Urethral pain

Urethral pain accompanies urethritis, concretions, foreign bodies, traumatic injuries, benign and malignant neoplasms of the urethra. It is detected in conditions accompanied by chronic urethral obstruction, some andrological and gynecological pathologies. Most often it has a cutting character, is associated with urination. To determine the cause of the symptom, complaints are collected, an external examination, imaging and laboratory tests are carried out. Treatment includes antibacterial agents, NSAIDs, immunostimulants, physiotherapy, surgical interventions.

Why does the urethra hurt
Urethritis
Urethral stones
Foreign bodies and injuries
Neoplasms
Chronic obstruction
Urethral diverticula
Prolapse of the urethral mucosa
Other urological pathologies
Andrological diseases
Women’s diseases
Diagnostics
Treatment
Conservative therapy
Surgical treatment
Prices for treatment
Why does the urethra hurt
Urethritis
Urethritis is a group of diseases, usually having an infectious nature. Less often, pathology develops against the background of allergies, toxic or radiation exposure. The main manifestations are itching, burning and pain during urination, pathological discharge from the urethra. The clinical picture varies somewhat depending on the type of pathogen:

Nonspecific urethritis. In acute primary inflammation, the symptoms are moderately pronounced, the discharge is mucopurulent or purulent in nature. In patients with chronic urethritis, pain may be absent, minor burning and itching are noted. Secondary inflammation occurs against the background of common infections, accompanied by mild soreness during urination, scanty mucopurulent secretions.
Gonorrhea. Signs appear 3-7 days after sexual contact with an infected partner or (less often) domestic infection. Acute urethritis manifests suddenly. It is manifested by cuts, pains and burning in combination with copious purulent grayish-yellow creamy secretions. When the process spreads to the posterior part of the canal in men, the body temperature rises to febrile figures. In the chronic form, tingling pains occur only at the beginning of urination.
Trichomoniasis and chlamydia. For these variants, an obliterated low-symptom course is typical. Itching and burning prevail, soreness is insignificant or absent. With trichomoniasis, the discharge is foamy, whitish, with chlamydia – yellowish, watery or mucopurulent. Patients with chlamydia may develop Reiter’s syndrome.
Candidal urethritis. It also proceeds with little symptoms. Mild itching and slight burning sensation are complemented by scanty whitish discharge, sometimes – short-term non-intense painful sensations when urinating.
Nonspecific bacterial, less often specific inflammation occurs not only in adults, but also in young patients. Pathology is most susceptible to patients aged 2-4 years. Urethritis in children is manifested by pain and burning during urine discharge, sometimes by dull pulling pain in the lower abdomen. Sudden painful urges, frequent urination, including at night, are possible.

Urethral stones
Men suffer more often. Secondary concretions that descend into the lumen of the urethra from the kidneys or bladder predominate. Traumatization of the walls of the organ by a moving stone is accompanied by sudden intense sharp pain. There are difficulties in urination, weakening and dispersion of the jet, hematuria. Complete obturation is manifested by acute urinary retention. Men with concretions of the posterior urethra complain of pain when sitting and walking.

Foreign bodies and injuries
Foreign objects in the urethra are more often found in children and young men. The first category introduces foreign bodies out of curiosity, the second – during masturbation. With small smooth objects, slight soreness and discomfort are observed, which gradually decrease, but reappear with sexual arousal and urination.

Sharp and large objects cause sharp pain, strong urges, pronounced anxiety, hematuria, with obstruction of the urethra – spotting. Subsequently, urethritis often develops with pain and burning in the urethra, perineum and penis, general hyperthermia, intoxication syndrome.

Men also predominate among the injured. In half of the cases, pathology occurs with severe pelvic fractures. Incomplete rupture is characterized by acute pain, pain, difficulty urinating, blood in the first portion of urine, hematomas of the scrotum and perineum. With complete ruptures, urine does not leave. Patients complain of sharp pain in the urethra and lower abdomen, inconclusive imperative urges.

Urethral pain
Neoplasms
Epithelial (condylomas, papillomas) and non-epithelial (fibroids, fibroids, angiomas, etc.) benign tumors are asymptomatic for a long time. Then itching and burning, discomfort and pain during urination, jet changes, contact spotting and blood impurities in the urine appear and slowly increase. When infected, the pain syndrome increases, there are pains. Dyspareunia is possible in women.

