Cutting and burning with urination: what to treat

A healthy person easily controls the process of deurination (emptying the bladder). Normally, during urination, there should be no uncomfortable sensations, and after - usually there is a feeling of relief.

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

[1], [2], [3], [4]

Causes of the cutting with urination

Resi when urinating may appear as a result of inflammatory lesions or mechanical damage to the mucous membrane and submucosal layer of the urethra, its strictures, changes in the chemical composition of urine.

The most common causes of discomfort in the form of cuts during deurination are inflammation of the urethra of bacterial genesis (gonorrhea, chlamydia, mycoplasmosis, ureaplasmosis), as well as viral (herpesvirus, adenovirus), parasitic (due to trichomoniasis) and fungal (Candida) transmitted during sexual intercourse . Candid urethritis, as well as the development of other types of opportunistic flora (ureaplasma), can be a consequence of the course of antibacterial therapy, hormone therapy, the effect of radiation, permanent stresses, 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 in women, but a strong half of humanity is also immune from it. The most common pathogens are E. Coli, streptococci and staphylococci.

Deurination with cutting pain can be observed in women with inflammation of the pelvic organs of various etiologies, most often - with vaginitis, in men - be one of the signs of prostatitis, epidimitis, vesiculitis, phimosis.

Cystitis, urethritis, pyelonephritis can occur due to transferred infectious diseases, for example, angina, sinusitis, purulent abscesses, when the infection enters the urinary organs with blood or lymph flow.

In addition to the infectious causes of inflammation in the urethra and, consequently, cutting pain with urination, there may also be an infectious pathogenesis of this discomfort.

So, the risk factors for the development of congestive urethritis are hemorrhoids, frequent constipation, prostatic hypertrophy, prolonged sexual acts. It develops as a result of circulatory disorders in the vessels of the submucosal layer of the urethra.

Mechanical damage to the mucous membrane of the urethra can result from long-term catheter placement, surgical operations, injuries, and the release of stone and sand fragments in the case of urolithiasis. The development of tumors in the urinary organs sometimes provokes an inflammatory process or blocks the removal of urine from the body.

The chemical composition of urine varies with gout (it concentrates oxalic acid), diabetes mellitus (glucose), as a result of long-term use of certain medications, poisoning with poisonous substances that affect the urinary organs, for example, mercury. Abuse of spicy dishes especially in combination with alcohol can also cause rezi when urinating, however, with the normalization of the diet they quickly pass, however, in patients with gout on this background, a prolonged exacerbation may begin.

"Sweet" urine of diabetics dries out the urethral mucosa, microcracks appear on the surface, and the process of urination becomes painful. Secondary infection may occur, and the condition of the patient is aggravated.

Non-infectious reasons include allergic reactions to means of intimate care, contraception, and linen from synthetic materials. Atopic vaginitis may occur in postmenopausal women.

[5], [6], [7], [8], [9]

Pathogenesis

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

[10], [11], [12], [13], [14]

Epidemiology

Analyzing the prevalence of bacterial urethritis in men, as the most common cause of cuts during deurination, there are gonorrheal urethritis, the incidence of which is just over 40 cases per 100 000 population. Chlamydial urethritis occurs twice as often, the rest of the treatment for the discharge from the urethra was more than 200 cases per 100 000 population. Statistics were provided by medical institutions dealing with genitourinary diseases. In other infectious agents, urethral inflammations in 40-60% of cases are caused by ureaplasma, up to 20% by mycoplasma, and up to 5% by Trichomonas. Viral urethrites were much less common than bacterial ureas: adenoviral - from 2 to 4%, herpesvirus - from 2 to 3%.

The highest incidence of gonorrhea was recorded in the UK (27.6 per 100,000 of the country's population), Latvia and Iceland (18.5 and 14.7, respectively). Greeks, Romanians, Czechs and Spaniards turned out to be the most respectable citizens, who honor family values. In these countries the most insignificant level of morbidity. At the age of 15 to 34 years account for three quarters of reported cases of gonorrhea among the entire population.

It is believed that the cystitis of different genesis was at least one-time carried by about a third of women and every eighth man. Women suffer from cystitis at any age, in males - the peak incidence falls on age over 40-45 years.

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

Urolithiasis occurs in the world at about the same frequency (5-10%), and in the economically developed countries, where protein foods predominate in the diet, the stones are found mainly in the kidneys, and in countries with a lower standard of living or the traditions of plant nutrition, the bladder is the main place of localization of concrements.

[15], [16], [17], [18], [19], [20],

Symptoms

Resi when urinating is most often the hallmark of diseases that spread through sexual contact. Clinical picture of gonorrheic urethritis in males is supplemented by mucopurulent droplet discharge from the urethra, burning and itching. The first signs of the disease may appear on the second or third day after infection, although sometimes the incubation period lasts up to two to three weeks. In men, especially young men, the disease usually proceeds with acute symptoms. With prolonged course of the disease, the symptoms are characteristic after urination.

Female representatives often tolerate the disease without severe symptoms, but in about 30% of cases, characteristic signs are frequent and frequent urination, grayish-whitish purulent discharge, there may be an admixture of mucus. In some cases, the sexuality of the labia and their soreness are noted. Often, gonococci parasitize in Trichomonas, causing heterogeneous infection, which usually occurs with severe symptoms: in male males, gonorrheal symptoms predominate, and female symptoms are predominantly trichomoniasis.

