and inguinal lymphadenitis.

In women with urethritis from herpes, scanty mucous discharge is possible. In addition, there is burning and tingling. Symptoms usually disappear after a few days, but there is a high chance of recurrence after a few weeks or months.

When a bacterial infection joins the herpetic urethritis, pus is present in the discharge and they become abundant. It is much more difficult to cure such a form.

How is this pathology treated?

To begin with, a reliable diagnosis is necessary in order not to harm yourself with self-medication. It is not easy to treat herpes urethritis, since the disease often occurs in a latent state. The best results are obtained by an integrated approach, including:

• the fight against clinical manifestations of the disease;
• exclusion of relapses;
• suppressive therapy.

When the first symptoms of herpetic urethritis are detected, treatment usually includes:

• taking Acyclovir three times a day, 400 mg for 7-10 days, or five times a day, 200 mg in the same course;
• Famciclovir up to five times a day, 250 mg in the same course;
• taking 1 g of Valaciclovir twice a day for ten days.

The sooner treatment begins, the easier it will be to get rid of clinical manifestations. If after a ten-day course of treatment it is not possible to recover, you can continue to take the medicine.

Basically, all these methods are aimed at stopping relapses, but do not completely exclude them. Special therapy for relapses is prescribed episodically with clinical manifestations of the disease. It is prescribed for long courses to people whose herpetic urethritis worsens up to six times a year or more.

After curing the disease, prevention may require a course lasting up to ten days, including:

• double dose of Acyclovir 400 mg;
• the use of famciclovir twice a day, 250 mg;
• a single dose of 500 mg Valaciclovir.

Also, doctors can prescribe Megasil, Bonofton, Bromuridine, Gossypol and other similar drugs. Additionally, immunomodulators are often required, including:

• Roferon;
• Cycloferon;
• Interferon and their analogues.

Until the final remission, a special vaccination against herpes infection may be required, which will help the body fight pathogenic viruses.

Herpetic urethritis is an inflammation of the urethra caused by the herpes simplex virus. According to statistics, this form of the disease accounts for 0.3 to 2.9% of all cases of non-gonococcal urethritis. The disease is not always accompanied by symptoms.

The herpes virus using PCR is isolated from the urethra of 5.4-7.6% of men. A feature of the pathological process is the lack of spread to the upper parts of the genitourinary system. Herpes does not even affect the entire urethra. The area of ​​inflammation is limited only to its distal part.

In this article you will learn:

Causes of herpetic urethritis

The immediate cause is the herpes simplex virus. In most cases, this is HPV type 2. Less commonly - type 1 (approximately 30% of cases). The disease is transmitted through sexual contact. When infected, not all patients develop inflammation of the urethra. Only one in three suffers from signs of urethritis. In the rest, the affected area is the genitals and the skin near them.

With herpetic urethritis, inflammatory foci form inside the urethra. They are presented:

• small erosions;
• diffusely reddened mucosa;
• vascular spots.

Methods of transmission of genital herpes and the path of the virus in the body

The main mode of transmission of the herpes virus is direct contact. Not surprisingly, in the vast majority of cases, men become infected with this disease during sexual contact.

A feature of herpes is that the virus is able to equally successfully penetrate the body in almost any way possible for it, as a rule - through the mucous membranes, a little less often - through damage to the outer integument of the body: scratches, sores, wounds. This means that regardless of where the herpes is localized in the carrier - on the lips, genitals or other parts of the body - it will equally easily be transferred to the genitals of the infected person upon contact.

herpetic urethritis virus

Related to this is the outbreak and rapid spread of the virus over the past half century. The sexual revolution of the 60s led to the massive popularization of oral sex, which at times increased the number of genital herpes infections from those who suffered from a seemingly harmless enough cold on the lips.

• airborne, which is not typical for the genital as a whole - this is how labial herpes (cold on the lips) is usually transmitted.
• household when using common hygiene products, towels, linen There is also a risk of infection of the child when caring for him from a mother infected with herpes. However, genital herpes is rarely transmitted in this way.

