Rash and burning when urinating: how to treat it

A healthy person easily controls the process of urination (emptying the bladder). Normally, there should be no discomfort during urination, and after – a feeling of relief usually appears.

The appearance of cutting pains accompanying the emptying of the bladder almost always indicates the presence of a pathological process and not only in the urinary organs.

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Causes urinary cramps

Pain during urination may occur as a result of inflammatory damage or mechanical damage to the mucous membrane and submucosal layer of the urethra, its strictures, and changes in the chemical composition of urine.

The most common causes of discomfort in the form of burning during urination are inflammations of the urethra of bacterial genesis (gonorrhoeal, chlamydial, mycoplasmal, ureaplasmal), as well as viral (herpesvirus, adenovirus), parasitic (due to trichomoniasis) and fungal (Candida), transmitted through sexual contact. Candidal urethritis, like the development of other types of opportunistic flora (ureaplasma), can be a consequence of a course of antibacterial therapy, hormone therapy, the effects of radiation, constant stress, a general decline in the standard of living and other factors that destroy the protective barrier of the human body.

Inflammation of the bladder (cystitis) is much more common among women, but the strong half of humanity is not immune from it either. The most common pathogens of the disease are E. coli, streptococci and staphylococci.

Urination with cutting pains can be observed in women with inflammation of the pelvic organs of various etiologies, most often with vaginitis, in men - it can be one of the signs of prostatitis, epidemiitis, vesiculitis, phimosis.

Cystitis, urethritis, pyelonephritis can occur as a result of previous infectious diseases, such as tonsillitis, sinusitis, purulent abscesses, when the infection enters the urinary organs through the bloodstream or lymph flow.

In addition to infectious causes of inflammation in the urethra and, as a consequence, cutting pain during urination, there may also be a non-infectious pathogenesis of the appearance of this discomfort.

Thus, risk factors for the development of congestive urethritis are hemorrhoids, frequent constipation, prostate hypertrophy, prolonged sexual intercourse. It develops as a result of impaired blood circulation in the vessels of the submucous layer of the urethra.

Mechanical damage to the mucous membrane of the urethra may occur as a result of long-term installation of a catheter, surgical operations, injuries, and also the release of fragments of stones and sand in the case of urolithiasis. The development of neoplasms in the urinary organs sometimes provokes an inflammatory process or blocks the removal of urine from the body.

The chemical composition of urine changes with gout (oxalic acid is concentrated in it), diabetes mellitus (glucose), as a result of long-term use of certain medications, poisoning with toxic substances that affect the urinary organs, such as mercury. Abuse of spicy foods, especially in combination with alcohol, can also cause pain when urinating, although with normalization of the diet they quickly pass, however, in patients with gout against this background, a long-term exacerbation may begin.

"Sweet" urine of diabetics dries out the mucous membrane of the urethra, microcracks appear on the surface, and the process of urination becomes painful. Secondary infection may occur, and the patient's condition worsens.

Non-infectious causes include allergic reactions to intimate care products, contraception, and synthetic underwear. Postmenopausal women may develop atrophic vaginitis.

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Pathogenesis

The pathogenesis of urethral infection is individual in each case, but, in general, when pathogens get on its mucous membrane, they begin to multiply, creating colonies. The products of their vital activity destroy the membranes of healthy cells of the urethra epithelium, causing inflammation in response. The damaged epithelium no longer protects the nerve endings, which respond with sharp pain to irritation by urine.

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Epidemiology

Analyzing the prevalence of bacterial urethritis in men, as the most common cause of pain during urination, gonorrheal urethritis is distinguished, the incidence of which is slightly more than 40 cases per 100,000 population. Chlamydial urethritis occurs twice as often, the remaining requests for discharge from the urethra amounted to more than 200 cases per 100,000 population. Statistics were provided by medical institutions dealing with genitourinary diseases. With other infectious agents, urethral inflammation in 40-60% of cases is caused by ureaplasma, up to 20% - mycoplasma, up to 5% - trichomonads. Viral urethritis was much less common than bacterial: adenovirus - from 2 to 4%, herpesvirus - from 2 to 3%.

The highest incidence of gonorrhea is recorded in Great Britain (27.6 per 100,000 population), Latvia and Iceland (18.5 and 14.7 respectively). Greeks, Romanians, Czechs and Spaniards turned out to be the most respectable citizens who respect family values. These countries have the lowest incidence rate. Three quarters of registered cases of gonorrhea among the entire population fall between the ages of 15 and 34.

It is believed that about a third of women and every eighth man have suffered from cystitis of various origins at least once. Women suffer from cystitis at any age, while for men the peak incidence is at the age of over 40-45 years.

The prevalence of bacterial prostatitis among the male population is estimated at 5-10%, with patients aged 20 to 42 years being the most common.

Urolithiasis occurs worldwide with approximately the same frequency (5-10%), and in economically developed countries, where protein products predominate in the diet, stones are found mainly in the kidneys, while in countries with a lower standard of living or plant-based diets, the bladder is the main site of localization of stones.

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Symptoms

Pain when urinating is most often a hallmark of diseases spread through sexual contact. The clinical picture of gonorrheal urethritis in males is complemented by mucopurulent dripping discharge from the urethra, burning and itching. The first signs of the disease may appear as early as the second or third day after infection, although sometimes the incubation period lasts up to two or three weeks. In men, especially young men, the disease usually occurs acutely with pronounced symptoms. With a long course of the disease, pain after urination is characteristic.