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

The males, basically, after infection become asymptomatic carriers of the disease. Clinical manifestations resemble inflammation of the urethra with droplets of grayish-green discharge.

Rezi when urinating causes an assumption about the possibility of chlamydial infection. Patients of both sexes are marked, transparent and not too abundant. Patients with this may bleed during the intermenstrual period and tenderness in the lower abdomen.

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

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

In male patients, resi before urination are a consequence of inflammation of the urethra. Purulent discharge, accumulating in the canal between urination, glues the lips of the inflamed urethra, causing tension and soreness. When the purulent plug is washed away under the pressure of urine, the discomfort ceases. This symptom is characteristic of gonorrhea, chlamydia, mycoplasmosis and candida urethritis.

The appearance of vaginal discharge (urethra) and stitching during urination is almost always symptoms of a venereal disease. Acute forms in addition to this combination are characterized by very palpable pains - lumbar, inguinal and in the inner thighs. Chronic course is usually manifested by pulling pains in the lower abdomen and discomfort during deurination. It is characterized by alternating exacerbations associated with high nervous and physical stress, colds, intense sexual life, and remissions, when the symptoms almost do not remind themselves.

In women,  urethritis  almost does not occur as an independent disease and is a complication of cervicitis, colpitis or vulvovaginitis. Infection due to the wide and short urethra almost immediately enters the bladder. Cystitis develops - mostly a woman's disease, men suffer extremely seldom. This disease is characterized by pollakiuria (frequent desires during the day) and carvings during urination, persistent and paroxysmal pains over the pubis. Urine is excreted in small portions and there is no feeling of relief and complete emptying of the bladder. Later in the urine can be found traces of pus and blood, it becomes cloudy, incontinence develops.

In persons of both sexes, the urine after urination can also indicate the presence of cystitis, traumas with small calculi, and in women for inflammation of the serous layer of the uterus (perimetritis). In men, at the end of urination, it speaks of narrowing the urethral lumen in combination with cystitis. As a separate sensation, after urinating, it occurs when the internal epithelium of the urethra is damaged. Urine is a physiological fluid, while passing through the urethra channel, the nerve receptors "calm down", however, when released from the liquid, the wounds are exposed and the resists are intensified.

Rezi in the abdomen with urination testify that inflammation from the urethra has spread to the genito-urinary organs. When inflammation of the bladder is characterized by suprapubic localization of pain, irradiating in the groin. The patient has an involuntary desire to alleviate the pain - he urinates, bending and pressing his hands to the stomach.

Cutting and frequent urination  is the main symptom of  cystitis. However, in addition, it can be noted with urolithiasis, when the patient is in an active state; urogenital tuberculosis (in the afternoon); hyperplasia of the prostate (at night and lying down); with the convergence of cardiac and renal edema (at night). Regardless of the time of day - with infectious diseases of genital organs, including - venereal, in combination with secretions; neoplasms compressing the bladder; pregnancy; disposition of the uterus; vesicles; strictures of the urethra; diabetes mellitus. This condition can be the result of hypothermia or a nervous system disorder.

In males, infection of the prostate with active infections or once transferred causes its inflammation. This cause is one of the most common, causing  pain and pain when urinating. In acute inflammation or during exacerbations of chronic chronic constipation pains are observed, giving mainly to the scrotum or perineum, sometimes to the sacral zone of the waist. Their intensity is affected by the change in sexual activity, and the pain can both intensify and weaken. Symptom of prostatitis  can be painful ejaculation and deurination.

In men, when urinating and pain in the side in combination with swelling and flushing of the scrotum, men may appear as a result of inflammation of the epididymitis epididymis. In young men, most often it is caused by venereal infections, in older people - conditionally pathogenic microorganisms, for example, E. Coli. Symptoms grow over time, pains descend into the scrotum, there may be mucopurulent discharge, large bloody inclusions in the urine, high fever and chills.

Rezi with urination and spotting  is a characteristic sign of  urolithiasis  (calculous formations in the bladder), showing themselves pains in combination with frequent urges for deurination during walking, physical exertion, shaking in transport. Kidney stones cause renal colic, with pain in the lumbar region very strong. Rezi in the process of deurination irradiate into the scrotum and labia. In urine, there is a presence of fresh blood without clots.

Back pain and pain when urinating in combination with swelling, the presence of proteins and erythrocytes in the urine can talk about  glomerulonephritis, and if there are also joint pains and inflammations, then - about rheumatoid arthritis.

Symptom of  renal colic  is a sharp pain in the kidneys, when you urinate while passing urine, giving to the perineal region, can talk about the movement of the stone in the kidneys. But if the attack passes, it does not mean that the stone safely left. It can block the ureter, urine accumulates in the kidney. Develops hydronephrosis - a very dangerous condition.