The main gateway for the virus is the mucous membranes of the body. Genital herpes is most often transmitted when viral particles enter the glans penis and anus. Here, men have a slight advantage over women - even if the virus gets on the skin near the vas deferens, the possibility of its penetration into the tracts themselves is small due to the small size of the opening of the urinary canal itself and the presence of biological fluids in it.

Symptoms of herpetic urethritis

Symptoms of herpetic urethritis in men occur 3-7 days after contact: on the penis, the inner surface of the foreskin, in the urethra, local erythema, vesicles appear, which, breaking through, form ulcers framed by a red inflammatory border.

Herpetic eruptions are usually localized in the navicular fossa and do not go beyond the hanging part of the urethra. With ureteroscopy, they look like multiple small erosions, sometimes merging into a larger focus, which is accompanied by pain and fever, inguinal lymphadenitis, dysuria.

There is scanty mucous discharge from the urethra, usually in the form of a morning drop, accompanied by a slight tingling or burning sensation. As a rule, the symptoms of herpetic urethritis disappear after 1-2 weeks. but most patients experience relapses at intervals of weeks to years.

As a rule, relapses of viral urethritis are milder than the primary infection. In the case of a bacterial infection, the discharge becomes purulent, more abundant, and the duration of the disease increases to 3 weeks or more. In sexual partners of patients with herpetic urethritis, long-term endocervicitis is often found, which is also very resistant to ongoing treatment.

Classification of herpetic urethritis

The infection is divided by doctors into 4 main forms. The division into forms is based on the severity of the symptoms of the disease.

1. Light form. The first episode is easy. The patient may complain of a small number of rashes localized intimately, but there are no complaints of fever and deterioration in general well-being, indicating general intoxication. Pathology recurs no more than 4 times a year.
2. Medium form. The first episode is a bit more difficult. The rash is characterized as more widespread, very thick, conspicuous. Localization is possible not only in the genital area, but also in other places. Fever, deterioration of health and other symptoms of viral intoxication are still absent. Relapses occur 5 or more times a year.
3. Severe form. If the infection is severe, the initial episode is considered severe. A thick, numerous eruption is found in the urethra, causing the patient great discomfort, which is difficult or impossible to ignore. The rash may spread to other parts of the body. There are complaints about the symptoms of general intoxication, although mild. The patient draws the doctor's attention to an increase in temperature, a deterioration in general well-being.
4. Very severe form. A very severe form is characterized by frequent relapses that are difficult to control even with medication. The patient complains of a pronounced spread of the rash, which is easily noticed by the doctor during the examination. Also, you can not ignore the high temperature and severe symptoms of intoxication. The frequency of recurrence of the disease directly depends on the form of the disease and the characteristics of the patient's immunity.

Diagnostics and therapy

A sign of the presence of infection - detection in scrapings or smears of the pathogen. The material is collected from the base of fresh herpetic lesions of the skin, mucous membranes of the urethra or from intracellular inclusions. To confirm the diagnosis, PCR diagnostics are performed, an indirect agglutination reaction (the herpes virus is fixed on sensitized erythrocytes). This is a quick study, the result can be known within a few hours.

Modern examination includes specific and sensitive methods for detecting the antigen of the virus. This is a direct immunofluorescence reaction, in which the nuclei of the affected structures are highlighted in bright green. Treatment of urethritis of herpetic nature is complex. The disease proceeds latently. Special principles have been developed that guarantee the successful treatment of genital herpes:

• treatment of the primary clinical episode of herpes;
• fight against relapses;
• long-term suppressive therapy.

Primary infection with genital herpes is treated with:

• Acyclovir (three times a day for a week);
• Famciclovir (5 times a day, 7-10 days);
• Valaciclovir (twice a day, 7-10 days).

Therapy of the disease is important to start at an early stage, the effectiveness and duration of treatment depends on it. With a poor result of treatment after the tenth day, it is possible to continue the course of taking the medication or replace it with an effective analogue.

