The inflammatory process in the urethra in men is quite common. Urethritis appears regardless of age, therefore it is very important to consult a doctor at the first signs of a genitourinary system disease. Such measures will make it possible to diagnose the problem in a timely manner and prescribe the correct therapy. There are several varieties of this ailment, including gonococcal urethritis, which will be discussed later.
Description
This type of urethritis is a sexually transmitted disease that is sexually transmitted and is caused by harmful microorganisms such as gonococci and neisseria. During unprotected intercourse, the causative agent of the disease appears on the urethral membrane of the man and begins active reproduction. This process gradually destroys the mucous membrane, its deformation occurs, and subsequently pathological changes in the tissues.
The inflammatory process gradually covers the subepithelial and submucosal tissues, which is explained by the movement of pathogenic microorganisms to the rear of the urethra. At the same time, bacteria actively multiply and destructively affect the urination system. The inflammatory process becomes more pronounced starting from the third day after infection.
Classification
There are several varieties of gonococcal urethritis. The main ones are as follows:
- Acute. It is accompanied by soreness and burning during urination. Due to the breakdown of the mucous membrane and tissues, pus appears, which is released during urination and has a gray color.
- Chronic. This variety occurs against the background of neglect of the disease or when treatment has been ineffective. As a rule, a chronic form of urethritis is a disease that lasts for more than two months, without having pronounced symptoms. Pain syndrome of a small degree of intensity, discharge either in a small amount or completely absent. Channel glands are affected in a chronic form of urethritis. The inflammatory process in this case has a focal character. Also, chronic gonorrhea urethritis is characterized by the appearance of soft and hard infiltrates, which are subsequently replaced by scars. A similar phenomenon subsequently causes a narrowing of the urethra and the occurrence of cysts.
- Latent. It proceeds without severe symptoms. In most cases, a person does not know about the disease and passes it through sexual contact to a partner. Gonococci are tenacious, as they have increased resistance to negative environmental conditions. They can remain active during the day, being on household items.
Chronic gonococcal urethritis is divided in turn into several types:
- infiltrative;
- granulation;
- urethral adenitis;
- desquamative.
Causes
Gonococcal urethritis in men can occur for various reasons. The main prerequisite for the development of the disease is the presence on the mucous membrane of the urethra of the gonococcus, which begin to multiply. In the vast majority of cases (about 90%), infection occurs during sexual intercourse. Moreover, if the disease in a man proceeds in a latent form, he, due to the absence of symptoms, may not suspect the presence of pathology and be a carrier of harmful bacteria.
In a third of cases, the disease does not appear for several months. Since gonococci can live for some time outside the carrier’s body, infection can occur even with indirect contact. For example, when using personal items of the carrier of the disease, such as towels, sponges or linen. When using a shared bath or toilet, gonococcus transmission is also possible.
Symptoms
A week after infection, the first signs of gonococcal urethritis appear. In some cases, the incubation period may be delayed up to several weeks. This directly depends on which part of the urethra was affected by gonococci and where the inflammatory process is localized. With damage to the anterior part of the canal, pain is virtually absent. In the case with the localization of inflammation in the back of the canal, the patient's body temperature can rise significantly, up to 39 degrees. Pain in this case is not pronounced. A man, as a rule, suffers from a burning sensation in the canal when urinating.
Pain during urination
The main signal for the occurrence of urethritis is pain during urination. The pain can be sharp, but short-lived. If there is a prolonged urinary retention, the man begins to experience severe discomfort. In the first portion of urine, a purulent impurity of gray color, as well as urethral filaments, may appear. Urine is cloudy.
If we talk about advanced cases of gonorrhea urethritis, then the appearance of an impurity of blood in the urine is possible. Soreness haunts the man during ejaculation. Blood clots can also be observed in semen. What tests for STDs for men need to be passed to identify this ailment?
Diagnostics
Before prescribing treatment, the specialist directs the patient to a detailed examination. This is necessary to clarify the diagnosis and select the correct therapeutic regimen. STD tests for men include the following procedures:
- Blood and urine tests.