Hematuria  (deurination with blood) is a symptom of many diseases, it is visually possible to notice a macrohematuria when the urine is colored red. Microhematuria is noticeable only when microscopic examination of urine, but from this it does not become less dangerous. Cutting and blood when urinating, dark red, is a symptom of acute cystitis or urogenital infection, especially if the emergence of this trouble (about two weeks) was preceded by unprotected sex. Blood scarlet, which appeared from the very beginning of a painful deurination, is a probable evidence of urethritis. Its presence indicates damage to the vessels located close to the urethra. If a lot of blood with clots is released, and urine is red-brown, then there is kidney bleeding or - from the ureters. Dark color speaks of stagnant phenomena. We can assume the disintegration of the neoplasm in these organs, their trauma. In this case, the resistances and burning are usually absent.

Difficult intermittent urination with blood  testifies to the development of the tumor process in the prostate gland, in particular,  prostate cancer,  prostate adenoma, this is also indicated by the presence of veins of blood in the semen. Hematospermia can be a symptom of inflammation in the urinary organs, prostatitis, and also - just a physiological phenomenon.

The cut in the lower abdomen with urination  can appear in almost all diseases of the genito-urinary organs of infectious and inflammatory genesis. Organic lesions are described above - cystitis, urethritis, urolithiasis, venereal diseases. They are combined with other symptoms already mentioned. Rezi can be moderate, quite tolerable, and can be very intense. Acute cutting pains during bladder emptying 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, it does not detect any impurities in the urine and itchy discharge. Laboratory tests in such pathologies show no anomalies, instrumental diagnostics - too.

Women can feel a strong cutting pain in the area above the pubis and in the process of deurination during acute gynecological pathologies: ectopic (ectopic) pregnancy, sudden rupture of the ovary vessels or twisting the legs of his cyst. The development of these catastrophic conditions occurs suddenly and is characterized by a rapid deterioration of the woman's well-being. In the presence of increasing paroxysmal or pulsating pain, in which the usual medications, for example, no-shpa, baralgin do not bring relief, the appearance of hemorrhagic symptoms (pallor, weakness, dizziness, development of syncope); pulse about 100 beats per minute or more, hypotension; the appearance of symptoms of inflammation of the peritoneum (the gases form, but do not depart, the skin is moist but cold, the frontal wall of the abdominal cavity is painful).

Sometimes such manifestations are reflected. Because of the anatomical proximity of the organs located at the bottom of the peritoneum, they can indicate their acute inflammation (appendicitis, endometrium, adnexitis). When the process of the caecum is located behind the peritoneum near the kidney and / or the ureter, this helps the pain to reach the genitals, and during the emptying of the bladder, rezi appear. The symptom of acute appendicitis is almost always a high fever.

The appearance of the above-described signs should prompt urgently to seek medical help.

Cutting and burning with urination, in addition to the cases already mentioned, can cause a local allergic reaction to unsuitable means for intimate hygiene, synthetic underwear, any brand of pads or condoms. With gout, such feelings refer to additional symptoms, however, microcrystalline uric acid, abundant in urine, damage the urethral mucosa, which leads to discomfort. In diabetics, the constant presence of high glucose in the urine leads to the drying and microcracks of the urethra epithelium.

In most cases,  cutting pain in the emptying of the bladder is  characteristic of local processes and systemic symptomatology is not observed. Nevertheless, especially with acute inflammatory processes in addition to the cuts, high fever, headache, weakness, nausea and vomiting can occur. An increase in body temperature may indicate a beginning purulent complication. In men, the temperature in combination with cuts is usually inherent in acute urethritis, in women - acute cyst. If symptoms have appeared that are typical for general intoxication of the body, you should immediately contact a medical institution.

In men, subfebrile fever in the evenings and rezi when urinating may be symptoms of urogenital tuberculosis. This disease is difficult to diagnose. In cases when it is taken for a venereal infection and treated with appropriate medications, temporary relief comes, but then the disease manifests itself again. In addition to the above symptoms, the patient feels constant weakness, pain in the perineum, irradiating to the lumbar region, he has problems with potency and sweating is observed.

Rez when urinating after intercourse is  most often the result of infection as a result of unprotected sexual intercourse. It can also be a sign of a neoplasm of the bladder, a stricture of the urethra, urolithiasis, disposition of the uterus or vagina, prostatic hyperplasia, diabetes mellitus, or atrophic vaginitis.

Cutting during urination during menstruation  can be provoked by any of the above reasons. Most often - it's cystitis, which in critical days is observed in many women. Thus, any inflammatory process in the pelvic organs that occurs latently can manifest itself. In this period, pathogenic microorganisms migrate unimpeded from the site of inflammation to the bladder, causing clinical signs of cystitis. Deurination with cuts on critical days or after their termination may indicate a laxly current almost asymptomatic inflammation of the internal genital organs or the spread of infection during this period. After all, menstrual blood is an excellent nutrient medium for pathogens.

Rezi in the process of emptying the bladder with menstruation can be a reaction to the use of a new gel for intimate hygiene, tampons and even gaskets of new brands. Perhaps changing the brand of hygiene products quickly enough to get rid of the rubber. From the use of tampons it is generally desirable to refuse or reduce their use to a minimum, changing 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 the bladder is emptied.

Rezi with urination after menstruation  can be interpreted as infection of the bladder in critical days, they indicate poor health in the body. It is advisable not to delay the process and consult a doctor to find out the reason.

