What is Urethritis (Gonorrhea)?
Urethritis (Gonorrhea) is a type of bacterial infection that affects both men and women. It is among the sexually transmitted diseases and especially affects the rectum region, throat, conjunctiva and urethra region.
Neisseria gonorrhoeae (gonococcus), which causes the disease, was discovered in 1879 by the German doctor Albert Neisser. Detection of the causative agent of gonorrhea enabled important steps to be taken for the diagnosis and treatment of the disease.
It is not possible for every woman who has intercourse with a man who has gonorrhea to be infected. Infection develops in only 60*90% of women. It is not easily passed from woman to man. 20-40% of men who have intercourse with a woman who has gonorrhea are infected. This infection is mostly located in the cervix in women.
Due to the structure of the tissues, this bacteria does not settle in the vagina. Except for the cervix, it holds the bartholin glands located in each part of the urethra and just at the entrance of the vagina, respectively. More than 80% of women do not show any particular symptoms. This is expressed as an indication that the incubation time may vary.
What Causes Urethritis (Gonorrhea)?
Gonorrhea is caused by a type of bacteria called Neisseria gonorrhoeae. A person infected with this bacterium can transmit the bacterium to their healthy partner during sexual intercourse. This is how bacteria and disease spread. Babies of pregnant women infected with Neisseria gonorrhoeae can also be infected at birth. Gonorrhea in these babies can cause problems, especially eye-related.
Sexually active women younger than 25 and their partners are at risk for contracting gonorrhea.
Other conditions that increase the risk of contracting the disease:
- Having sexual contact with a new partner
- Having sex with people who have other partners and having sex with more than one person
- It can be listed as having previously had gonorrhea or another sexually transmitted disease.
What are The Symptoms of Urethritis (Gonorrhea)?
Gonorrhea symptoms can appear differently in men and women. Although some patients have gonorrhea, they do not show any serious symptoms and may not notice the disease. However, even in cases where the symptoms are not noticed, the disease can cause serious problems in the person’s body and cause the disease to be transmitted to other people. For this reason, it is recommended that people with an active sexual life have a gonorrhea test once a year.
Gonorrhea symptoms usually appear 4-7 days after the bacteria enters the body. Symptoms usually appear on the genitals.
Symptoms of the disease in other areas that may affect other than the genitals are:
- Itching sensation in the rectum area.
- Discharge from the rectum.
- Unusual pain when defecating.
- Slight blood stains that can be noticed by looking at toilet paper or underwear.
- Discharge that may occur in one or both eyes. This discharge is usually inflammatory.
- Hypersensitivity to light and eye pain in the eyes.
- Swelling of the lymph nodes in the neck area.
- Sore throat.
- Difficulty trying to swallow.
- Pain in the intestines and lower abdomen.
- In cases where the gonorrhea bacteria settles in the joints, these joints can become inflamed. This is called septic arthritis.
The joints where the bacteria settles take a reddish appearance, swell, and the person feels constant pain in the joint area. The disease can spread to the blood along with the joints, thus making it very risky.
What are the Symptoms of Urethritis (Gonorrhea) Affecting the Genital System?
Signs and Symptoms of Male Urethritis (Gonorrhea) Infection Include:
Gonorrhea shows symptoms that can be more easily identified in men, so it is easily diagnosed in men. Gonorrhea occurs in men 1 week after suspected sexual intercourse.
- First mild and then severe burning
- Having a thick consistency of white, yellow or green discharge from the penis
- Redness after discharge
- Feeling burning and pain while urinating
- Itching in the anal area
- Bleeding or discharge from the rectum
- Breech infection
- Pain and swelling in the testicles
- Pain in the throat and swelling in the left glands
- Difficulty, pain and bleeding while defecating
If gonorrhea is not treated, the sperm ducts become inflamed, leading to male infertility. Patients need to urinate frequently, but they urinate less when urinating. In some patients, the disease may not show any symptoms.
Signs and Symptoms of Gonorrhea Infection in Women Include:
The symptoms of gonorrhea in women are much milder than in men, sometimes even symptoms may not be seen.
- Pain while urinating
- Itching in the anal area and anus
- Bleeding or discharge from the anus
- Yellow or green vaginal discharge
- Foul-smelling discharge
- Weakness and high fever
- Redness and tearing of the eyes
- Bleeding outside of menstrual periods
- Abdominal and lower abdominal pain
- Pain in the groin area
- Swelling around the vagina
- Burning sensation and itching in the vagina area
- Pain during and after sexual intercourse
- Inflammation of the fallopian tubes and ovaries
- Pelvic inflammation
- Cramping in the groin and pelvic area
If gonorrhea is not treated, this inflammation spreads and the infection spreads to other organs. It can also lead to ectopic pregnancy and infertility. Infection may occur in the rectum and mouth area after anal and oral intercourse. In addition, this disease can be transmitted from the pregnant mother to the baby. In this case, redness and discharge may occur in the baby and even lead to blindness.
How is Urethritis (Gonorrhea) Diagnosed?
To determine if gonorrhea is present, the following is done:
The discharge detected on physical examination is sometimes diagnostic. In addition, this discharge can be taken on a slide and examined under a microscope. The presence of abundant leukocytes and diplococcal bacteria is valuable for a definitive diagnosis.
