Mycotic (candida) urethritis

Candidal urethritis is classified as mycotic (fungal). This pathology is relatively rare.

[ 1 ], [ 2 ], [ 3 ]

What causes candidal urethritis?

Most often, candidal urethritis occurs in patients with endocrine disorders ( diabetes mellitus ) or against the background of long-term antibacterial therapy. In patients without endocrine disorders, mycotic urethritis as a result of antibiotic therapy occurs relatively rarely. In women, candidal urethritis may be a consequence of total damage to the genitals by a fungal infection, which is considered one of the most common mycoses in women. In men, mycotic urethritis is isolated.

Infection occurs sexually. Among the causative agents of candidiasis are yeast-like fungi of the genus Candida, of which there are currently more than 150 species. In 80-90% of cases, the disease is caused by C. albicans, in 1-5% by C. tropicalis, and in 10% by C. Grabrata. A large number of pseudomycelium threads in thick, dense mucus are found in the discharge from the urethra. Other species of Candida rarely cause damage to the vagina and vulva. Women with these diseases, as well as their sexual partners, often develop damage to the urethra caused by Candida or Gardnerella vaginalis.

Symptoms of Candidal Urethritis

Candidal urethritis usually begins subacutely, its course is sluggish. The incubation period lasts on average 10-20 days. Subjective symptoms of candidal urethritis do not have characteristic signs. Sometimes the appearance of discharge is preceded by paresthesia in the form of mild itching or burning. Symptoms of candidal urethritis are usually scanty or watery discharge from the urethra of a pale pink color, but they can also be thick, mucous, with long threads visible to the naked eye, quickly settling to the bottom of the vessel. Lesions of the accessory sex glands in mycotic urethritis are rare, but balanoposthitis is very common.

Candidal urethritis is characterized by the formation of a whitish coating in the form of cheesy spots on the mucous membrane of the urethra. The mucous membrane is edematous, sharply hyperemic.

Candidal urethritis can be complicated by prostatitis, epididymitis, cystitis, especially with a mixed infection caused by fungi and pathogenic microorganisms.

[ 4 ], [ 5 ]

Diagnosis of candidal urethritis

Diagnosis of candidal urethritis is not difficult. Candida albicans is detected both on the affected skin and in the discharge from the urethra. Direct microscopy of native and stained preparations reveals a large number of pseudomycelium threads in thick dense mucus.

[ 6 ], [ 7 ], [ 8 ], [ 9 ], [ 10 ]

Treatment of candidal urethritis

The obtained data on the activity of fluconazole allow its continued use as a drug of choice for the treatment of most forms of candidal infection. Therefore, the main drug for the treatment of candidal lesions of the urinary tract and vagina in women is considered to be fluconazole at a dose of 150 mg once or 200 mg on the first day, then 100 mg once a day for 4 days.

In 10-15% of cases of women, candidal vaginosis is combined with bacterial vaginosis, in which case parallel administration of antibacterial therapy is necessary.

Treatment of candidal urethritis involves the use of local procedures: installation of the urethra with a 1% aqueous solution of clotrimazole, miramistin. For external treatment of candidiasis of the skin of the head and foreskin of the penis, clotrimazole is used in the form of a 1% cream. In the case of a combination of candidal infection with trichomonas, metronidazole or other antitrichomonal agents are additionally recommended. Candidal urethritis should be treated in both partners.