The development of cystitis can cause rezi with urination and a delay in menstrual periods. This is a fairly common phenomenon in women. However, not the cystitis itself is the cause of the delay, but the inflammation affecting the ovaries and causing hormonal imbalance. Simply the symptoms of cystitis are more visible and therefore there is an opinion that cystitis can cause a delay in menstruation. Delay in menstrual and discomfort during urination can occur for various reasons: pregnancy, venereal infections. This symptom should alert and force the woman not to postpone the visit to the doctor.

Resi when urinating in the morning  is a special case of painful urination and can occur with erased forms of urethritis, endometritis and myometrium. When infecting with pubic lice, burning and itching during urination can appear only in the morning after a night's sleep.

Frequent urination without rezi is  not always a symptom of the disease, however, the cause is still to find out. Frequently called the number of urination more than 10-15 per day. First, after analyzing your diet and drinks, you need to understand whether this affects the frequency of deurination. The diuretic effect is possessed by coffee, beer, herbal teas and some preparations. Pollakiuria (urge to frequent emptying of the bladder during the day) is observed in women bearing a child, with fluctuations in the hormonal background, in particular, in the climacteric period. This symptom can also indicate the presence of diabetes or urolithiasis, so you need to see a doctor.

Night -  nocturia, can be accompanied by a decrease in the amount of excreted urine during the day (true nocturia), not constant - does not affect daytime deurination. It develops in pathologies of the heart and blood vessels, liver, kidneys, endocrine diseases and others.

The cause of the appearance of the rez when urinating in women can be chronic fatigue, changes in the immune and hormonal status, frequent hypothermia, alcohol and spicy foods, insufficient hygiene procedures or improper technique of their performance. But if this symptom is accompanied by discharge, turbid urine and the presence of blood in it, frequent or incomplete and difficult withdrawal of this physiological fluid, vagina in urination, pain and even slightly subfebrile elevated temperature, you should immediately seek medical advice.

Slurry when urinating in men can have completely innocent reasons, not requiring medical intervention - abuse of alcoholic beverages and / or spicy spicy food, intense sexual intercourse the day before or a minor perineal injury. These manifestations are usually not accompanied by other symptoms and quickly pass on their own.

In men, the neck in the head with urination may indicate the release of small calculous formations, sand and its trauma. Not following carefully the hygiene rules can cause inflammation of the head of the penis and foreskin (balanitis, balanostitis), its consequence can be phimosis - constriction and compaction of the prepuce and inability to expose the head. Possible and the reverse sequence of events - phimosis can lead to inflammation. In this case, the rez when urinating in the head of the penis is accompanied by pains of the whole organ and often - the lower part of the abdomen. The risk factor for the development of balanitis is diabetes, since "sweet urine" is a wonderful breeding ground for the reproduction of microbes.

Resi when urinating in a child

In childhood, urinary tract infection often occurs, which is accompanied by discomfort in the process of deurination. A typical sign of infection in a child is urinary incontinence, both during night sleep and during wakefulness. On the contrary, there may be a stranguria (difficult bladder emptying) or oliguria (discharge of urine drop by drop), urine may have a sharp odor, and also fever (fever, chills), weakness and lack of desire to eat.

In this case, as a result of hypothermia, cystitis often arises, suddenly and acutely. Typical is frequent, every quarter of an hour, and a meager deurination with pain, cuts and burning. The temperature may rise.

In childhood, stones can appear in the kidneys, bladder, ureters. In this case, there are not only rezi in the process of urination, but also symptomatology of renal colic - paroxysmal cutting pains in the lower back or lower abdomen, irritability, vomiting and nausea.

Often in boys there is a phimosis - the inability to expose the head of the penis due to the narrowness of the hole in the foreskin, which causes an inflammatory process, caused by the accumulation of secret in its folds. It is characterized by cuts with urination, localized in the head and foreskin area, secretions with pus, lymph nodes and temperature. When the head of the penis is infringed (paraphimosis), the child experiences severe pain, the squeezed head can turn blue and swell.

Children examine their bodies and often thrust foreign objects into the natural openings of the body, in particular, into the urethra. This also can cause rezi and burning sensation during deurination, and also - it can block the urine output.

Injury of the perineum and genital organs can cause their inflammation. And "adult" bacterial infections suggest that they were preceded by some kind of sexual abuse.

[21]

Rezi when urinating in pregnant women

During this period, the appearance of burning and cutting in the process of deurination is noted much more often. Firstly, this is facilitated by a change in the immune and hormonal status of women in this period, and secondly, the growing uterus presses on the bladder and may arise as a desire to frequent its emptying, and some discomfort. Slurry when urinating during pregnancy can appear from contact with intimate hygiene products, which in the usual state of such a reaction did not cause, and also - a decrease in immunity can trigger the growth of fungal flora and candidiasis. The pressure of the uterus on the bladder can provoke relapses of chronic diseases of the genitourinary sphere.

However, in addition to physiological reasons, this phenomenon can be a sign of dozing infectious and non-infectious diseases, which can be dangerous to both the mother and her unborn baby. Therefore, when you see cuts, you need to report them to the doctor. The most likely pathological causes of this symptom are urolithiasis, cystitis, inflammation of the internal genital organs, and other diseases.