Females often suffer from the disease without any pronounced symptoms, but in about 30% of cases the characteristic signs are pain and frequent urination, greyish-whitish purulent discharge, and may contain mucus. In some cases, swelling and soreness of the labia are observed. Often, gonococci parasitize in trichomonads, causing heterogeneous infections, which usually occur with pronounced symptoms: in males, gonorrheal symptoms prevail, in females - trichomoniasis.

The initial stage of infection with trichomonas infection is accompanied by urethritis. Trichomoniasis in females in most cases occurs with pronounced symptoms, foamy discharge from the vagina is specific. Different in color - grayish, greenish, yellowish with an unpleasant odor, irritating the mucous membrane of the external genitalia and vagina. Painful urination with frequent urges is a typical complaint of patients, sometimes pain in the lower abdomen occurs.

Males, after infection, generally become asymptomatic carriers of the disease. Clinical manifestations resemble inflammation of the urethra with droplet grayish-green discharge.

Pain during urination suggests the possibility of chlamydial infection. Patients of both sexes experience discharge, which is transparent and not too abundant. In female patients, bleeding is possible between menstrual periods and pain in the lower abdomen.

Frequent and painful urination is one of the symptoms of ureaplasmosis or mycoplasmosis; in the first case, the discharge is cloudy, in the second, it is transparent.

Candidiasis (thrush) is characterized by cheesy white discharge, causing hyperemia and severe itching of the vagina or urethra, up to neurotic disorders.

In male patients, pain before urination is a consequence of inflammation of the urethra. Purulent discharge, accumulating in the canal between urinations, glues the lips of the inflamed urethra, causing tension and pain. When the purulent plug is washed out under the pressure of urine, the discomfort stops. This symptom is characteristic of gonorrheal, chlamydial, mycoplasmal and candidal urethritis.

The appearance of vaginal discharge (urethral discharge) and pain during urination are almost always symptoms of a venereal disease. Acute forms, in addition to this combination, are characterized by very noticeable pain - lumbar, groin and in the inner thighs. Chronic course usually manifests itself in nagging pain in the lower abdomen and discomfort during urination. It is characterized by alternating exacerbations associated with high nervous and physical stress, colds, intense sexual life, and remissions, when the symptoms practically do not remind of themselves.

In women, urethritis is almost never seen as an independent disease and is a complication of cervicitis, colpitis or vulvovaginitis. Due to the wide and short urethra, the infection almost immediately gets into the bladder. Cystitis develops - mainly a female disease, men get sick extremely rarely. This disease is characterized by pollakiuria (frequent urges during the day) and pain during urination, constant and paroxysmal pain above the pubis. Urine is excreted in small portions and there is no feeling of relief and complete emptying of the bladder. Later, traces of pus and blood can be found in the urine, it becomes cloudy, and urinary incontinence develops.

In both sexes, pain after urination may also indicate cystitis, injuries from small stones, and in women, inflammation of the serous layer of the uterus (perimetritis). In men, pain at the end of urination indicates a narrowing of the urethra in combination with cystitis. As a separate sensation, pain after urination occurs with damage to the internal epithelium of the urethra. Urine is a physiological fluid, and when it passes through the urethral canal, the nerve receptors "calm down", however, when the fluid is released, the wounds are exposed and the pain intensifies.

Abdominal pain during urination indicates that the inflammation has spread from the urethra to the genitourinary organs. Inflammation of the bladder is characterized by suprapubic pain localization, radiating to the groin. The patient has an involuntary desire to relieve the pain - he urinates, bending over and pressing his hands to his stomach.

Burning and frequent urination are the main symptoms of cystitis. However, it can also be observed in urolithiasis, when the patient is in an active state; urogenital tuberculosis (during the day); prostatic hyperplasia (at night and in a supine position); with the convergence of cardiac and renal edema (at night). Regardless of the time of day - in infectious diseases of the genital organs, including venereal diseases, in combination with discharge; neoplasms that compress the bladder; pregnancy; disposition of the uterus; vesiculitis; urethral strictures; diabetes mellitus. This condition can be the result of hypothermia or a nervous system disorder.

In males, infection of the prostate gland with active infections or past infections causes its inflammation. This is one of the most common causes of pain and burning during urination. During acute inflammation or during exacerbations of chronic inflammation, constant cramping pains are observed, radiating mainly to the scrotum or perineum, sometimes to the sacral area of the lower back. Their intensity is affected by changes in sexual activity, and the pain can either increase or decrease. A symptom of prostatitis can be painful ejaculation and urination.

In men, pain when urinating and pain in the side combined with swelling and hyperemia of the scrotum may appear as a result of inflammation of the appendages of the testicle ( epididymitis ). In young men, it is most often caused by sexually transmitted infections, in older people - opportunistic microorganisms, such as E. coli. Symptoms increase over time, pain descends into the scrotum, there may be mucopurulent discharge, small bloody inclusions in the urine, high temperature and chills.

Pain during urination and bloody discharge are a characteristic sign of urolithiasis (calculous formations in the bladder), which manifest themselves as pain combined with frequent urges to urinate when walking, during physical exertion, or shaking in transport. Kidney stones cause renal colic, with very severe pain in the lumbar region. Pain during urination radiates to the scrotum and labia. Fresh blood without clots is observed in the urine.

Pain in the lower back and burning sensation when urinating in combination with swelling, the presence of proteins and red blood cells in the urine may indicate glomerulonephritis, and if there are also joint pains and inflammation, then rheumatoid arthritis.

A symptom of renal colic is a sharp pain in the kidneys, a burning sensation when urinating, radiating to the perineum, which may indicate the movement of a kidney stone. But if the attack passes, this does not mean that the stone has passed safely. It can block the ureter, and urine accumulates in the kidney. Hydronephrosis develops - a very dangerous condition.

