Acute urethritis

　　Acute urethritis is a very common reproductive infection disease, mainly caused by urethral obstruction, such as urethral stricture, phimosis, posterior urethral valve, urethral foreign body, tumor, calculus, urethral injury, foreign body, obstruction, which weaken the rinsing effect of urine and are prone to induce acute urethritis. It is also divided into many types of urethritis due to different pathogenic bacteria. Acute urethritis can be divided into general bacterial urethritis, gonococcal urethritis, and non-gonococcal urethritis. Different types of urethritis also have different causes of onset. Common ones include:

　　Bacterial urethritis is caused by various bacteria entering the urethra (such as Escherichia coli, Neisseria gonorrhoeae-like, mycoplasma, chlamydia, Candida albicans, Trichomonas, and some bacteria that are commonly resident in the human body, etc.).

　　Gonococcal urethritis is caused by Neisseria gonorrhoeae through unhygienic sexual activity. The main manifestations are: after being infected with gonococcal urethritis, there is usually a 2-5-day latency period. Initially, the symptoms are redness and itching of the urethral opening, with slight pain, followed by purulent discharge from the urethral opening, which gradually worsens. At this time, if no special treatment is taken, it can develop into chronic gonococcal urethritis. Some patients may develop prostatitis, seminal vesiculitis, epididymitis, etc.

　　There are also non-gonococcal urethritis among the types of urethritis. Masturbation habits, excessive sexual activity, smoking, drinking, wearing tight underwear, long-term cycling, horseback riding, long-term indwelling catheters, urethral foreign bodies, etc., can cause pressure and injury to the urethra, leading to local congestion, ischemia, and hypoxia, reducing the resistance of the urethral mucosa and making it more susceptible to infection and disease.

　　Since the symptoms of acute urethritis are mild and do not affect normal life, some people may consider it a minor illness. Over time, this can develop into chronic urethritis, which can lead to many complications.

　　In males, complications can include orchitis, epididymitis, prostatitis, seminal vesiculitis, epididymal nodules, fallopian tube obstruction, leading to a decrease in sperm count and quality, impotence, premature ejaculation, and male infertility; in females, complications can include vaginitis, cervicitis, adnexitis, endometritis, and pelvic inflammation. Severe urethritis can even lead to infertility, miscarriage, stillbirth, ectopic pregnancy, low birth weight of newborns, purulent conjunctivitis, and respiratory tract infections.

　　The special structure of the female urogenital system makes the female urethra shorter and wider, which is more susceptible to bacterial entry. Urethritis can affect both the body and daily life, causing various uncomfortable symptoms. After bacteria infect the urethra, they can cause abscesses on the urethra, leading to scarring and narrowing of the urethra in the future, making urination difficult and the urine stream thin. In addition, symptoms such as increased secretions and vulvar itching can make many women feel embarrassed. Acute urethritis can lead to infertility, and the prostate may be invaded, causing prostatitis, with symptoms such as perineal and lower back pain. In severe cases, it can lead to infertility. The harm of acute urethritis can cause arthritis. In severe cases, bacteria can invade the knee joint, causing arthritis. It can affect offspring: children born to infected women may suffer from conjunctivitis. If acute urethritis is not treated in a timely manner, it is easy to trigger cervical diseases in women, such as cervical inflammation, cervical erosion, and it is also easy to trigger conditions such as salpingitis, pelvic inflammation, and endometritis.

