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Urethral Inflammation

Urethritis is infection and inflammation of the lining of the urethra the narrow tube that carries urine out of the body and which in men also carries semen. Urethritis is caused by bacteria and may involve the bladder prostate and reproductive organs. It can affect males and females of all ages; females are at higher risk.

Signs and Symptoms

In both sexes but particularly in women the disease may not show symptoms. When it does symptoms include the following.

In men:

bulletBurning during urination
bulletPus or whitish mucous discharge from the penis
bulletBurning or itching around the penile opening

In women:

bulletPainful urination
bulletUnusual vaginal discharge

What Causes It?

bulletBacteria and other organisms entering the urethra
bulletBruising during sexual intercourse (in women)
bulletInfection reaching the urethra from the prostate gland or through the penis opening (in men)
bulletBacterial infection after you have taken a course of antibiotics
bulletReiter's syndrome
bulletSexually transmitted diseases (STDs) such as chlamydia syphilis or HIV/AIDS

What to Expect at Your Provider's Office

A physical examination of your genitals will be necessary and laboratory tests will be done on a urine sample and a specimen of mucus taken from inside the urethra and in women the vagina.

Treatment Options

Treatment Plan

Treatment includes antibiotics or other medications to kill the infection. Sex partners should be treated as well. It is important to refraining from sexual activity until the treatment is completed because infections can remain active even after your symptoms have disappeared. This will help prevent reinfection.

Drug Therapies

Prescription

Antibiotics:

bulletTetracycline erythromycin—for urethritis
bulletCeftriaxone olfoxacin ciprolfoxacin—for Neisseria gonorrhoeae
bulletDoxycycline olfoxacin—for Chlamydia trachomatis

For protozoa infection:

bulletMetronidazole clindamycin—for Trichomonas

Antiviral:

bulletAcyclovir famciclovir valacyclovir—for herpes simplex

Over the Counter

N/A

Complementary and Alternative Therapies

Nutrition herbs and homeopathic remedies are useful in fighting infection relieving pain and stengthening the urinary system.

Nutrition

You can make the following changes in your diet to help treat urethritis.

bulletEliminate any known food allergens.
bulletEliminate refined foods sweetened fruit juices caffeine alcohol and sugar which may compromise immunity and irritate the urinary tract.
bulletCranberries and blueberries are helpful because they contain substances that stop bacteria from adhering to the urinary tract.
bulletVitamin C (1 000 mg three times per day) makes your urine more acidic which keeps bacteria from growing.
bulletBeta-carotene (25 000 to 50 000 IU per day) is necessary for immune function and healthy mucous membranes.
bulletZinc (30 to 50 mg per day) helps your immune system .

Herbs

Herbs may be used as dried extracts (capsules powders teas) glycerites (glycerine extracts) or tinctures (alcohol extracts). Teas should be made with 1 tsp. herb per cup of hot water. Steep covered 5 to 10 minutes for leaf or flowers and 10 to 20 minutes for roots.

Herbal therapy should begin at the first sign of symptoms and continue for three days after the symptoms go away. Teas provide the best treatment for infectious urethritis because the additional fluid intake helps the flushing action. Combine two herbs from each of the following categories and drink 4 to 6 cups per day.

Urinary antiseptics fight bacteria and include the following.

bulletUva ursi (Arctostaphylos uva ursi)
bulletBuchu (Agathosma betulina)
bulletThyme leaf (Thymus vulgaris)
bulletPipsissewa (Chimaphila umbellata)

Urinary astringents tone and heal the urinary tract and include the following.

bulletHorsetail (Equisetum arvense)
bulletPlantain (Plantago major)
bulletCleavers (Galium aparine)

Urinary demulcents soothe the urinary tract and include the following.

bulletCorn silk (Zea mays)
bulletCouch grass (Agropyron repens)
bulletMarshmallow root (Althea officinalis) is best used alone in a cold infusion. Soak 1 heaping tbsp. of marshmallow root in 1 qt. of cold water overnight. Strain and drink during the day in addition to any other urinary tea.

For advanced or recurrent infections prepare a tincture of equal parts goldenseal (Hydrastis canadensis) and coneflower (Echinacea purpurea). Take 30 drops four to six times per day in addition to the urinary tea. For noninfectious urethritis or for urethritis with severe pain and spasm add kava kava (Piper methysticum) to any of the above formulas. A periwash may be helpful in reducing pain with urination. Place 1 tsp. of the coneflower/goldenseal tincture in an 8-oz. peri bottle. Fill with water. Rinse off after each time you urinate.

Homeopathy

Some of the most common remedies used for urethritis are listed below. Usually the dose is 12X to 30C every one to four hours until your symptoms get better.

bulletStaphysagria for urinary infections associated with sexual intercourse
bulletApis mellifica for stinging pains that are made worse by warmth
bulletCantharis for intolerable urging with "scalding" urine
bulletSarsaparilla for burning after urination

Acupuncture

Acupuncture may be helpful in enhancing your body's immune function.

Following Up

If your urethritis was caused by a sexually transmitted disease your sexual partners may need to be treated as well.

Special Considerations

STDs can cause permanent damage to reproductive organs and infertility in both sexes. They also can cause difficulties during pregnancy; premature delivery; low birth weight; and infections in newborns.

Supporting Research

Bartram T. Encyclopedia of Herbal Medicine. Dorset England: Grace Publishers; 1995:436–437.

Berkow R Beers MH. The Merck Manual of Diagnosis and Therapy. Rahway NJ: Merck and Company; 1992.

Blumenthal M ed. The Complete German Commission E Monographs. Boston Mass: Integrative Medicine Communications; 1998:432.

Bowie WR. Approach to men with urethritis and urologic complications of sexually transmitted diseases. Med Clin North Am. 1990;74:1543–1557. Accessed at www.thriveonline.com.

Hoffman D. The New Holistic Herbal. New York NY: Barnes & Noble Books; 1995:109–110.

Kruzel T. The Homeopathic Emergency Guide. Berkeley Calif: North Atlantic Books; 1992:98–102.

Shealy CN. The Illustrated Encyclopedia of Healing Remedies. Boston Mass: Element Books Limited; 1998.

Tierney LM et al eds. Current Medical Diagnosis & Treatment 1999. 38th ed. Stamford Conn: Appleton & Lange; 1999.

Virtual Hospital: University of Iowa Family Practice Handbook. 3rd ed. Available at www.vh.org.