Hematuria (urination with blood) is a symptom of many diseases, macrohematuria can be visually noticed when urine is colored red. Microhematuria is noticeable only during microscopic examination of urine, but this does not make it less dangerous. Burning pain and blood during urination, dark red in color, is a symptom of acute cystitis or urogenital infection, especially if the onset of this problem (approximately two weeks) was preceded by unprotected sex. Scarlet blood that appears from the very beginning of painful urination is a probable sign of urethritis. Its presence indicates damage to the vessels located close to the urethra. If a lot of blood with clots is released, and the urine is red-brown, then this is a manifestation of renal bleeding or - from the ureters. Dark color indicates stagnation. It is possible to assume the disintegration of a neoplasm in these organs, their injury. In this case, pain and burning are usually absent.

Difficulty in intermittent urination with blood indicates the development of a tumor process in the prostate gland, in particular, prostate cancer, prostate adenoma, the presence of blood streaks in the sperm also indicates this. Hematospermia can be a symptom of inflammation in the urinary organs, prostatitis, and also simply a physiological phenomenon.

Pain in the lower abdomen when urinating can occur with almost all diseases of the genitourinary organs of infectious and inflammatory genesis. Organic lesions are described above - cystitis, urethritis, urolithiasis, venereal diseases. They are combined with other symptoms already mentioned. Pain can be moderate, quite tolerable, or very intense. Sharp cutting pain when emptying the bladder can be a symptom of cystalgia - a disorder of nervous regulation, leading to pain, in this case, along the nerves of the urinary system. Visually, no impurities in the urine and itchy discharge are detected. Laboratory tests for such pathologies do not show any anomalies, instrumental diagnostics - either.

Women may feel severe cutting pain in the area above the pubis and burning during urination in acute gynecological pathologies: ectopic (extrauterine) pregnancy, sudden rupture of ovarian vessels or torsion of the ovarian cyst stalk. The development of these catastrophic conditions occurs suddenly and is characterized by a rapid deterioration in the woman's well-being. In the presence of increasing paroxysmal or pulsating pain, for which conventional medications, such as no-shpa, baralgin do not bring relief, the appearance of hemorrhagic symptoms (pallor, weakness, dizziness, development of a syncopal state); pulse of about 100 beats per minute or more, hypotension; the appearance of symptoms of peritoneal inflammation (gases are formed but do not pass; the skin is moist but cold; the frontal wall of the abdominal cavity is painful).

Sometimes such manifestations are of a reflected nature. Due to the anatomical proximity of the organs located below the peritoneum, they may indicate their acute inflammation (appendicitis, endometritis, adnexitis). When the appendix of the cecum is located behind the peritoneum near the kidney and/or ureter, this contributes to the pain being transmitted to the genitals, and pain occurs during emptying the bladder. A symptom of acute appendicitis is almost always a high temperature.

The appearance of the above symptoms should prompt you to seek immediate medical attention.

In addition to the cases already listed, pain and burning during urination can be caused by a local allergic reaction to unsuitable intimate hygiene products, synthetic underwear, a certain brand of pads or condoms. In gout, such sensations are considered additional symptoms, however, microcrystals of uric acid, which are abundant in urine, damage the mucous membrane of the urethra, which leads to discomfort. In diabetics, the constant presence of high glucose levels in the urine leads to drying out and microcracks in the epithelium of the urethra.

In most cases, cutting pains when emptying the bladder are characteristic of local processes and systemic symptoms are not observed. However, especially in acute inflammatory processes, in addition to cutting pains, high temperature, headache, weakness, nausea and vomiting may be observed. An increase in body temperature may indicate the onset of a purulent complication. In men, temperature combined with cutting pains is usually characteristic of acute urethritis, in women - acute cystitis. If symptoms characteristic of general intoxication of the body appear, you should immediately contact a medical institution.

In men, subfebrile temperature in the evenings and pain when urinating may be symptoms of urogenital tuberculosis. This disease is difficult to diagnose. In cases where it is mistaken for a venereal infection and treated with appropriate drugs, temporary relief occurs, but then the disease makes itself known again. In addition to the above symptoms, the patient feels constant weakness, pain in the perineum, radiating to the lumbar region, he has problems with potency and increased sweating.

Pain when urinating after sexual intercourse is most often a consequence of infection as a result of unprotected sexual contact. It may also be a sign of a bladder tumor, urethral stricture, urolithiasis, disposition (prolapse) of the uterus or vagina, prostatic hyperplasia, diabetes mellitus, or atrophic vaginitis.

Burning urination during menstruation can be caused by any of the above reasons. Most often, it is cystitis, which is observed in many women during critical days. In this way, any inflammatory process in the pelvic organs, occurring latently, can manifest itself. During this period, pathogenic microorganisms freely migrate from the site of inflammation to the bladder, causing clinical signs of cystitis. Urination with burning during critical days or after their end may indicate a sluggish, practically asymptomatic inflammation of the internal genital organs or the spread of infection during this period. After all, menstrual blood is an excellent breeding ground for pathogenic microbes.

Pain during urination during menstruation may be a reaction to the use of a new intimate hygiene gel, tampons, and even new brands of pads. Perhaps, by changing the brand of hygiene products, you will be able to get rid of the pain quite quickly. It is advisable to refuse to use tampons at all or reduce their use to a minimum, changing them every three to four hours. Tampons contribute to the stagnation of menstrual blood and the intensive development of pathogenic flora in it, which can cause a cutting pain in the urethra when emptying the bladder.

Pain when urinating after menstruation can be interpreted as infection of the bladder during critical days, they indicate trouble in the body. It is advisable not to delay the process and consult a doctor to find out the cause.