　　In male patients with acute urethritis, there are symptoms such as a large amount of urethral discharge, which begins as mucous and gradually becomes purulent. In female patients, the urethral discharge is unique. Regardless of gender, during urination, there is a burning pain, frequent urination, and urgency in the urethra, and in severe cases, urethral spasms can occur. Urinalysis shows pus cells and red blood cells. In chronic urethritis, the urethral discharge gradually diminishes, or only a small amount of serous discharge can be found at the urethral orifice upon the first urination in the morning. The urinary irritation symptoms are not as obvious as in the acute stage, and some patients may be asymptomatic. Urethritis can directly spread to the bladder or prostate, causing cystitis or prostatitis. If acute urethritis is not treated properly, it can lead to the development of perineal abscesses, which can penetrate the skin of the penis to become a urethral fistula. During the healing process of urethritis, fibrosis can cause urethral stenosis. Men may appear a small amount of white urethral discharge or soiled underwear one to three weeks after an unprotected sexual encounter, with a crusty film sealing the urethral orifice upon waking up, and a slight burning or itching sensation during urination. Female patients may have less typical symptoms; many women mistake them for symptoms of gynecological diseases and do not pay attention. Common symptoms include increased leukorrhea, slight vulvar itching, mild urinary burning, slight discomfort at the urethral orifice, and in those who have not been discovered for a long time, there may be dull pain in the lower abdomen (not related to the menstrual cycle) and menstrual disorders. If there are chronic gynecological diseases that do not respond to treatment, it is recommended to conduct relevant tests for non-gonococcal urethritis and vaginal inflammation to clarify the cause and cure the disease.

　　Acute urethritis can affect both men and women. Men are more likely to have it simultaneously with prostatitis; women have shorter urethras, making it easier for bacteria to invade. This disease is common and frequently occurs, with an incidence rate of about 30% to 45% in the population. Some measures can be taken to prevent it:

　　1. Develop the habit of washing hands: Surveys have found that people's hands are covered with a large number of pathogenic microorganisms, such as chlamydia and mycoplasma, which can侵入尿道 through defecation and cause infection. Therefore, developing good hygiene habits is crucial, especially before and after meals.

　　2. Regularly clean the vulva and anus: When cleaning, be careful with the order, first clean the vulva and then the anus, and never do the opposite; towels and basins should be used by one person only, otherwise bacteria can easily enter the urethral orifice.

　　3. Choose high-quality detergents and sanitary napkins: It is essential to purchase products from regular manufacturers to avoid poor-quality products from disrupting the normal flora of the human body, which can反而 weaken the local resistance. When purchasing sanitary napkins, pay attention to product quality and avoid long-term storage to prevent the growth of bacteria and the occurrence of infections of the vulva and vagina. If symptoms such as vulvar itching and increased leukorrhea appear, it is advisable to see a doctor early.

　　4. Drink plenty of water: Clinical evidence shows that drinking a large amount of water every day, urinating once every 2-3 hours, can prevent the reproduction of bacteria in the urinary tract, reduce the incidence of urinary tract infections, and this practical and effective method is the most practical and effective way to prevent urinary tract infections. Therefore, this harmless method plays an irreplaceable role in the early stage of urethritis onset or during the remission stage.

　　5. Pay attention to personal hygiene: Take a bath frequently, do not advocate taking a bath in a basin, and clothes should be stored separately; change underwear frequently, especially new underwear or underwear that has not been worn for a long time, and wash and dry it before wearing; wear breathable and moisture-absorbent cotton fabric underwear, try to wear less tight pants or jeans, and wear more breathable dresses, which is very important for protecting women's health.

　　5. Choose cotton underwear: Avoid wearing tight pants and underwear, choose breathable and comfortable cotton underwear to keep the perineum clean and dry, reducing the chance of bacterial growth.

　　Acute urethritis is a very common reproductive infection disease, mainly induced by urethral obstruction. Due to different pathogenic bacteria, it is also divided into many types of urethritis. Acute urethritis can be divided into general bacterial urethritis, gonococcal urethritis, and non-gonococcal urethritis. Routine laboratory tests often performed for acute urethritis:

　　1. Urinalysis Examination shows an increase in leukocytes or purulent urine, accompanied by an increase in red blood cells, a few showing gross hematuria. Urinalysis test can find a large number of pus cells and red blood cells in the first cup, while the second and third cups are basically normal. The number of bacteria in the initial urine culture is significantly higher than that in the middle urine. Urethral or vaginal secretion smears show intracellular or extracellular gonococci in gonococcal urethritis, and non-specific urethritis can be cultured with secretions or anterior urethral swabs, showing a large amount of bacterial growth. No bacteria were found in the smears and cultures, indicating a possible infection with mycoplasma or chlamydia, and special culture methods or PCR tests can be performed.

