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Bacterial urethritis
Last reviewed: 04.07.2025

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Bacterial urethritis is a urological disease in which the discharge from the urethra contains various types of staphylococci, streptococci, E. coli, enterococci and other opportunistic microorganisms.
In addition, it is possible for microbes to be introduced that did not exist on the mucous membrane of the urethra. Identifying the etiologic factor in patients with bacterial urethritis presents certain difficulties, especially for bacteria of the genus Neisseria, which are similar in their properties to gonococci.
Causes bacterial urethritis
Bacterial urethritis in women is a serious problem, since lower urinary tract infections are rarely isolated. In women with recurrent urinary tract infection, gram-negative microflora is present in the vaginal environment in 56% of cases, whereas in women with no history of urinary tract infection, it was found in only 24% of the examined patients. In patients with recurrent urinary tract infection, the vagina is very often colonized with E. coli, Enterococcus faecalis, Proteus mirabilis and Klebsiella.
In postmenopause, due to a decrease in estrogen levels, women develop atrophy of the mucous membranes of the urogenital area. The epithelium in the vagina and urethra becomes thin, glycogen deficiency occurs, lactic acid production decreases, and vaginal pH increases. These changes in the vaginal environment contribute to the excessive growth of non-acid coliform bacteria and the disappearance of lactobacilli, creating favorable conditions for colonization of the vagina by opportunistic and pathogenic microflora. At the same time, the frequency of ascending lower urinary tract infection (including lesions of the urethra) increases in the postmenopausal period.
Symptoms bacterial urethritis
Symptoms of bacterial urethritis caused by bacteria of the genera Esherichia colli, Klebsiella, Enterobacter, Serratia, Proteus, Citrobacter, Providencia depend on the localization of the pathological process and cannot be differentiated from infections caused by other bacteria based on symptoms and signs of the disease alone.
Therefore, it is very important to determine the infectious agent, including its species and type, its quantity in 1 ml of fresh urine and its sensitivity to antibiotics. All this is essential for determining the pathogenesis and prescribing treatment for bacterial urethritis.
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Treatment bacterial urethritis
Protected aminopenicillins, second- and third-generation cephalosporins, fluoroquinolones, and aminoglycosides have a pronounced antimicrobial effect on bacteria of the Enterobacteriaceae family. However, sensitivity to these drugs varies among different strains, so it must be determined using laboratory methods.
A pronounced therapeutic effect can be achieved with a simultaneous combination of two or more antibacterial drugs, depending on the identified sensitivity to them and taking into account the mixed infection. Bacterial urethritis treatment involves a combination of antibacterial drugs with drugs that potentiate the action of antibiotics, increase the protective mechanisms of the patient's body, facilitate the delivery of antibacterial agents to the lesions, and ensure their therapeutic concentration in tissues and blood serum.
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