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McKesson Clinical Reference Systems: Women's Health Advisor 2002.2
Urethritis
What is urethritis?
Urethritis refers to irritation or inflammation of the
urethra. The urethra is the tube that empties urine from
the bladder. A woman's urethra is short (about 2 inches
long), and the opening is just above the vagina. Because
the opening of the urethra is so close to the vagina and
anus, bacteria can easily enter it from these areas.
How does it occur?
Most often urethritis results from a sexually transmitted
disease (STD). Examples of STDs are chlamydia, gonorrhea,
herpes simplex virus, and human papilloma virus, and
trichomoniasis.
In most older women, the tissues of the urethra and bladder
become thinner and drier after menopause. This is the
usual cause of urethritis in older women.
Urethritis may at times simply be an irritation caused by
rubbing or pressure on the groin area. For example, tight
clothing can cause urethritis. It may also result from
an irritant such as soap, powder, or spermicides. Some
people can't use spermicides for this reason.
Sometimes vaginal infections (for example, a yeast
infection) cause women to have symptoms of urethritis.
What are the symptoms?
The symptoms are similar to the symptoms of a bladder
infection:
- pain when you urinate
- frequent urges to urinate
- the feeling that the bladder is never empty
- pain during sexual intercourse.
How is it diagnosed?
Your health care provider will ask about possible irritants
and your recent sexual history.
In women the diagnosis can be more difficult than in men.
Urethritis almost never causes a discharge from a woman's
urethra. Occasionally the urethra is inflamed. Your health
care provider will examine the urethra and area around it
and will obtain a urine sample. He or she may also swab the
urethral area. The cervix may be swabbed to test for
chlamydial infection in the pelvis. Your provider may also
look for drying and thinning of the tissues in your genital
area.
What is the treatment?
If there is no evidence of chemical irritation and no
evidence of infection in the urine, you may be treated for
chlamydial infection as the cause of urethritis. If lab
tests show that the urethritis is caused by an STD, your
health care provider will prescribe an antibiotic for the
infection. You may be treated with an antibiotic even
before lab results are available. Your health care provider
may prescribe Pyridium (a bladder sedative) to help relieve
discomfort.
For older women the most common treatment for genital tissue
thinning and dryness is estrogen. Oral estrogen, estrogen
cream for the genital area, or estrogen skin patches may be
used.
If your health care provider finds or suspects that you have
an STD, your sexual partner(s) must be treated too. To
avoid reinfection, use latex condoms if you have intercourse
while you are taking the antibiotic. Your health care
provider may recommend that you avoid intercourse for a
while.
How long will the symptoms last?
Symptoms caused by an infection should stop within a few
days of starting the antibiotic.
In the case of postmenopausal tissue changes treated with
estrogen, it may be 6 weeks to 3 months before you have some
relief from your symptoms.
What can be done to help prevent urethritis?
- Avoid irritants and chemicals that cause redness, burning,
or itching in the area of the urethra.
- Menopausal and older women may consider using oral
estrogen, estrogen vaginal cream, or estrogen skin
patches to help prevent tissue thinning and dryness.
- Use condoms during sexual intercourse if you have
concerns about getting an STD.
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