The development of cystitis can cause pain when urinating and delayed menstruation. This is a fairly common occurrence in women. However, it is not cystitis itself that causes the delay, but the inflammation that affects the ovaries and causes hormonal imbalance. It is just that the symptoms of cystitis are more noticeable and therefore there is an opinion that cystitis can cause delayed menstruation. Delayed menstruation and discomfort when urinating can occur for various reasons: pregnancy, sexually transmitted infections. This symptom should alert a woman and make her visit to the doctor not to postpone.

Burning during urination in the morning is a special case of painful urination and can occur in latent forms of urethritis, endometritis and myometritis. When infected with pubic lice, burning and itching during urination may appear only in the morning after a night's sleep.

Frequent urination without pain is not always a symptom of a disease, however, the cause should still be found out. Frequent urination is more than 10-15 times a day. First, analyze your diet and drinks, you need to understand whether this affects the frequency of urination. Coffee, beer, herbal teas and some drugs have a diuretic effect. Pollakiuria (the urge to frequently empty the bladder during the day) is observed in women who are carrying a child, with fluctuations in hormonal levels, in particular, during menopause. This symptom may also indicate diabetes or urolithiasis, so you should consult a doctor.

Night - nocturia, may be accompanied by a decrease in the amount of urine excreted during the day (true nocturia), not constant - does not affect daytime urination. Develops with pathologies of the heart and blood vessels, liver, kidneys, endocrinological diseases, etc.

The cause of pain when urinating in women can be chronic fatigue, changes in the immune and hormonal status, frequent hypothermia, alcohol and spicy food consumption, insufficiently frequent hygiene procedures or improper technique for performing them. But if this symptom is accompanied by discharge, cloudy urine and the presence of blood in it, frequent or incomplete and difficult discharge of this physiological fluid, pain in the vagina when urinating, pain and even a slightly elevated temperature to subfebrile values, you must immediately seek medical advice.

Burning pain when urinating in men can have quite innocent causes that do not require medical intervention - abuse of alcoholic beverages and/or spicy food, intense sexual intercourse the day before, or a minor injury to the perineum. These manifestations are usually not accompanied by other symptoms and quickly go away on their own.

In men, a burning sensation in the head of the penis during urination may indicate the release of small calculus formations, sand and its injury. Not following the rules of hygiene too carefully can cause inflammation of the head of the penis and foreskin (balanitis, balanposthitis), its consequence can be phimosis - narrowing and thickening of the foreskin and the inability to expose the head. The opposite sequence of events is also possible - phimosis can lead to inflammation. In this case, burning during urination in the head of the penis is accompanied by pain in the entire organ and often - in the lower abdomen. A risk factor for the development of balanitis is diabetes mellitus, since "sweet urine" is an excellent breeding ground for microbes.

Pain when urinating in a child

In childhood, urinary tract infections often occur, which are accompanied by discomfort during urination. A typical sign of infection in a child is urinary incontinence both during sleep at night and while awake. On the contrary, stranguria (difficulty emptying the bladder) or oliguria (urine leakage in drops) may be observed, urine may have a strong odor, as well as fever (heat, chills), weakness and lack of desire to eat.

In this case, as a result of hypothermia, cystitis often occurs, suddenly and acutely. Frequent, every quarter of an hour, and scanty urination with pain, cutting and burning is typical. The temperature may rise.

In childhood, stones may appear in the kidneys, bladder, and ureters. In this case, not only pain during urination is observed, but also symptoms of renal colic - paroxysmal cutting pain in the lower back or abdomen, irritability, vomiting, and nausea.

Phimosis is often found in boys - the inability to expose the head of the penis due to the narrowness of the opening in the foreskin, which causes an inflammatory process caused by the accumulation of secretions in its folds. It is characterized by pain during urination, localized in the area of the head and foreskin, discharge with pus, enlarged lymph nodes and temperature. When the head of the penis is pinched (paraphimosis), the child feels severe pain, the compressed head may turn blue and swell.

Children explore their bodies and often insert foreign objects into the body's natural openings, particularly into the urethra. This can also cause pain and burning during urination, and can also block the flow of urine.

Trauma to the perineum and genitals can cause inflammation. And "adult" bacterial infections suggest that they were preceded by some kind of sexual abuse.

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Pain when urinating in pregnant women

During this period, the occurrence of burning and stinging during urination is observed much more often. Firstly, this is facilitated by changes in the immune and hormonal status of a woman during this period, secondly, the growing uterus presses on the bladder and there may be both the urge to empty it frequently and a certain discomfort. Stinging during urination during pregnancy may appear from contact with intimate hygiene products that normally do not cause such a reaction, and also - a decrease in immunity can provoke the growth of fungal flora and candidiasis. Pressure from the uterus on the bladder can provoke relapses of chronic diseases of the genitourinary system.

However, in addition to physiological causes, this phenomenon may be a sign of dormant infectious and non-infectious diseases that can be dangerous for both the mother and her unborn child. Therefore, if pain occurs, it is necessary to inform the doctor about it. The most likely pathological causes of this symptom are urolithiasis, cystitis, inflammation of the internal genital organs, as well as other diseases.

The appearance of additional symptoms that should prompt you to seek medical help without delay, such as pain and other discomfort in the lower abdomen, pollakiuria (nocturia), a feeling of incomplete emptying of the bladder after urination, color changes, turbidity and a strong odor of urine.