The drug of choice in the treatment of the disease is Acyclovir. Can it cure herpes? Usually, this remedy is quite successful in fighting the disease. It has been proven that the drug, with its timely and proper use, reduces the prevalence of the virus, the severity of clinical symptoms. It is prescribed in tablet form, in the form of injections or topically (3-5% acyclovir ointment).

What is dangerous herpes in the bladder

The virus negatively affects the entire reproductive and reproductive system. Usually infection is not limited to one organ. Possible complications depending on the location of the lesion, and the type of disease:

1. Chronic herpes of the bladder - leads to the appearance of wounds and damage to the integrity of the structure, up to rupture of the walls.
2. Infertility and involuntary abortion - if the infection passes to the genitals, the woman cannot bear the child normally. With prolonged damage, scars appear in the genital tract, preventing natural fertilization.
3. Violation of the kidneys - a worsened outflow of urine, the likelihood of developing reflux (reverse reflux of urine) leads to severe pathologies. Patients are diagnosed with renal failure, pyelonephritis.
4. Problems with the bladder in men quickly affect the functions of the prostate gland, often becoming the cause of the development of prostatitis.

Inflammation of the urethra in the bladder

A viral illness will not go away on its own. Perhaps a temporary reduction in symptomatic manifestations. In this case, the disease will develop in a recurrent, chronic form. The negative impact of the herpes virus on the bladder will continue, which will lead to the appearance of ulcers, rupture of the walls and partial loss of function of damaged tissues.

Genital and simple herpes are not cured on their own. Long-term drug therapy is required. Folk remedies and alternative medicine are ineffective.

How is this pathology treated?

First, you need a reliable diagnosis from a doctor who treats urethritis, so as not to harm yourself with self-medication. It is not easy to treat herpes urethritis, since the disease often occurs in a latent state. The best results are obtained by an integrated approach, including:

• the fight against clinical manifestations of the disease;
• exclusion of relapses;
• suppressive therapy.

When the first symptoms of herpetic urethritis are detected, treatment usually includes:

• taking Acyclovir three times a day, 400 mg for 7-10 days, or five times a day, 200 mg in the same course;
• Famciclovir up to five times a day, 250 mg in the same course;
• taking 1 g of Valaciclovir twice a day for ten days.

The sooner treatment begins, the easier it will be to get rid of clinical manifestations. If after a ten-day course of taking antibiotics, urethritis cannot be cured, you can continue to take the medicine. After curing the disease, prevention may require a course lasting up to ten days, including:

• double dose of Acyclovir 400 mg;
• the use of famciclovir twice a day, 250 mg;
• a single dose of 500 mg Valaciclovir.

Also, doctors can prescribe Megasil, Bonofton, Bromuridine, Gossypol and other similar drugs. Additionally, immunomodulators are often required, including:

• Roferon;
• Cycloferon;
• Interferon and their analogues.

Until the final remission, a special vaccination against herpes infection may be required, which will help the body fight pathogenic viruses.

Preventive measures

The main rule of prevention is to reduce the risk of microflora disturbance. Experts recommend:

1. Eat properly. It is necessary to abandon the consumption of junk food, which includes fast food and fast food.
2. Eliminate stress, neurosis and prolonged depression.
3. Timely treat infectious lesions of the genital tract.
4. Use contraceptives during intercourse.
5. Follow the rules of intimate hygiene. Having vaginal sex after anal sex is necessary only after washing. Water procedures should be performed not only by a woman, but also by a man.

In addition, it is necessary to have a regular sexual life and exclude the frequent change of sexual partners. Compliance with the rules of prevention will help reduce the risk of developing the disease.

Herpetic urethritis is a disease in which the pathological process affects the genitals. The cause of the symptoms is the herpes virus, which can penetrate the mucous membranes during unprotected intercourse. Treatment is always long, and the disappearance of symptoms does not mean complete recovery. Once in the body once, the herpes virus remains there forever. Ointments or antiviral drugs will not help to achieve complete recovery. That is why it is important to observe hygiene and preventive measures.