Appearance of additional signs that should induce, without delay, to seek medical help, such as pain and other discomfort in the lower abdomen, pollakiuria (nocturia), a feeling of incomplete bladder release after deurination, color changes, turbidity and a sharp smell of urine.

A considerable number of women have rez when they urinate after giving birth. The most likely cause is cystitis. Its development is favored by: bladder overflow, associated with rare deurination, infection, changes in the immune and hormonal status, circulatory disorders in the pelvic organs. Risk factors for pathological cuts are hypothermia and postpartum catheterization. This discomfort with deurination in the puerperium can occur due to other causes, so the appearance of this symptom requires diagnosis and treatment.

Resi when urinating after Caesarean is accompanied by a variety of infectious and chronic diseases, aggravated by surgical manipulation. The weakened organism of a woman after the intervention is susceptible to infections. Resi can be observed in any interval of deurination, after it, or at urge. Urine can also change color and transparency. With catarrhal cystitis in the fluid, mucus fragments are observed, purulent fragments impart a turbidity to urine, hemorrhagic cystitis is diagnosed when there is blood in the urine.

Diagnostics of the cutting with urination

The appearance of all sorts of unusual and uncomfortable sensations during the emptying of the bladder should prompt the medical institution to go through a thorough examination and establish the causes of their occurrence. Timely diagnosis is the key to successful treatment.

After visual inspection and talking with the patient, the doctor prescribes tests: clinical - blood and urine.

With the help of a clinical blood test, you can identify the presence of an inflammatory process, a violation of hematopoiesis. Immunoenzyme analysis of blood, allows you to detect antibodies to various pathogens of infection of bacteriological and viral origin.

Clinical analysis of urine allows you to identify traces of blood and mucus, white blood cells and other components that should not normally be present. If this analysis shows deviations in the composition of urine, assign specific urological analyzes of urine according to Nechiporenko, according to Zimnitsky.

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

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

Instrumental diagnostics for complaints about rezi in the process of urination consists in an ultrasound study that provides a visual representation of the internal sexual and urinary organs, the presence or absence of cysts, tumors, hyperplasia, and calculi. Tomography, computer or magnetic resonance, allows a more detailed study of the affected organ, cystourethroscopy - the inner epithelium of the bladder and urethra.

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

[22], [23], [24], [25], [26]

Differential diagnosis

Differential diagnosis is based on the results of all laboratory and instrumental studies. Carefully conducted examinations will help to identify the cause of the cuts and timely prescribe the treatment of a venereal or gynecological disease, remove concrements or tumors.

[27], [28], [29], [30], [31]

Treatment of the cutting with urination

Rezy with urination can be caused by a variety of causes, so treatment of inflammation in the urethra implies a variety of therapeutic techniques. Medications used in the treatment of micturition pathology are prescribed depending on the detected pathogens of inflammation. Most often in the treatment schemes used antibacterial, fungicidal and antiviral drugs, necessarily stimulate the immune system, additionally designate local procedures - instillations.

Acute inflammations give in to intensive treatment faster than chronic ones. Therapy is started immediately with drugs that must destroy the causative agent of the infection. In chronic forms, immunomodulators are first appointed, and later they begin the main treatment aimed at eradicating a pathogenic microorganism. The most common urethritis (cervicitis) appears after unprotected sexual contact. To effectively cure the disease, the treatment regimen is appointed individually, taking into account the sensitivity of the microorganism to certain drugs and the tolerability of the drug by the patient. If a patient has a combined form of infection, this is also taken into account when prescribing drugs. It must also be remembered that all sexual partners also need treatment.

With gonorrheic urethritis, Cefaclor  or  Spectinomycin are most commonly prescribed  . The first of them - a preparation of a cephalosporin series of a bactericidal type of action, belongs to the second generation. Oppressing the process of reproduction of gonococci, preventing the formation of their cell membranes, which leads to the death of pathogenic flora. It is active in many kinds of bacteria capable of infecting the genitourinary system, in particular streptococci, staphylococci, Escherichia coli (the most likely causative agent of cystitis). It is produced in capsules and granules for the manufacture of suspension, can be prescribed from infancy. With gonorrheal urethritis, patients older than 10 years are prescribed a single dose of 3 g, children - dosed individually. Antibacterial action is strengthened in combination with metronidazole, which is valuable in gonorrhea-trichomoniasis urethritis. But in combination with tetracyclines, which are often prescribed for chlamydia, the bacterial effect is reduced.

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

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

When trichomonads are detected , Metronidazole is administered to patients  , often in the form of candles, which provides a good therapeutic effect in combination with the lack of systemic action on the body. Suppositories are used once a day before bedtime, usually for ten days. These suppositories are not given to pregnant and lactating women, patients with hematopoietic disorders and nervous system disorders.

Mycoplasma and chlamydia are sensitive to  tetracycline  and its derivatives. This is a classic antibacterial drug, which has a wide range of applications, it is prescribed for gonococcal infection. Dosage individually depending on the form of release of the drug and the type of bacterial infection. Adults daily dose should not exceed two grams. Children over the age of seven are prescribed in the form of a suspension. Has many side effects, can cause allergic reactions, photosensitization and candidiasis of mucous membranes.