A considerable number of women experience pain when urinating after childbirth. The most probable cause is cystitis. Its development is facilitated by: overflow of the bladder associated with rare urination, infection, changes in the immune and hormonal status, circulatory disorders in the pelvic organs. Risk factors for the occurrence of pathological pain are hypothermia and postpartum catheterization. This discomfort when urinating in the postpartum period can also occur due to other reasons, so the appearance of this symptom requires diagnosis and treatment.

Pain when urinating after a Caesarean section accompanies many infectious and chronic diseases that have worsened as a result of the surgical manipulation. A woman's weakened body is susceptible to infections after the intervention. Pain can be observed at any time during urination, after it, or when there is an urge. Urine can also change color and transparency. In catarrhal cystitis, mucus fragments are observed in the fluid, purulent fragments make the urine turbid, hemorrhagic cystitis is diagnosed when there is blood in the urine.

Diagnostics urinary cramps

The appearance of various kinds of unusual and uncomfortable sensations when emptying the bladder should prompt you to contact a medical institution for a thorough examination and determination of the causes of their occurrence. Timely diagnosis is the key to successful treatment.

After a visual examination and conversation with the patient, the doctor will prescribe tests: clinical - blood and urine.

With the help of a clinical blood test, it is possible to detect the presence of an inflammatory process, a violation of hematopoiesis. An enzyme immunoassay of blood allows you to detect antibodies to various pathogens of bacterial and viral origin.

Clinical urine analysis allows to detect traces of blood and mucus, leukocytes and other components that should not be present normally. If this analysis shows deviations in the composition of urine, specific urological urine tests according to Nechiporenko and Zimnitsky are prescribed.

Bacterial tests of urine and a smear from the vagina (urethra), and smear microscopy are prescribed.

A modern method based on the polymerase chain reaction allows us to identify DNA (RNA) fragments of any pathogenic microorganisms in selected samples of material, the most informative study, which, however, is not carried out in all laboratories, even in large cities.

Instrumental diagnostics for complaints of pain during urination consists of ultrasound examination, which provides a visual representation of the internal genital and urinary organs, the presence or absence of cysts, tumors, hyperplasia, and stones. Tomography, computer or magnetic resonance, allows for a more detailed examination of the affected organ, cystourethroscopy - the internal epithelium of the bladder and urethra.

It may be necessary to consult an endocrinologist, rheumatologist and other specialists depending on the identified pathologies.

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Differential diagnosis

Differential diagnostics is carried out based on the results of all laboratory and instrumental studies. Carefully conducted examinations will help to identify the cause of colic and promptly prescribe treatment for a venereal or gynecological disease, remove stones or neoplasms.

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Treatment urinary cramps

Pain when urinating can be caused by many reasons, therefore, treatment of the inflammatory process in the urethra involves a variety of therapeutic methods. Medicines used in the treatment of urination pathology are prescribed depending on the identified causative agent of inflammation. Most often, antibacterial, fungicidal and antiviral drugs are used in treatment regimens, stimulation of the immune system is mandatory, and local procedures are additionally prescribed - instillations.

Acute inflammations respond to intensive treatment faster than chronic ones. Therapy begins immediately with drugs that should destroy the infectious agent. In chronic forms, immunomodulators are prescribed first, and later the main treatment aimed at eradicating the pathogenic microorganism is started. Most often, urethritis (cervicitis) appears after unprotected sexual contact. In order to effectively cure the disease, the treatment regimen is prescribed individually, taking into account the sensitivity of the microorganism to certain drugs and the patient's tolerance of this drug. If the patient has a combined form of infection, this is also taken into account when prescribing drugs. It is also necessary to remember that all sexual partners also need treatment.

For gonorrheal urethritis, Cefaclor or Spectinomycin are most often prescribed. The first of them is a cephalosporin drug of the bactericidal type of action, belongs to the second generation. It inhibits the process of reproduction of gonococci, preventing the formation of their cell membranes, which leads to the death of pathogenic flora. It is active against many types of bacteria that can infect the genitourinary system, in particular, streptococci, staphylococci, E. coli (the most likely causative agents of cystitis). It is available in capsules and granules for the manufacture of a suspension, can be prescribed from infancy. For gonorrheal urethritis, patients over 10 years old are prescribed a single dose of 3 g, children are dosed individually. The antibacterial effect is enhanced in combination with metronidazole, which is valuable for gonorrheal-trichomonal urethritis. However, in combination with tetracyclines, which are often prescribed for chlamydia, the bacterial effect is reduced.

Spectinomycin is a bacteriostatic agent that, when it enters the cell of a pathogenic microorganism, blocks its growth and development. In high doses, it exhibits bactericidal properties. It is used for sensitization to β-lactam antibiotics. Patients are prescribed intramuscular injections of the drug.

Both drugs have a range of side effects, including nausea, vomiting, insomnia, fever and some others.

If trichomonas is detected as a pathogen, patients are prescribed Metronidazole, women often in the form of suppositories, which provides a good therapeutic effect in combination with the absence of a systemic effect on the body. Suppositories are used once a day before bedtime, usually for ten days. These suppositories are not prescribed to pregnant and lactating women, patients with hematopoiesis disorders and nervous system disorders.

Mycoplasma and chlamydia are sensitive to Tetracycline and its derivatives. This is a classic antibacterial drug with a wide range of applications, it is also prescribed for gonococcal infection. The dosage is individual, depending on the form of the drug and the type of bacterial infection. For adults, the daily dose should not exceed two grams. Children over seven years old are prescribed in the form of a suspension. It has many side effects, can cause allergic reactions, photosensitivity and candidiasis of the mucous membranes.