Polyps occur more often in people over 45 years of age. The clinical manifestations resemble urethritis or cystitis. Burning and painful sensations in the urethra appear during the discharge of urine, during walking and sexual contacts. A type of polyp is a caruncle that develops in women during menopause. There is pain during and after the completion of urination, increased urge, splashing of the jet, sometimes – urethrorrhagia. Pathology is often complicated by prolonged severe cystitis and urethritis, pronounced dyspareunia.

Malignant tumors in men are characterized by difficulty urinating, the presence of compaction, urethrorrhagia, pus-like discharge. Pains appear during the spread of the process, radiate into the perineum, are combined with swelling of the penis and scrotum, inguinal lymphadenitis. In women with urethral cancer, soreness and burning in the urethra, dyspareunia, urethrorrhagia, urinary incontinence are observed. When neoplasia passes to the vagina, pain occurs over the womb.

Chronic obstruction
It is formed with valves and strictures of the urethra. Urethral valves are more common in early childhood, less common in adult men who have undergone urological surgery and manipulation. Patients are concerned about moderate painful sensations during urination, sluggishness of the jet, nocturnal urges. Among patients with urethral strictures, there is a 2-4-fold predominance of men. Pain is an optional symptom, it occurs against the background of weakening and splashing of the jet, feelings of incomplete emptying of the detrusor.

Urethral diverticula
Pain in the urethra and inguinal-iliac region, combined with incontinence, pollakiuria, dysuria are noted with a complicated course of diverticula. Typically, difficult painful urination in an intermittent stream with the retention of urges and leakage of urine even after emptying the bladder. Pyuria and hematuria are possible. Large diverticula complicate sexual intercourse due to swelling and pain in the vagina.

Prolapse of the urethral mucosa
It is diagnosed in adolescent girls and women of menopausal age. Patients complain of a feeling of a foreign body, followed by burning and pain. In the area of the external opening of the urethra, a painful cyanotic or pinkish dense formation is revealed. Painful, frequent urges are noted, urinary incontinence is possible. With swelling of the mucous membrane, acute ischuria develops.

Other urological pathologies
Pains and cuts in the urethra are accompanied by many diseases of the bladder:

Cystitis: acute, chronic, postcoital, interstitial.
Volumetric formations: urachus cysts, benign tumors, carcinomas.
Emergency conditions: traumatic injuries and foreign bodies of the bladder, acute urinary retention, paracystitis.
Cystolithiasis.
Andrological diseases
Pain in the urethra is especially pronounced in acute prostatitis. It is combined with pain in the perineum and sacrum area, sometimes radiates into the anus. There is pain and increased urination, possible urinary retention, difficulty defecating. With chronic prostatitis, pain in the urethra, above the pubis, in the groin and perineum is aching, constant, and increases at the initial and final stages of urination.

Pain in the urethra with prostatitis in children appears during urination, supplemented by constant pulling pains and discomfort in the perineum, lower abdomen, giving into the scrotum and rectum. Along with prostatitis, soreness in the urethra sometimes accompanies prostate cancer and prostate adenoma, which develop mainly in old age. Pain occurs during ejaculation or urination. Combined with pain in the pelvis, perineum, over the pubis, dysuria and ischuria.

Women’s diseases
80% of women with paraurethral cysts have frequent urges, urethral soreness, pain, burning, mucous discharge from the urethra. An elastic formation can be felt in the meatus zone. Vestibulovaginal hypospadias can be another cause of pain, severe discomfort, burning and pain during urine discharge.