Bacterial urethritis. The causative agents are: staphylococci, streptococci, Escherichia coli, gardnerella, etc. The infection can enter the urethra through sexual contact, as well as due to its spread from the genitourinary tract with pyelonephritis, prostatitis, vesiculitis, urethral injury. More than 230 strains of bacteria have been isolated, which, under a certain situation, are able to recognize inflammation of the urethral mucosa.

The average duration of the incubation period for bacterial urethritis is 12-14 days (from 2 to 20 days). More often their clinical course is asymptomatic, sluggish. Less commonly, bacterial urethritis becomes acute.

Urethritis caused by diplococci, similar to gonococci (pseudogonococci), usually occurs as an acute urethritis.

Gardnerella, as a rule, cause oligosymptomatic urethritis, often ending in self-healing.

Bacterial urethritis often (in 30% or more) ends with complications (balanoposthitis, epididymitis, prostatitis, cystitis, etc.).

Chlamydial urethritis.

Caused by obligate intracellular bacteria, which are the most common cause of urethritis in men. According to various researchers, 1.5 million people fall ill with urogenital chlamydia every year in Russia.

Chlamydia go through extracellular and intracellular stages of development. A mature extracellular infectious form is an elementary body that can penetrate intracellularly. Intracellular elementary bodies are transformed into reticular bodies capable of growth and division. Elementary bodies are resistant, and reticular bodies are susceptible to antibiotic therapy.

The average duration of the incubation period is 3-4 weeks. The source of infection is a patient with an asymptomatic form of an acute or chronic disease.

Transmission occurs by contact (sexual) through genital-genital, genital-anal and oral-genital contacts, as well as non-sexually - through the placenta, during childbirth, by household means, due to contamination (from the genitals to the eyes with hands, in violation of hygiene rules).

In men, chlamydial urethritis in 70% of cases proceeds as an asymptomatic or asymptomatic inflammation (with scanty mucopurulent discharge), which can last for several months. Much less often (in 5%), urethritis can be acute, while inflammation is not much different from gonococcal lesions. In 25% of cases, chlamydial urethritis can have a subacute course, not much different from chronic, except perhaps more abundant discharge from the urethra, especially in the morning. In the initial stages of the disease, the anterior urethra is affected; in the chronic course, the inflammation passes to the posterior urethra and becomes total. In 30-40% of observations, symptoms of prostatitis, vesiculitis, epididymitis, funiculitis join.

Chlamydial infection does not cause permanent immunity, therefore reinfection is possible due to the exchange of infection with partners. In 2-4% of cases, Reiter's disease develops against the background of chlamydial urethritis.

Reiter's disease. It is characterized by systemic lesions of the urogenital organs, eyes, joints (like asymmetric reactive arthritis), as well as damage to the skin, mucous membranes and internal organs. It develops as a complication of untreated chlamydia.

Trichomonas urethritis.

Trichomonas is transmitted sexually. Domestic transmission is rare. It can persist in urine for up to 24 hours, in semen for several hours, and survive in damp laundry. The incubation period for Trichomonas urethritis averages 5-15 days. There are the following forms of trichomoniasis: acute, subacute, chronic, trichomonas-denunciation.

In the acute form, the inflammatory process proceeds rapidly with abundant muco-foamy on the first day and with muco-purulent discharge from the urethra from the second day with frequent and painful urination.

With subacute urethritis, the symptoms are less pronounced, discharge from the urethra occurs in small amounts, purulent. The first portion of urine contains purulent flakes.

In chronic trichomonas urethritis, itching, burning, crawling in the urethra, and frequent urination come to the fore. Urethral discharge scanty. Since in chronic urethritis the inflammatory process passes to the posterior urethra, complications develop in the form of prostatitis, vesiculitis, epididymitis, with a long course, the formation of urethral strictures is possible.

Mycoplasmal urethritis.