Currently, many strains of bacteria resistant to tetracyclines have appeared. Therefore, in the treatment of bacterial urethritis, drugs from the fluoroquinolone group are used, for example, Pefloxacin, which is active against chlamydia, mycoplasma, gonococci, ureaplasma, E. coli, staphylococci and streptococci. The active ingredient of the drug blocks the construction of the DNA chain of bacteria, causing their death. Effective in infections of the genitourinary system. Prescribed both orally and in the form of intravenous drip infusions at the age of over 15 years. Contraindicated in pregnant and lactating women. In the treatment of infectious diseases of the urinary system, 400 mg is used once.

Candidiasis (thrush) is treated with antifungal agents. Levorin is used both orally in the form of tablets and externally in the form of ointment and aqueous suspensions. The causative agents of candidiasis and trichomonads are sensitive to this agent. It is practically non-toxic and does not accumulate in the body. As a result of use, cough and hyperthermia may develop. Orally it is not prescribed for acute intestinal infections, liver diseases, gastroduodenal ulcers, aqueous suspensions - for uterine bleeding. Two or three times a day 400-500 thousand units are prescribed, the duration of treatment is from ten to 12 days. In childhood, the daily dosage is calculated per kilogram of the child's weight: 0-1 year - 25 thousand units; 2-5 years - 200 thousand units; 6 and older - 200-250 thousand units. The daily dose is divided into three or four doses.

For non-specific inflammation of the urethra, antibacterial agents with a broad range of activity are prescribed.

In case of herpesvirus or adenovirus infection, drugs with antiviral action are prescribed. For example, Neovir, which inhibits the development of viruses in cells by activating the body's production of endogenous interferon. The drug is effective against chlamydia and candidiasis. It is not prescribed to children, pregnant and lactating women, or autoimmune diseases. During the period of administration, body temperature may increase to subfebrile levels, and allergies in the form of urticaria may occur. The tablets are swallowed whole every 48 hours at 0.75 g, intramuscularly - 0.25 g at the same time interval.

Treatment of cystitis is carried out in several directions: destruction of pathogenic flora, removal of inflammation and normalization of urine flow. The same fluoroquinolone antibiotics are used - pefloxacin, cifrana, ofloxacin and others, as well as - Monural or Nitroxoline or antiviral (Acyclovir) and antifungal agents (Levorin).

Monural is used for acute bacterial cystitis, non-specific bacterial urethritis, bacteriuria in pregnant women. Fosfomycin trometamol (the active ingredient of Manural) has activity against a large number of pathogenic bacteria. The drug is taken once. The therapeutic effect of the drug lasts for about two days. During this time, urine is sterilized. Adult patients take a single dose of 3g. Children over five years old - 2g.

To relieve pain, medications are prescribed that relax the muscles of the bladder (No-shpa) and painkillers (Ketorolac, Benzocaine).

In the case of phosphate and oxalate stones, gout is prescribed therapy with Cystone. This is a multi-component drug containing plant extracts and having the ability to relieve inflammation, reduce the likelihood of crystalline formations and cause their micro-crushing. The drug has a certain antimicrobial and antispasmodic activity. Rare cases of sensitization to the ingredients of the drug have been registered. Can be used during pregnancy and lactation.

Microcrushing and removal of crystalline formations: the drug is taken three times a day after meals, children 2-5 years old - half a tablet; 6-13 years old - one tablet. Patients over 14 years old - two tablets. Such dosages are taken for three or four months.

To continue treatment, the drug is dosed as follows: children 2-5 years old - a quarter of a tablet; 6-13 years old - half a tablet. Patients over 14 years old - one whole tablet. The reduced dose is taken twice a day. The drug is taken until the stones are completely eliminated from the body.

Infectious lesions of the urinary tract: the drug is taken three times a day after meals, children aged 2-5 years - half a tablet; 6-13 years - one tablet. Patients over 14 years - two tablets. Duration of treatment is from one month to one and a half. Relapses of the disease require the following dosage: children aged 2-5 years - a quarter of a tablet; 6-13 years - half a tablet. Patients over 14 years - one whole tablet. Take three times a day for 1.5-3 months.

Acute renal colic is relieved by taking the medicine three times a day: children 2-5 years old – half a tablet; 6-13 years old – one tablet. Patients over 14 years old – two tablets. Take until symptoms disappear.

For preventive purposes, the drug is taken three times a day from four to five months in the following dosages: children 2-5 years old - a quarter of a tablet; 6-13 years old - half a tablet. Patients over 14 years old - one whole tablet.

In all cases, patients are prescribed immune-boosting agents. Galavit is an immunostimulant that also has a strong anti-inflammatory effect. By regulating the activity of macrophages, it improves the body's resistance to infections and blocks the production of pro-inflammatory agents. It is contraindicated for pregnant women and people sensitized to its ingredients. No side effects have been recorded. Simultaneous administration with any drugs is possible. Rectal suppositories Galavit are prescribed for urogenital infections according to the following scheme: two units (2 g) - the initial dose, then one suppository twice or three times a day until the symptoms are eliminated, then one suppository every three days. In total, the course of treatment requires up to 25 rectal suppositories.

Non-infectious diseases of the genitourinary system are treated according to the following scheme: the first two days - two suppositories (2 g) once a day; then every three days - one suppository. In total, the course of treatment requires 15-25 rectal suppositories.

When treating diseases that cause pain when urinating, a course of vitamins C, E, and group B is prescribed.

In the treatment of chronic processes: chlamydia in both sexes, cystitis in women, urethritis and prostatitis in men, instillations are used (infusion of a liquid or emulsified drug into the bladder or urethra). Thanks to these procedures, recovery occurs faster and the need for antibiotics decreases.