Urethrocystoscopy
Urethrocystoscopy
Diagnostics
Diagnostic measures are carried out by a urologist. If necessary, patients are referred to an andrologist, gynecologist or oncologist. The specialist collects complaints, finds out the anamnesis of life, establishes the circumstances of the appearance and nature of painful sensations, the presence of other symptoms, the dynamics of the development of the disease. Women are examined on a chair. According to the indications, men are prescribed a finger examination of the rectum. The diagnostic action plan includes the following procedures:

Ultrasonography. Ultrasound of the urethra is informative for injuries, diverticula, foreign bodies, tumors, concretions. To obtain more complete data on the state of the urinary tract, to exclude damage to the overlying departments, ultrasound of the bladder is prescribed. Women perform ultrasound of the pelvic organs. Men have an ultrasound of the prostate.
X-ray examination. Retrograde urethrography is recommended for traumatic injuries, diverticulitis, benign and malignant neoplasia, concretions. In some cases, descending urethrography, excretory urography, prostatography, cystography, pelvic radiography are indicated.
Other visualization techniques. They are mainly used for malignant tumors. Conducted to clarify the localization and prevalence of the pathological process, the involvement of neighboring organs. The list of diagnostic manipulations may include abdominal MRI, lymphadenography, etc.
Laboratory tests. Urine tests are the most indicative. Leukocyturia, hematuria, bacteriuria, proteinuria can be detected in OAM. According to the data of a three-glass sample, the level of lesion is determined. The nature of the microflora is assessed by microscopy. To clarify the type of pathogen and its sensitivity to antibiotics, a microbiological study is carried out. For STIs, PCR and ELISA are prescribed. The type and degree of differentiation of neoplasias are determined during histological analysis.
Treatment
Conservative therapy
The list of therapeutic measures is determined by the features of the pathological process:

Urethritis. Antibiotics are prescribed for acute nonspecific and gonorrheal urethritis, antibacterial therapy is supplemented with corticosteroids for chlamydia, antiprotozoal agents are used for trichomoniasis, and antimycotic agents for candidiasis. Chronic inflammation is an indication for complex therapy, which, along with the listed drugs, provides for instillation of silver nitrate and collargol.
Injuries and foreign bodies. Sprains and bruises of the urethra are subject to conservative treatment. Cold, rest, NSAIDs, hemostatic agents, tranquilizers, drugs with sedative effect, preventive antibiotic therapy are recommended. Small foreign objects are sometimes successfully removed with urine current, using special techniques.
Mucosal prolapse. Warm sedentary baths are used to relieve swelling. In mild cases, bladder catheterization is performed for a period of 10-12 days. Manipulation allows not only to set the urethra, but also to fix the mucous membrane, preventing further loss.
Prostatitis. Long-term antibiotic therapy is carried out, with a persistent course, immunostimulants are used. Non-drug measures include prostate massage, electromagnetic vibrations, ultrasound, laser exposure. If there are contraindications to physiotherapy, medicinal microclysms are performed.
Malignant tumors. Chemotherapy, remote or contact radiation therapy may be required.
Surgical treatment
For urological diseases , the following surgical techniques are used:

Stones of the urethra: endoscopic removal, epicystostomy and cystotomy to extract concretions from the posterior urethra.
Traumatic injuries: suprapubic epicystostomy, primary urethrourethroanastomosis, delayed urethral plastic surgery on a catheter.
Foreign bodies: transurethral removal, surgical removal by dissecting the urethra or moving an object into the bladder and subsequent cystotomy.
Tumors: chemical destruction, electrocoagulation, plasma coagulation, laser or radio wave removal of condylomas, transurethral resection, circular resection, cystectomy, cystoprostectomy, amputation of the penis.
Chronic obstruction: urethrocystoanastomosis or endourethral resection of valves, augmentation, stenting or resection of the urethra, urethrotomy.
Diverticula: marsupialization, transurethral or transvaginal diverticulectomy.
Prolapse: sling urethropexy, mucosal plication or resection.
Patients with prostate adenoma undergo transurethral resection, laser vaporization or laser enucleation. According to the indications, a trans-bubble or posadilon adenomectomy is performed. In case of prostate cancer, various variants of prostatectomy are used. Paraurethral cysts in women are removed by excision. In female hypospadias, non-surgical plastic surgery using hyaluronic acid or urethral transposition is performed.

Post Views: 516

Urethral pain

Urethral pain

Cellulite

Micromastia

Small buttocks

Most Popular

WHO: 1 billion people in the world are served by medical institutions without reliable power supply

Gastritis symptoms and what is it

Diarrhea

Rectal prolapse

Recent Comments