Treatment of Urethritis

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ID-100169954Inflammation of urethra (the tube through which urine passes from urinary bladder to outside environment during urination) is called urethritis. Inflammation of urethra occurs mainly due to infection by various bacteria such as E. coli, gonococcus (Neisseria gonorrhoeae is the organism that commonly causes sexually transmitted disease or STD gonorrhea), Chlamydia trachomatis, tricomonas, Mycoplasma genitalium, Ureaplasma urealyticum etc. and viruses (such as herpes simplex virus, HSV-1 and HSV-2).

What are the symptoms of urethritis?

The symptoms of urethritis are:

  • Pain during urination (known as dysuria) is the most important symptom of urethritis
  • Other common symptoms of urethritis include urgency and/or frequency of urination, difficulty of urination etc.
  • Less common symptoms of urethritis include dyspareunia (pain during sexual intercourse), discharge from opening of urethra (for men as well as women and known as pyuria), and discharge from vagina (for women), blood in semen or urine in men.

Treatment of urethritis:

Because urethritis is most commonly caused by bacteria (rarely due to viruses), the treatment of choice is appropriate antibiotics, which is usually curative. For selecting appropriate antibiotics for treatment of trichomoniasis, the urine or discharge from urethra should be cultured and antibiotic sensitivity tested.

Commonly used antibiotics for treatment of urethritis include:

  • Azithromycin (1,000 mg or 1 gram orally single dose NGU or non-gonococcal urethritis)
  • Levofloxacin, ofloxacin
  • Doxycycline (100-200 mg daily for 7 days for NGU or non-gonococcal urethritis)
  • Ceftrixone (125 mg intramuscularly as single dose), cefpodoxime (400 mg orally single dose), cefixime (400 mg orally single dose)
  • Metronidazole or tinidazole is used for treatment urethritis caused by trichomonas infection (trichomoniasis)

Urethritis due to HSV-1 and HSV-2 can be treated with antiviral antibiotics such as famciclovir, acyclovir, valacyclovir etc. Treatment of urethritis due to viruses by antiviral antibiotics is not as effective as that of treatment of urethritis due to bacteria (highly effective antibiotics are avilable).

Preventive measures to reduce incidence of urethritis include maintenance of good perineal hygiene. Good perineal hygiene includes proper cleaning/wiping after urination or defecation, avoidance of vaginal deodorants (sprays) etc.

Sexual intercourse should be avoided until symptoms of urethritis subside after adequate treatment with antibiotics. Treatment of sexual partner is also essential for complete cure of urethritis and for prevention further exposure to causative agents.

Image courtesy of khunaspix / FreeDigitalPhotos.net

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