Physiotherapy is not performed during the acute stage. Physiotherapy will be very useful during the recovery period. In case of urethritis and cystitis, electrophoresis with antibiotics may be prescribed, allowing them to be delivered to the destination quickly and painlessly. Ultra-high-frequency therapy, heating with high-frequency currents (diathermy) improves blood circulation in organs and local immunity.

Magnetic, laser, microwave and ultrasound therapy are used. Treatment methods are selected individually, taking into account the anamnesis, tolerance, and concomitant diseases.

Folk remedies

It is hardly possible to cope with sexually transmitted infections using folk remedies, non-specific urethritis and cystitis also pass much faster with drug therapy. Using only folk remedies, you can slightly suppress the symptoms and transfer an acute disease to the category of chronic ones. However, in complex treatment plans there is also a place for the use of folk medicine.

Inflammation of the urinary tract is treated with the well-known parsley and dill.

It is useful to drink fresh parsley juice. It is squeezed from stems with leaves and roots, well cleaned and chopped with a blender. The juice is taken by a tablespoon during the recovery period, it has an anti-inflammatory and diuretic effect, contains B vitamins and ascorbic acid, but in severe forms of urolithiasis in combination with the inflammatory process, as well as - it is better not to use it for pregnant women.

But an infusion of parsley greens can treat cystitis in any case, except for an allergy to this plant. The infusion is prepared as follows: a tablespoon of chopped greens is poured with two glasses of cold boiled water. For this, the water is not allowed to boil strongly and for a long time, but is turned off when small bubbles begin to rise to the surface and cooled. Infuse from eight to ten hours, a portion is intended for consumption during one day.

Using the same recipe, you can prepare an infusion of parsley seeds in the proportion: one teaspoon of seeds per two glasses of cold boiled water. Take the same way.

To treat urethritis, it is recommended to prepare a decoction of parsley in milk. Place the parsley on the bottom of an enamel pan and pour milk over it so that it is covered. Boil and cook for about five minutes, making sure that the milk does not "run away". Cool, strain, take two tablespoons every two to three hours.

Parsley seed powder on the tip of a knife can be taken twice or thrice daily.

Dill seeds are also used to treat cystitis. An infusion is made from them: one tablespoon of dry seeds, ground in a coffee grinder into flour, is poured into a thermos and filled with 200 ml of boiling water, and left for at least two hours. Take 100 ml once or twice a day.

Or a decoction: pour boiling water over the seeds in the same proportion and simmer in a water bath for a quarter of an hour, strain and take ½ cup four to five times a day.

Dill seeds are contraindicated for people with low blood pressure and gallbladder pathologies.

Perhaps the simplest remedy for urolithiasis is daily consumption of tea made from apple peel. It can be either fresh or dried. The main thing is to drink it every day. A more precise recipe for this tea looks like this: dry the apple peel, grind it into powder and brew two teaspoons of powder in a glass of water for twenty minutes. A simplified version, they say, also works.

Another remedy for those who can tolerate honey is to drink a glass of honey water in the morning on an empty stomach in the first quarter of an hour after waking up (dilute two teaspoons of honey in a glass of clean water). This should be done daily, the result depends on the severity of the disease and may appear in a month or even six months.

Herbal treatment for cystitis, urethritis, vaginitis involves washing, for example, with chamomile. The decoction for this procedure is prepared as follows: a tablespoon of flowers is poured into an enamel bowl with ½ liter of boiling water and brought to a boil again. Strain warm and use for washing.

You can make sitz baths with chamomile by brewing a larger volume in the proportions of the previous recipe.

For candidal lesions, a decoction for douching or baths can be made with calendula according to the previous recipe.

Lingonberry leaf is used to treat diseases of the excretory system. Lingonberry leaf infusion is prepared by pouring 200 ml of boiling water over a tablespoon of raw material. Leave for an hour, strain and drink three times a day before meals.

Herbal infusion with lingonberry leaves: for three parts of leaves take two parts of violet flowers, fireweed leaves, sage grass, dandelion (the whole plant with the root), one part of mint leaves, chamomile flowers, marshmallow root (all plants should be crushed). Pour a tablespoon of the herbal mixture into a thermos with hot (about 85℃) water. Infuse for an hour. Dosage scheme: on the first day - eight times ¼ cup; then each day the number of doses is reduced by one, until there are four doses left, continue until the symptoms disappear. The infusion can be used for douching and baths.

Pain in the urethra can be reduced by drinking a decoction of linden blossom at night: a pinch of dried raw material is brewed with a glass of boiling water in an enamel bowl and boiled for about 10 minutes.

Homeopathy

Homeopathic treatment of patients with inflammation of the urinary tract of various origins, especially with a history of drug allergy, can give good results. When individually selecting a homeopathic medicine, the background against which the urinary disorder developed is necessarily taken into account. The goal of homeopathic treatment is to increase the individual's defenses and activate the functional abilities of his body. A positive therapeutic effect of homeopathic treatment is possible only with the correct choice of constitutional medicine. For diseases of the genitourinary system, the following is prescribed:

Aconitum (Aconite) is the main drug for acute and suddenly developed cystitis.

Arnica (Arnica) – damage to the urethra as a result of medical procedures and accidental injuries.

Berberis (Barberry) – effective for urolithiasis, including in childhood, prescribed for pain during emptying the bladder in the lumbar-lateral region, burning in the perineum (more on the right side), for patients with gout and arthritis.

Borax (Bora) - is recommended as an effective remedy for candidiasis of the genitourinary organs, especially caused by antibiotic therapy; it is prescribed for difficulties with urination, nocturia, pain during and after urination, pain in the urethra even in between urinations.

