The urethra is the connection between the urinary bladder and the outside world. Although the urinary stream flushes possible pathogens regularly outside, nevertheless some germs manage to move up the urethra. Infectious urethritis is one of the most common consequences of sexually transmitted diseases. There are also other causes of inflammation of the urethra.
Endangered groups of people
Urethritis can occur alone or in combination with other inflammations of the kidneys and urinary tract. Particularly susceptible persons are those whose urethra has been damaged, for example, by a narrowing or sloughing, and patients with weakened immune defense, for example, in the case of cancer, diabetes or chronic inflammation.
Which forms are there and how are they created?
Specialists distinguish the specific from the nonspecific urethritis.
- Specific urethritis (gonorrheal urethritis): The cause of this urethritis is an infection with the gonorrhea clots Neisseria gonorrhoeae (gonococci), which are transmitted during intercourse.
- Nonspecific urethritis (non-gonorrhoeal urethritis): This form is also often caused by germs (in 50 percent chlamydia), but also other bacteria, viruses and fungi), which are mainly transmitted during intercourse or, for example, in the context of a study such as cystoscopy can be. Non-specific urethritis can also be due to other causes. It can be acute or chronic.
In the acute form, there are basically three mechanisms of origin:
- infection by pathogens that come from the outside and travel up the urethra ("ascending infection"),
- an inflammation caused by germs already above the urethra in the urinary bladder, prostate or kidney and migrating downwards ("descending infection") as well
- a rare allergic inflammation through contraceptives such as suppositories or ointments.
The chronic or recurrent form can be caused either by particularly resistant pathogens, an insufficiently treated acute infection or a renewed infection by the sexual partner.
In postmenopausal women or after removal of the ovaries, there may be a change in the mucosa of the vagina and urethra due to estrogen deficiency, which may also cause inflammatory reactions (senile urethritis).
In Reiter's disease, urethritis is one of the typical symptoms in addition to inflammation of the joints and conjunctiva.
Other causes of the chronic form include mechanical stimuli (for example, when a bladder catheter is constantly lying), chemical stimuli (eg cancer drugs excreted in the urine) and radiation (cancer treatment). A previously damaged urethra is in turn more susceptible to germs.