　　2. Urethral secretion smears and staining Urethral secretion smears and bacterial cultures show pathogenic bacteria.

　　3. Urethral secretion examination Gram staining of urethral secretion smears shows polymorphonuclear leukocytes, and an average of ≥5 per field under oil immersion (1000 times) is positive.

　　4. Cystoscopy examination For diagnosis, the bladder condition can be observed through cystoscopy; through ureteral catheter cystoscopy, a thin ureteral catheter can be inserted into the renal pelvis to collect urine separately, and routine examination and culture can be performed

　　According to the physical condition of patients with acute urethritis, provide nutritious liquid or semi-liquid foods. Increase water intake to ensure fluid balance and excrete sufficient urine, with daily urine volume should be above 1500mL, to promote the rapid excretion of bacteria and inflammatory secretions. For the diet of patients with acute urethritis:

　　1. What foods are good for the body:

　　Acute urethritis patients should first pay attention to diet and nutrition, consume more foods rich in B vitamins: such as wheat, sorghum, Euryale ferox, honey, tofu, chicken, chives, milk, etc.; eat more fruits and fresh vegetables to keep the bowels smooth; drink plenty of water.

　　2. What foods are bad for the body and should be avoided:

　　(1) Avoid spicy foods

　　Spicy foods (such as chili, ginger, scallion, garlic, etc.) are easy to produce dryness and heat, causing internal organs to accumulate heat toxins, thereby aggravating the symptoms of the disease.

　　(2) Avoid seafood allergens

　　Fishy and smelly products such as mandarin fish, yellow croaker, hairtail, black croaker, shrimp, crab, etc., can promote damp-heat, which is not conducive to the regression of inflammation, so they should be avoided.

　　(3) Avoid sweet and greasy foods

　　Greasy foods such as lard, fatty pork, butter, beef fat, mutton fat, etc., high-sugar foods such as chocolate, candy, sweet pastries, cream cakes, etc.

　　The key to the treatment of acute urethritis is timeliness, and it is not advisable to avoid diseases and take antibiotics and other drugs randomly without respecting medical advice, which is very easy to transform into chronic urethritis. Patients should drink plenty of water to increase urine output, rinse the urethral secretion during urination; pay attention to rest and avoid sexual activity in the short term during the acute period; use sedative analgesic antispasmodic drugs to relieve pain.

　　Acute urethritis is treated with the combined use of antibiotics and chemical drugs, with good efficacy. Recently, the combined use of norfloxacin and sulfonamide drugs has been satisfactory in clinical practice. General treatment should pay attention to rest and supplement sufficient fluids. During the acute period, sexual activity should be avoided to prevent the extension of the disease course. At the same time, traditional Chinese medicine with multi-target action can be taken to enhance the body's immunity. Acute urethritis can be treated with the combined use of antibiotics and chemical drugs, with good efficacy. Recently, the combined use of norfloxacin and sulfonamide drugs has been satisfactory in clinical practice. General treatment should pay attention to rest and supplement sufficient fluids. During the acute period, sexual activity should be avoided to prevent the extension of the disease course. During the chronic period, if there is stricture at the urethral orifice or inside the urethra, urethral dilation or urethral orifice split should be performed. For patients with chronic posterior urethritis with long-term and recurrent attacks and poor efficacy of systemic medication, local urethral medication can be considered.

　　Patients with acute urethritis are not allowed to drink alcohol during treatment. After completing a course of treatment, follow-up should be carried out. Whether the patient takes the medicine on time and in the correct dose. Because the treatment of non-gonococcal urethritis is different from gonorrhea, which can be treated in a short period of time with sufficient dosage, and the frequency of taking medicine is high and the duration is long, patients are easy to forget to take medicine due to work or other reasons, or stop taking medicine after 1 to 2 days because of the basic disappearance, affecting the efficacy or recurrence. At this time, do not rush to change the medicine.