Cannabis sativa (hemp) is effective in treating genitourinary pathologies, including pain during urination, purulent, mucous and bloody discharge, frequent urge to empty the bladder, pressing pain during urination, inflammatory processes in the kidneys, excretion of sand and small stones in the urine, phimosis.

Equisetum (Horsetail) – is prescribed for pain during urination in pregnant women and in the postpartum period, with a large amount of mucus and proteins in the urine, pain in the kidneys, bladder, constant urge to empty it, urinary incontinence at any time of the day.

Petroselinum (Parsley) - acute cystitis, urethritis in both sexes, including children, burning and itching inside the urethra, the opening of which is often glued together by secretions; for the stronger sex - the remedy of choice for inflammation and benign neoplasm of the prostate gland. Uva ursi (Bear's ears) - hemorrhagic cystitis, inflammation combined with urolithiasis.

If there are problems with the genitourinary system, other medications may be prescribed; the choice is up to the doctor.

The drug treatment regimens may include pharmacy complex homeopathic remedies, such as Solidago Compositum S. This drug is indicated for acute and chronic urological pathologies, sexually transmitted infections, urolithiasis, gout, allergic diseases, prostatitis and prostate adenoma, urethral strictures and other diseases of the genitourinary system. A multicomponent injection product that includes ingredients of plant, animal, and mineral origin that optimize functions and catalyze metabolic processes in the urinary tract, as well as nosodes related to it. The drug has no contraindications or side effects.

Injections are made in all possible ways (subcutaneously, intradermally, intramuscularly, intravenously, by segments or acupuncture points). The frequency of administration is from one injection per week to three, acute conditions are relieved by daily injections.

The contents of the ampoules can be taken orally. The dosage in all cases is as follows: aged 6-12 years – single administration of 1.5 ml; over 12 years – 2.2 ml (whole ampoule).

Can be used in combination with other drugs.

The following drugs can be prescribed as immunostimulants for pathologies of the genitourinary system.

Echinacea compositum CH is a complex homeopathic medicine containing 24 components. It is indicated for infectious and inflammatory processes of various genesis, including pyelitis, cystitis, glomerulonephritis, decreased immunity and intoxications. Contraindicated in active tuberculosis, blood cancer, HIV infection. Sensitization reactions (skin rashes and hypersalivation) are possible. It is prescribed intramuscularly, one ampoule from one to three injections per week. In rare cases, an increase in body temperature may be observed as a result of immune stimulation, which does not require discontinuation of the drug.

Ubiquinone compositum, a multicomponent homeopathic preparation that normalizes metabolic processes, is prescribed for hypoxia, enzyme and vitamin-mineral deficiency, intoxication, exhaustion, tissue degeneration. The action is based on the activation of immune protection and restoration of the functioning of internal organs due to the components contained in the preparation. It is produced in ampoules for intramuscular administration similar to the previous remedy.

In case of vitamin absorption disorders, for regulation of oxidation-reduction processes, detoxification and restoration of normal metabolism, Coenzyme compositum is used. It is produced in ampoules for intramuscular injection, the principle of its action and application is similar to the previous means.

Surgical treatment

Surgical intervention may be necessary if pain when emptying the bladder is caused by injuries to the genitals or perineum, urethral strictures, or phimosis.

Stones in the kidneys, ureters, and bladder cannot always be dissolved by conservative methods. Then they resort to surgical removal, using contact or remote crushing methods, and sometimes with the help of open surgery.

Neoplasms generally require surgical treatment.

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Complications and consequences

Ignoring or attempting to treat sexually transmitted infections at home leads to undesirable results. In women, gonococcal infection can be complicated by purulent bartholinitis, vaginitis, endocervicitis. Long-term inflammation of the Bartholin glands can end in the development of a tumor process. In men, the most common complications are prostatitis, epidymitis, couperitis, narrowing of the urethra.

Inflammations also complicate other sexually transmitted infections. The consequence of their incorrect treatment or failure to follow all medical recommendations may be infertility in both sexes, in particular, ureaplasmosis causes a decrease in sperm motility.

In pregnant women, sexually transmitted infections lead to miscarriages, fetal death, and premature birth. A newborn child can become infected during childbirth, and there is also a risk of intrauterine infection.

Non-infectious causes of pain when urinating, such as a spontaneous attack of renal colic that is subsequently complicated by hydronephrosis, may result in a rupture of the ureter or kidney necrosis.

The consequences of ignoring or insufficiently thorough treatment of diseases, the symptom of which is sometimes quite harmless and quite moderate pain when emptying the bladder, can lead to very serious consequences requiring urgent surgical intervention.

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Prevention

Preventing the occurrence of pain when urinating consists of following simple rules:

• regular implementation of necessary hygiene procedures, selection of intimate hygiene products that do not irritate the mucous membranes of the genitourinary organs;
• avoiding tight synthetic underwear;
• avoidance of unprotected casual sexual contact;
• periodic sanitation of foci of chronic infections in the body;
• promptly seek medical advice if symptoms of infection appear;
• drinking enough fluids;
• increasing personal stress resistance;
• avoiding hypothermia;
• regular emptying of the bladder.

Maintaining a healthy lifestyle, a balanced diet that includes all the necessary substances for the normal functioning of the body, and physical activity will be the key to good immunity and prevention of problems with urination.

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Forecast

In most cases, pain when emptying the bladder is caused by reasons that can be completely eliminated by timely consultation with a doctor and following his recommendations.

Some diseases such as genital herpes are considered incurable, the formation of stones, gout require compliance with certain recommendations, but do not have a significant impact on work capacity and quality of life.

In general, the prognosis depends on the cause of the symptom.

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