At present, many strains of bacteria resistant to tetracyclines have appeared. Therefore, in the treatment of bacterial urethritis used drugs from the group of fluoroquinolones, for example,  Pefloxacin,  showing activity for chlamydia, mycoplasma, gonococcus, ureaplasma, E. Coli, staphylococci and streptococci. The active ingredient of the drug blocks the construction of a chain of bacterial DNA, causing their death. Effective with infection of the genitourinary system. Assign both inside and in the form of drip intravenous infusions over the age of 15 years. Contraindicated in pregnant and lactating women. In the treatment of infectious diseases of the urinary tract 400 mg is applied once.

Candidiasis (thrush) is treated with antifungal agents. Levorin  is used either orally in the form of tablets, or externally in the form of ointments and aqueous suspensions. To this agent, pathogens of candidiasis and Trichomonas are sensitive. It is virtually non-toxic and does not accumulate in the body. Due to the use, cough and hyperthermia may develop. Orally not prescribed for acute intestinal infections, liver diseases, gastroduodenal ulcers, aqueous suspensions - with uterine bleeding. A two-three-hour appointment of 400-500 thousand units is 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.

With nonspecific inflammations of the urethra, antibacterial agents with a wide range of activity are prescribed.

When lesions with herpesvirus or adenovirus infection, drugs with antiviral action are prescribed. For example,  Neovir, which inhibits the development of viruses in cells by activating the production of endogenous interferon by the body. The drug is effective in chlamydia and candidiasis. It is not prescribed for children, pregnant and lactating women, for autoimmune diseases. In the period of admission, the body temperature may rise to subfebrile indicators, an allergy in the form of urticaria. Tablets are swallowed whole every 48 hours at 0.75 g, intramuscularly - at 0.25 g with the same time interval.

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

Monural is  used for acute bacterial cystitis, nonspecific 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 about two days. During this time, urine sterilization takes place. Adult patients take a single dose of 3g. Children older than five years - 2d.

To remove the pain syndrome appoint funds that relax the muscles of the bladder (No-shpa), painkillers (Ketorolac, Benzocaine).

With the formation of phosphate and oxalate stones, gout is prescribed therapy with  Cyston.  It is a multicomponent preparation containing plant extracts and having the ability to relieve inflammation, reduce the likelihood of crystalline formations and cause their microbreeding. The drug has a certain antimicrobial and spasmolytic activity. Rare cases of sensitization to the ingredients of the drug have been reported. Can be used during pregnancy and lactation.

Mikrodroblenie and the withdrawal of crystalline formations: the drug is taken three times a day after meals, children 2-5 years - a half tablet; 6-13 years - one tablet. Patients older than 14 years - two tablets. Such dosages are taken within three or four months.

To continue treatment, the drug is dosed in the following way: children 2-5 years - on a quarter of the tablet; 6-13 years - a half tablet. Patients older than 14 years - one whole tablet. A reduced dose is taken twice a day. The reception is carried out until the excreta is completely removed from the body.

Infectious lesions of the urinary tract: the drug is taken three times a day after meals, children 2-5 years - a half tablet; 6-13 years - one tablet. Patients older than 14 years - two tablets. Duration of treatment - from a month to a year and a half. Relapses of the disease require the following dosing: children 2-5 years - on quaternary tablets; 6-13 years - a half tablet. Patients older than 14 years - one whole tablet. Admission is threefold for 1.5-3 months.

Acute renal colic is stopped by a threefold method: children 2-5 years - on a half tablet; 6-13 years - one tablet. Patients older than 14 years - two tablets. Take before the disappearance of symptoms.

For prophylactic purposes, the drug is taken three times a day for four to five months in dosages: children 2-5 years - on a quarter of a tablet; 6-13 years - a half tablet. Patients older than 14 years - one whole tablet.

In all cases, patients are assigned funds that enhance immunity. Galavit  is an immunostimulating drug that simultaneously has a strong anti-inflammatory effect. By regulating the activity of macrophages, it improves the resistance of the organism to infections and blocks the production of pro-inflammatory agents. Contraindicated in pregnant women and persons sensitized to its ingredients. Side effects are not fixed. Possible simultaneous reception with any medications. Rectal suppositories Galavit is prescribed in cases of urogenital infections according to the following scheme: two units (2 g) - the initial dose, then one suppository twice or thrice a day before the symptomatology is eliminated, then every three days one suppository. In total, up to 25 rectal suppositories are taken for treatment.

Noninfectious diseases of the genitourinary sphere are treated according to the scheme: the first two days - two suppositories (2g) once a day; then every three days for one suppository. In total, 15-25 rectal suppositories are taken for treatment.

In the treatment of diseases that cause rez when urinating, prescribe vitamins C, E, group B.

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

Physiotherapeutic treatment during the acute period is not carried out. During the recovery period, the physical procedures will be very useful. With urethritis, cystitis, electrophoresis with antibiotics can be prescribed, which allows them to be delivered quickly and painlessly. Ultrafrequency therapy, warming by high-frequency currents (diathermy) improves blood circulation in organs and local immunity.