They are caused by bacteria that have a plastic shell and contain DNA and RNA. The ability of mycoplasmas to take any shape allows them to penetrate bacterial filters.

Infection with mycoplasma infection occurs mainly through sexual contact. Intrauterine infection of the fetus was also established during its passage through the infected birth canal. Mycoplasma attaches to the epithelium of the urethra, can be carried by spermatozoa; in addition, it colonizes the foreskin. The incubation period lasts from 3 to 5 weeks.

There are no specific signs for mycoplasmal urethritis. As a rule, urethritis of mycoplasmal origin proceeds chronically. In this case, there are often lesions of the prostate gland, seminal vesicle, epididymis, which leads to infertility. Attaching to the head of the sperm, mycoplasma can reduce its fertilizing ability. Under certain conditions, mycoplasma infection can cause inflammation of the urinary organs (cystitis, pyelonephritis). Urogenital mycoplasmosis is often combined with intestinal damage (enterocolitis).

Herpetic urethritis.

Cause two serotypes of DNA containing herpes simplex viruses HSV-1 and HSV-2. Herpes is one of the most common human infections.

The disease is transmitted mainly sexually from a patient with genital herpes. Often, the genital virus is also transmitted from a herpes carrier who does not have symptoms of the disease. The method of infection with the virus can be genital-genital, oral-genital, genital-anal. There is a risk of neonatal infection of newborns, which can occur both during the passage of the birth canal and in the postpartum period with active herpetic manifestations in the mother or medical personnel.

During the initial infection with the herpes simplex virus, the virus enters the cells of susceptible mucosal or skin surfaces. It is then taken up by sensory nerve endings and transported to the nerve cells of the dorsal ganglion roots, where it is stored. Infection can be latent when the virus is present in the body without causing disease; and virulent when herpes is activated and causes local lesions. The disease in this case proceeds as chronic, relapsing, cyclic with localized, rarely generalized manifestations.

The initial symptoms of herpetic urethritis may be general complaints: fever, weakness, myalgia, headache. At the same time, there is a burning sensation in the urethra, which increases during urination, soreness of the lymph nodes. On the head, the skin of the penis, on the visible part (possibly on the invisible) of the mucosa of the urethra, a typical development of herpetic elements is noted, accompanied by a burning sensation, itching, and pain in the genital area. Initially, vesicles appear, which erode, become wet, then dry up, forming crusts, which fall off as epithelization progresses. Temporary hyperemia and pigmentation remain at the site of the lesion. A light yellow discharge may appear from the urethra.

Clinical manifestations of primary infection last about 3 weeks, local symptoms appear on the 2-14th day. Recurrent infection in the presence of antibodies to the virus is less pronounced. The clinical picture develops within 8-15 days. Stressful situations, overheating, hypothermia, a decrease in the body's defenses, etc. contribute to recurrence. Herpes, destroying the human immune system, can cause secondary immunodeficiency.

Some researchers note the connection of genital herpes with cervical cancer and prostate cancer.

Candida urethritis.

It is caused by opportunistic yeast-like Candida fungi, of which there are more than 150 species. 7 species are pathogenic for humans.

Candidiasis of the genital organs is more common in women, less often in men. An important role in the pathogenesis of the disease belongs to a decrease in immunity, dysbacteriosis, beriberi, hormonal disorders, diabetes, the condition of the mucous membranes of the skin! Candidiasis lesions are often combined with other pathogens of sexual infections (chlamydia, ureaplasmas, viruses, etc.).

The incubation period for candidal urethritis lasts from 2 weeks to 1 month, almost always proceeds torpid, rarely begins subacutely. The onset of the disease is accompanied by parasthesia, itching, burning, scanty discharge (thick, mucous). At the same time, diffuse and limited whitish-gray plaques appear on the mucous membrane of the urethra, under which a sharp hyperemia is determined. Candidal urethritis often occurs against the background of treated prostatitis, epididymitis vesiculitis, cystitis caused by other pathogens.

