Fungal urethritis

　　Fungal urethritis is an inflammatory lesion of the urethra caused by fungi. Fungi naturally exist in the human body, usually in areas such as the skin, oropharynx, colon, vagina, etc. During large-area burns, acute renal failure, severe diabetes, the body's resistance decreases; or when using broad-spectrum antibiotics for a long time, and also using corticosteroids for a long time, it can cause dysbiosis in the body, and the fungi take advantage of this to grow and reproduce. It can directly cause fungal urethritis, and can also ascend to the upper urinary tract, causing fungal infection, even fungal sepsis, and fungal urethritis can be an early manifestation of it.

　　After urinary tract infection, abscesses may form on the urethra, and the scarring that follows can lead to urethral stricture, causing difficulty in urination and a thin urinary stream; in addition, the prostate may also be invaded, resulting in prostatitis, with symptoms such as perineal pain and lower back pain. In severe cases, the patient's epididymis may also be damaged, leading to infertility. Infected women may give birth to children with conjunctivitis. Severe infection may lead to arthritis when bacteria invade the knee joint. Non-sexual urethritis may also cause similar complications.

　　Candida, also known as candidiasis, can be transmitted through sexual contact when there is candidal infection of the external genitalia, leading to the occurrence of candidal urethritis. Clinically, the symptoms of most patients with candidal urethritis can be felt as urethral itching, burning sensation during urination, occasional tingling, and a few patients may also have symptoms of secretion excretion.

　　(1) Stick to drinking plenty of water:The urine excreted by the kidneys has a flushing effect on the bladder and urethra, which is conducive to the excretion of bacteria. Drinking plenty 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 infection, and this is the most practical and effective method of preventing urinary tract infection. Drinking plenty of water every day during the onset or remission of the disease is also conducive to the recovery of the disease, and drinking tea or light bamboo leaf tea also has a certain preventive effect.

　　(2) Pay attention to personal hygiene:The female genital area and urethral opening are inhabited by a large number of bacteria, which are the prerequisite for the occurrence of urinary tract infections. Therefore, it is necessary to pay attention to the cleanliness of the genital area, use female hygiene products with a Ph4 weak acid formula to clean the private parts, take frequent showers, and do not use pool or bathtub bathing. Change underwear frequently, and pay special attention to this during marriage, menstruation, pregnancy, and postpartum period. Newborn girls should change diapers frequently.

　　(3) Try to avoid using urological infection instruments and catheters:Urological instruments are prone to carry bacteria from the distal urethra into the bladder and upper urinary tract, and urinary catheterization is prone to persistent bacteriuria, so they should be avoided as much as possible. When necessary, strict disinfection should be carried out, and urine culture should be performed 48 hours after the use of urological instruments to observe whether urinary tract infection occurs. For patients who already have bacteriuria before the use of urological instruments, it is advisable to control the infection first.

　　Some patients may not have bacterial urine at the time, but have a history of recurrent urinary tract infections or urinary tract abnormalities in the past. It is advisable to take antibiotics to prevent infection for 48 hours before and after urinary tract examination. For the first three days of indwelling urinary catheterization, the administration of antimicrobial drugs can prevent or delay the occurrence of urinary tract infection, but there is no preventive effect after 3 days. In addition, the closed drainage system connected to the urinary catheter can significantly reduce the incidence of urinary tract infection.

　　The main methods for detecting candidal urethritis are as follows:

　　1. The urethral opening is swollen, with purulent secretion, and there may be tenderness along the urethra. The edges are everted, and the mucosal surface is often adhered with serous or purulent secretion, and sometimes there are superficial ulcers.

　　2. Distinguish according to the symptoms of urethral irritation, such as frequent urination, urgency, dysuria, and discomfort during urination. These symptoms vary in severity among different patients. Acute inflammatory patients often have obvious urinary tract irritation symptoms; however, in elderly, children, and patients with chronic urinary tract infection, the symptoms of urinary tract irritation are usually mild, such as mild frequent urination, urgency, or discomfort during urination.

　　3. Urinary secretion smear staining examination or bacterial culture shows pathogenic bacteria, which can be differentiated from gonococcal urethritis. 4. There are a large number of red blood cells and white blood cells in the urine, and the first cup of urine in the three-cup test is obviously abnormal.

　　Eat less spicy things, and don't eat too sweet. Acids are okay. During the onset or remission of the disease, drinking plenty of water every day is also beneficial for the recovery of the disease, and drinking tea or dilute bamboo leaf tea can also have a certain preventive effect.

　　The most common symptoms of candidal vaginitis are excessive leukorrhea, burning and itching of the vulva and vagina, urinary difficulty due to external factors, and vulvar map-like erythema (candidal or monilial vulvovaginitis). The typical leukorrhea is in the form of curd-like or in the form of pieces, the vaginal mucosa is highly inflamed, and there are white thrush-like plaques attached, which are easy to peel off, and the underlying is the eroded base of the damaged mucosa, or shallow ulcers may form. Severe cases may leave ecchymosis. However, not all leukorrhea has the above typical features, and it can range from watery to curd-like leukorrhea, such as some that are completely thin and clear serous exudates, often containing white flake-like substances.

　　General Treatment:Firstly, eliminate the triggering factors in the treatment of candidal vaginitis: if there is diabetes, active treatment should be given. Timely stop the use of broad-spectrum antibiotics, estrogens, and corticosteroid hormones. Develop good hygiene habits and keep the vulva dry, avoiding scratching.

　　Altering the vaginal pH level:The pH value most suitable for the growth of Candida albicans is 5.5, and the slightly acidic environment of the vagina can maintain the self-cleaning function of the vagina. For normal people, it is 3.7-4.5. Therefore, the female care liquid with a Ph4 weak acid formula, in addition to being suitable for daily cleaning and maintenance, can also inhibit the growth and reproduction of fungi during the treatment period.

　　Medication Therapy:The treatment of vulvovaginal candidiasis includes local medication, systemic medication, and combined medication (oral plus local). The choice of local or systemic antifungal drugs should be made; the duration of the course should be determined according to the patient's clinical classification. In the treatment of vaginal candidiasis, it is required that sexual partners undergo genital fungal culture and appropriate antifungal treatment, and they should be treated simultaneously. After the symptoms disappear during treatment, it is necessary to have a review after each menstrual period and consolidate treatment for one course.