Applicable magnetic, laser, microwave and ultrasound therapy. Methods of treatment are selected individually taking into account anamnesis, tolerability, concomitant diseases.

Alternative treatment

With venereal infections, it is hardly possible to cope with alternative drugs, nonspecific urethritis and cystitis also go much faster with medical therapy. Using exclusively alternative means, it is possible to muffle symptoms slightly and to transfer an acute disease into a chronic one. However, in complex treatment schemes there is a place for the use of alternative medicine.

Inflammation of the urinary organs is treated well by all familiar parsley and dill.

It is useful to drink fresh parsley juice. It is squeezed out of stems with leaves and roots, well-peeled and crushed with a blender. Take juice on a tablespoon during recovery, it has anti-inflammatory and diuretic action, contains vitamins B and ascorbic acid, but with severe forms of urolithiasis in combination with the inflammatory process, and also - pregnant women it is better not to use it.

But the infusion of parsley can be treated with cystitis in any case, except for allergies to this plant. Prepare the infusion as follows: a tablespoon of chopped green pour two cups of cold boiled water. Water is not allowed to boil for a long time and is turned off when small bubbles begin to rise to the surface and cool. Insist from eight to ten hours, the portion is intended for consumption for one day.

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

For the treatment of urethritis, it is recommended to prepare a decoction of parsley on milk. Parsley is spread on the bottom of the enameled pot and poured with milk to cover. Boil and boil for five minutes, making sure that the milk does not "run away." Cool, drain, take two tablespoons every two to three hours.

Powder from parsley seeds on the tip of the knife can be taken twice or thrice a day.

Seeds of dill are also used in the treatment of cystitis. Of these, infusion is made: one tablespoon of dry, ground on a coffee grinder into a flour, the seeds are covered in a thermos bottle and poured 200ml of boiling water, let it stand for at least two hours. Take 100ml once or twice a day.

Or a decoction: in the same proportion, the seeds are poured with boiling water and are doused in a water bath for a quarter of an hour, filtered and take ½ cup four to five times a day.

Seeds of dill are contraindicated for persons with low blood pressure and gallbladder pathologies.

The most, perhaps, simple remedy for urolithiasis is the daily use of tea from the rind of apples. It can be both fresh and dried. The main thing is to drink it every day. A more accurate recipe for this tea is as follows: dry apple peel, grind into powder and brew two teaspoons of powder in a glass of water for twenty minutes. The simplified version, it is claimed, also works.

Another remedy for those who suffer from honey - in the morning on an empty stomach in the first quarter of an hour after awakening to drink a glass of honey water (two teaspoons of honey diluted in a glass of clean water). Do this every day, the result depends on the neglect of the disease and can manifest itself in a month and six months.

Treatment with herbs for cystitis, urethritis, vaginitis involves the erosion, for example, chamomile. Decoction for this procedure is prepared in the following way: a tablespoon of flowers are poured into enameled dishes of ½ liter of boiling water and brought again to a boil. Filter the warm and use for washing.

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

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

In the treatment of diseases of excretory system, a leaf of cranberries is used. Infusion of cranberry leaf is prepared by filling a tablespoon of raw material with boiling water in a volume of 200ml. Hold the hour, strain and drink for three meals during the day before eating.

Herbaceous leaves with cowberry leaves: two pieces of leaves are taken: violet flowers, ivan tea leaves, sage grass, dandelion (the whole plant with a root), one leaves of mint, chamomile flowers, althea root (all plants must be crushed ). A tablespoon of phyto-mixture is poured in a thermos of hot (about 85 ℃) water. Insist an hour. Scheme of admission: on the first day - eight times for ¼ cup; then every day the number of receptions is reduced by one until four receptions remain, continue until the symptoms disappear. Infusion can be used for bathing and washing.

Pain in the urethra can be reduced by drinking a decoction of lime-colored decoction overnight: a pinch of dried raw material is brewed with a glass of boiling water in an enameled pot and boiled for about 10 minutes.

Homeopathy

Good results can be given homeopathic treatment of patients with inflammation of the urinary tract of various genesis, especially with a history of medicated medical allergy. With an individual selection of homeopathic medicine, it is necessary to take into account the background of the urinary disorder. The goal of homeopathic treatment is to increase the protective forces of the individual and to activate the functional abilities of his organism. The positive therapeutic effect of homeopathic treatment is possible only with the correct choice of a constitutional drug. When diseases of the genitourinary system are prescribed:

Aconitum (Aconite) - the main drug for acute and sudden development of cystitis.

Arnica (Arnica) - damage to the urethra as a result of medical manipulation and accidental trauma.

Berberis (Barbaris) - effective in urolithiasis, and in childhood, is prescribed for pain during the emptying of the bladder in the lumbar-lateral area, burning in the perineum (more on the right side), patients with gout and arthritis.

Borax (Bura) - is recommended as an effective agent for candidiasis of the genito-urinary organs, especially caused by atibiotikoterapii; appointed with difficulty with urination, nocturia, cuts with and after urination, tenderness of the urethra, even in the intervals between deurinations.

Cannabis sativa (Cannabis) is effective in the pathology of the genitourinary sphere, including rezi during deurination, purulent, mucous and bloody discharge, frequent urge to empty the bladder, pressing pain during deurination, inflammatory processes in the kidneys, excretion of sand and small concrements with urine, phimosis.