- A smear from the urethra to determine the presence and type of infection.
- Examination of the scrotum and prostate gland.
- The study of prostate secretion.
- Urinalysis according to Nechiporenko.
- PCR
The interpretation of the analysis for gonococci with microscopy looks like this:
- With a positive result, detritus, mucus (1+), epithelium, white blood cells, normal or modified, can be detected in the material.
- Inflammation is present if 3-5 leukocytes are detected, and an amount of 10 or more indicates a pronounced inflammatory process.
- When conducting Gram stain, gram-negative diplococcus bacteria (Neisser gonococcus) can be detected.
- A smear for gonococci is regarded as the norm if there are no Neisser gonococci in the test material.
As a rule, on the basis of the above analyzes, a diagnosis is made and antibacterial therapy is prescribed. Antibiotics are selected based on which pathogen caused urethritis. Gonococcal infections are adversely affected by various groups of antibacterial drugs, including penicillins and tetracyclines. Consider the drugs in detail.
Penicillins and tetracyclines antibiotics
There are a number of penicillin-based drugs that show increased activity against gonococci. The most popular among them are:
- "Benzylpenicillin." It is taken in a dosage of 3.4 million units.
- Ampioks. It is taken over two days at 0.5 grams up to five times a day at regular intervals.
- Chloramphenicol. It is taken in a 6 gram course. Doctors recommend taking the drug in combination with B vitamins and ascorbic acid, which will minimize the side effects of the antibiotic.
Antibiotics often cause allergic reactions, this must be considered.
If gonorrheal urethritis has become chronic, antibiotic therapy is carried out in combination with urethral bougieurage. Instillations are also carried out with a solution of collargol and silver nitrate.
Among the drugs from the tetracycline group, the following stand out:
- "Erythromycin." It is taken in a dosage of 10 million units an hour before meals.
- "Clafran." Introduced intramuscularly twice a day for 1 gram.
- Ketocef. Designed for injection of 1.5 grams once a day.
- According to the instructions for use with Oletetrin tablets, it is a combined antibacterial drug with a wide spectrum of action based on tetracycline and oleandomycin. Capsules are very often prescribed for infections of the genitourinary system. The dosage for adults is 250 mg 4 times a day. The duration of therapy is from five to ten days.
Instructions for use of Oletetrin tablets should be strictly observed.
Immune therapy
The gonococcal variety of urethritis strongly affects human immunity. Therefore, along with taking antibiotics (penicillins and tetracyclines), patients are often also prescribed immunostimulating drugs. The most effective of them are:
- "Potassium Orotate." It is taken up to four times a day at 0.5 grams.
- "Methyluracil." It has a pronounced anti-inflammatory effect. It is taken at 0.5 grams in the morning and evening. The treatment is up to two weeks.
- Glyceram. It is taken for ten days at 0.005 grams three times a day.
- Aloe extract is allowed to be administered subcutaneously at 1 mg for a month.
In addition, the treatment of urethritis involves the use of various enzyme preparations:
- Trypsin. It is administered intramuscularly for five days in the morning and evening.
- "Plazmol." Designed for subcutaneous administration of 1 mg for 10 days.
Prevention
The viability of gonococci when released into the environment is up to a day. To avoid infection, only personal towels, slippers and other hygiene items should be used. One of the precautions is the handling of things of an infected person with antiseptic agents. You can also wash them at a temperature not lower than 60 degrees, and dry them in direct sunlight. In these conditions, gonococci die.
Most often, gonococci are transmitted as a result of unprotected intercourse. Sometimes the infection is localized not only in the urethra, but also in the nasopharynx and rectum. This may result from anal or oral sex with a carrier of the disease. For this reason, it is recommended to always use barrier methods of contraception.
If unprotected intercourse has occurred, it is necessary to treat the vagina and urethra in men with solutions based on chlorhexidine or miramistin. This must be done no later than two hours after sexual intercourse.