Often with candidal urethritis, there is a lesion of the head and foreskin of the penis. In this case, swelling, hyperemia of the foreskin and glans penis are observed, with areas of whitish-gray plaque, which, when removed, form surface erosion and cracks. Scarring of erosions and cracks in a chronic course can lead to the formation of cicatricial phimosis.

The presence of various types of urethritis pathogens requires timely application for qualified medical care, for a comprehensive examination and the appointment of competent etiotropic treatment. On the basis of our medical clinics, a comprehensive diagnosis of infections transmitted through sexual contact is carried out. The equipment of our centers allows us to quickly and efficiently treat urethritis of any etiology

Our experts will be happy to help you!

Treatment of herpetic urethritis is an extremely difficult task, since the disease can be latent. Principles of treatment of genital herpes:

• treatment of the first clinical episode of herpes;
• relapse treatment;
• long-term suppressive therapy.

• acyclovir 400 mg orally 3 times a day for 7-10 days or 200 mg orally 5 times a day for 7-10 days;
• or famciclovir 250 mg orally 5 times a day for 7-10 days;
• or valaciclovir 1 g orally 2 times a day for 7-10 days.

Treatment of herpetic urethritis should be started as early as possible, immediately after the first symptoms of the disease appear.

With insufficient effectiveness of treatment after a 10-day course, further administration of the drug is possible.

Aciclovir is the drug of choice and usually provides a fairly successful treatment. Clinical observations have confirmed the effectiveness of this drug: when it is used in patients with a primary lesion of the genital tract, both the spread of the virus and the severity of clinical symptoms decrease. The drug is used orally, intravenously, topically (3-5% acyclovir ointment).

Existing methods of treatment of herpetic urethritis can only stop the recurrence of the disease, but not eliminate the recurrence of the disease. Most patients with a first clinical episode of herpes simplex type 2 infection then experience a relapse of the disease. This is less common in patients initially infected with herpes simplex type 1. Antiherpetic therapy for relapses is given episodically during the clinical manifestations of genital herpes to improve the condition of patients and reduce the duration of relapse. It is prescribed for a long time as a suppressive therapy, which reduces the number of relapses in patients with frequent exacerbations of the disease (more than 6 times a year) by 70-80%. With this treatment, many patients note the absence of clinical episodes. There is evidence of the efficacy and safety of taking acyclovir for more than 6 years and valaciclovir and famciclovir for more than a year.

Episodic treatment of recurrence of genital herpes should be started on the first day of clinical manifestations or during the prodromal period.

• acyclovir 400 mg 3 times a day for 5 days, or 800 mg 2 times a day for 5 days, or 800 mg 3 times a day for 2 days; .
• or famciclovir 125 mg 3 times a day for 5 days or 100" m 2 times a day for 1 day;
• or valacyclovir 1 g 2 times a day for 5 days or 500 mg 2 times a day for 3 days.

In order to prevent recurrence of herpes infection, suppressive therapy regimens have been developed:

• acyclovir 400 mg 2 times a day;
• or famciclovir 250 mg twice a day;
• or valacyclovir 500 mg 1 time per day or 1 g 1 time per day.

Valaciclovir 500 mg once daily may be less effective than other dosing regimens, as is aciclovir in patients with very frequent disease relapses (more than 10 times per year). This dictates the need to find more effective methods of chemotherapy and specific prevention of this infection.

Etiotropic treatment of herpetic urethritis may also include bromuridin, ribovirin, bonofton, epigen, gossypol, megasil.

In recurrent forms of herpetic infection, antiviral therapy is supplemented with the appointment of immunomodulators (interleukins, cycloferon, roferon, interferon inducers).

For complete remission, vaccination with a herpes vaccine and antioxidant protection are required.

It should be noted that in the treatment of children, elderly and senile people suffering from herpetic urethritis, patients with chronic renal and hepatic insufficiency, including those on hemodialysis, an appropriate dose adjustment of the drugs is necessary.