This can help you identify bacteria in the urinary tract.
Swab from The Affected Area:
A swab can be taken from the throat, urinary tract, vagina or rectum, examined under a microscope, and cultured.
Home test kits for gonorrhea for women are available: They contain vaginal swabs for self-testing that are sent to a specific laboratory for testing.
Testing for Other Sexually Transmitted Infections:
He or she may recommend tests for other sexually transmitted infections. Gonorrhea increases the risk of contracting these infections, especially the chlamydia that accompanies gonorrhea. Sexually transmitted diseases other than gonorrhea are called non-gonococcal urethritis. Chlamydia trachomatis (15–40%), Ureaplasma urealyticum (10–40%), Mycoplasma genitalium (15–25%), less frequently Trichomonas vaginalis (2–5%), HSV and enteric bacteria are the causative agents of non-gonococcal urethritis. gets. Despite all investigations, the causative agent cannot be identified in approximately 20% of the cases.
How is Urethritis (Gonorrhea) Treated?
Adult Urethritis (Gonorrhea) Treatment:
Adults with gonorrhea are treated with antibiotics. He recommends treating it with ceftriaxone given as an injection, along with oral azithromycin (Zithromax). If you are allergic to ceftriaxone, you may be given oral gemifloxacin or injectable gentamicin. A question may come to mind, in how many days the gonorrhea will heal; At the beginning of the treatment, the symptoms may disappear within a few days, but if the treatment is not completed, it may recur and the partner may be infected many times.
Urethritis (Gonorrhea) Treatment for Partners:
Your partner should also receive the same treatment, even if they don’t have any signs or symptoms. Even if you have been treated for gonorrhea, an untreated partner can infect you repeatedly.
Urethritis (Gonorrhea) Treatment for Babies:
Babies born to mothers who have gonorrhea and develop the infection can be treated with antibiotics. Patients receiving treatment to prevent re-infections should be told not to have sexual intercourse for seven days. The partners with whom the patient had intercourse within 60 days before the start of treatment should also be informed that treatment should be given.
Since the probability of recurrence within 6 months after treatment is high; After 3 to 6 months, nucleic acid amplification tests are ordered regardless of the presence of symptoms.
Routine post-treatment cultures are not recommended for patients treated with the recommended treatment regimens. However, if symptoms persist after treatment, they are re-evaluated and antimicrobial susceptibility testing is performed for ongoing gonococcal infections.
Infections detected after treatment can be considered as a new infection (reinfection) developed due to inadequate or untreated sexual partner.
For persistent infections, Chlamydia trachomatis or other organisms should be considered. In addition, the patient’s compliance with the treatment and the developed resistance to the antibiotic used should also be evaluated.
Treatment of Recurrent or Resistant Infection:
Objective signs of urethritis should be demonstrated before empirical (blinding) therapy is repeated. In the case of recurrent, recurrent urethritis in a male patient, in case of non-adherence to treatment and re-exposure to an untreated sexual partner, the initial treatment regimen should be used.
Other patients should have a urethral culture for T. vaginalis. Metronidazole (2 grams single dose orally) + erythromycin (500 mg 4 times a day for 7 days) or ethylsuccinate (800 mg 4 times a day for 7 days) is given to patients who have received appropriate initial therapy and have not re-experienced with an untreated sexual partner. This regimen also includes T. vaginalis and genital mycoplasmas.
Untreated gonorrhea can lead to major complications such as:
Gonorrhea can spread to the uterus and fallopian tubes, causing PID. PID can lead to an increased risk of pregnancy complications and infertility. PID requires immediate treatment.
Gonorrhea can cause inflammation of the epididymitis, where the sperm ducts are located. If left untreated, epididymitis can cause infertility.
Infection Spreading to The Joints:
Gonorrhoeae bacteria can spread through the bloodstream and infect other parts of your body, including your joints, giving symptoms such as fever, rash, skin sores, joint pain, swelling.
Increased Risk of HIV/AIDS:
Having gonorrhea makes you more susceptible to the HIV virus that causes AIDS.
Complications in Babies:
Babies who get gonorrhea from their mothers during birth may develop head wounds, blindness, and various infections.
What are The Ways to Prevent Urethritis (Gonorrhea)?
To reduce your risk of gonorrhea:
Use Condoms If You Are Sexually Active:
Avoiding Relationship Is The Surest Way To Prevent Gonorrhea.
Limit Your Number of Sexual Partners:
Being in a monogamous relationship where neither partner is involved with anyone else can reduce your risk.
Make Sure You And Your Partner Have Been Tested For Sexually Transmitted Infections:
Get tested before engaging in sexual intercourse and share your results with each other.
Do Not Have Sexual Intercourse With People You Think Have a Sexually Transmitted Disease:
If your partner has signs or symptoms of a sexually transmitted infection, such as burning during urination or genital redness or sores, do not have sex with that person.
Have Gonorrhea Screened Regularly:
Annual screening is recommended for sexually active women younger than 25 and older women at high risk of infection.
To avoid getting gonorrhea again, abstain from sex until you and your partner have completed treatment and the symptoms have subsided.
HIV testing is also recommended for anyone diagnosed with a sexually transmitted infection. Depending on your risk factors, testing for additional sexually transmitted infections may also be helpful.