Equisetum (Horsetail) - is prescribed when cutting in the process of urination to pregnant women and in the postpartum period, with a large amount of mucus and proteins in the urine, pain in the kidneys, bladder, constant calls for emptying, urinary incontinence at any time of the day.

Petroselinum (Parsley) - acute cystitis, urethritis in persons of both sexes, including in children, rubbing and itching inside the urethra, the opening of which is often glued together with excreta; for representatives of the stronger sex - a means of choice for inflammation and benign neoplasm of the prostate. Uva ursi (Honey ears) - hemorrhagic cystitis, inflammation in combination with urolithiasis.

In case of problems with the organs of the genitourinary system, other drugs may be prescribed, a choice for the doctor.

Pharmaceutical complex homeopathic remedies, for example, Solidago Compositum S, may be included in drug treatment regimens  .  This drug is indicated for acute and chronic urological pathologies, infectious diseases transmitted through sexual contact, urolithiasis, gout, allergic diseases, prostatitis and prostate adenoma, strictures urethra and other diseases of the genitourinary sphere. Multicomponent means for injections, including ingredients of vegetable, animal, mineral origin, optimizing functions and catalyzing the processes of urinary tract metabolism, as well as nosodes related to it. The drug does not register any contraindications and side effects.

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

You can take the contents of the ampoules inside. Dosed in all cases as follows: at the age of 6-12 years - a single injection of 1.5 ml; over 12 years - 2.2ml (whole ampoule).

Possible application in combination with other drugs.

As immunostimulating agents in pathologies of the urogenital system, the following drugs can be prescribed.

Echinacea compositum CH  is a complex homeopathic medicine containing 24 components. It is shown in infectious and inflammatory processes of various genesis, including pyelitis, cystitis, glomerulonephritis, immunity decline and intoxication. Contraindicated with active tuberculosis, blood cancer, HIV infection. Possible reactions of sensitization (skin rashes and hypersalivation). It is prescribed intramuscularly for one ampoule from one to three injections per week. In rare cases, there may be an increase in body temperature as a consequence of stimulation of immunity, which does not require the withdrawal of the drug.

Ubiquinone compositum, a multicomponent homeopathic preparation, normalizing metabolic processes, is prescribed for hypoxia, enzymatic and vitamin-mineral deficiency, intoxication, exhaustion, tissue degeneration. The action is based on the activation of immune defense and restoration of the functioning of internal organs due to the components contained in the preparation. Produced in ampoules for intramuscular injection is similar to the previous agent.

If the absorption of vitamins is impaired, Coenzyme compositum is used to regulate oxidation-reduction processes, detoxify and restore normal metabolism  .  It is produced in ampoules for intramuscular injection, the principle of its action and application is similar to the previous ones.

Surgery

Intervention surgeon may be necessary if the rezi during the emptying of the bladder caused by trauma to the genitals or perineum, with urethral strictures, phimosis.

Stones in the kidneys, ureters, bladder can not always be dissolved by conservative methods. Then resort to their removal by surgical means, using methods of contact or remote crushing, and sometimes - and with the help of open surgical intervention.

Neoplasms, in general, require surgical treatment.

[32], [33], [34], [35], [36], [37], [38], [39]

Complications and consequences

Ignoring or trying 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 result in the development of a tumor process. In men, the most common complications are prostatitis, epidemitis, cupernitis, narrowing of the urethra.

Inflammations complicate and other infections that spread sexually. The consequence of their incorrect treatment or non-compliance with all medical recommendations can be infertility in people of both sexes, in particular, ureaplasmosis causes a decrease in sperm motility.

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

Non-infectious causes of cuts during urination, for example, a self-initiated attack of renal colic, complicated later by hydronephrosis, can result in ureteral rupture or kidney necrosis.

The consequences of ignoring or insufficiently careful treatment of diseases, the symptom of which are sometimes quite innocuous and quite moderate rezi during the emptying of the bladder, can lead to very serious consequences requiring urgent surgical intervention.

[40], [41], [42],

Prevention

Prevention of the emergence of cuts during urination consists in following simple rules:

• regular carrying out of necessary hygienic procedures, selection of means for intimate hygiene, not causing irritation of mucous membranes of urinogenital organs;
• refusal of close synthetic linen;
• exclusion of unprotected casual sexual contacts;
• periodic sanitation of foci of chronic infections in the body;
• timely application for medical advice in case of symptoms of infection;
• fluid intake in sufficient quantity;
• increased personal stress resistance;
• avoidance of hypothermia;
• regular emptying of the bladder.

Maintaining a healthy lifestyle, nutrition, including all the necessary substances for the normal functioning of the body, physical activity will be a pledge of good immunity and prevention of problems with urination.

[43], [44], [45], [46], [47], [48]

Forecast

In most cases, rezi when emptying the bladder are caused by the causes, which can be completely eliminated if the doctor calls on the doctor in time and follows his recommendations.

Some diseases such as genital herpes are considered incurable, the formation of concrements, gout require compliance with certain recommendations, but they have no significant effect on the ability to work and quality of life.

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

[49], [50], [51], [52], [53]