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Urethritis: a common problem for men...and women

Homeopathy offers a better solution

Urethritis or inflammation of the urethra (the tube leading from the bladder
to the outside of the body) is a very common condition. Physicians treat more
than three million cases each year, typically with antibiotics. While antibiotics
are often successful in eliminating symptoms, the patient is frequently left
with a disruption of the intestinal flora leading to digestive disturbances,
a susceptibility to repeated infections, or an infection that is driven into
deeper organs of the body such as the prostate and kidneys.
     Prior to the advent of antibiotics, treatment of
urethritis was undertaken with herbal and homeopathic medicines with great success.
In my practice, I have successfully treated many cases of urethritis using only
homeopathic medicine, or homeopathic medicines in combination with herbal medicines,
and have found this to be an excellent treatment option.
     Although allergies or hormonal changes can cause
urethritis, in the vast majority of cases, it is sexually acquired. The incidence
is higher in younger and more sexually active males. Men and women may also harbor
an infection for years, passing it back and forth with their partners without
being aware they have an infection.

Common symptoms
Common symptoms of urethritis in men and women typically include two or more
of the following:
•     Frequent urination
•     An increase in the urgency to urinate
•     Burning felt in the urethra
•     Itching in the urethra
•     A discharge, which may only be seen in the
morning when first emptying the bladder, or as a discharge on bedclothes or underwear.

Anatomical factors
The urethra provides a conduit for the elimination of urine from the bladder
and also plays a role in protecting the rest of the urinary system from infection.
Differences in anatomy and physiology between men and women contribute to differences
in the types of symptoms seen with inflammation.
     The male urethra is approximately 15 to 20 centimeters
long, originating in the bladder and ending at the meatus (opening of the penis).
It can be broken down into three distinct parts: prostatic urethra, membranous
urethra, and spongy urethra. Each has its own characteristics, and from a symptom
standpoint, knowledge of each region's function can help lead the clinician to
the source of the problem. These areas are also noted in the homeopathic repertory
as bladder neck, fossa navicularis, and urethral meatus, respectively. In addition,
the types of pain and discharge experienced can often help the clinician pinpoint
the site and degree of inflammation. While in conventional medicine this isn't
as important, to the homeopathic clinician, their notation can often help with
remedy selection.
     In men, part of the urethra runs through the prostate
gland, and with inflammation, it may be difficult to distinguish between urethritis
and prostatitis. Therefore, many physicians will perform a 3-glass urinalysis
to determine the location of the infection. This requires the patient to collect
three different urine samples before and after prostatic massage, which are then
analyzed for mucus, red blood cells, and white blood cells.
     The female urethra is a shorter, muscular tube
2 to 6 centimeters in length, lined by a mucous membrane. The mucous membrane's
size changes during a woman's monthly cycle as it is affected by estrogen-progesterone
fluctuations. Men do not experience this and thus their urethral mucosa is much
thinner. Consequently, men are more susceptible to infections and know much sooner
when they have an inflammation of the urethra than women do.
     Chronic urethritis is more frequently seen in women
(whereas chronic prostatitis is frequently seen in men). Women may have a low-level
urethritis and not be fully aware of it, or they may think that they have a bladder
infection or are just suffering from urge incontinence. Women may also experience
a condition termed "senile urethritis" at menopause as estrogen levels decline,
resulting in a dry, pale urethral mucosa, and possibly vaginal itching, burning
and frequent urination, a sense of urgency, and urge incontinence.

Individual susceptibility and causative agents
While urethritis is almost always acquired from intercourse, not every person
exposed to organisms such as Neisseria gonorrhea or Chlamydia trachomatis will
contract the disease. It depends upon the individual's susceptibility. Both the
male and female genito-urinary systems possess defense mechanisms designed to
fend off infection. In women, it is the secretion of the periurethral glands
of Skene and monthly menstrual cycles that allow for a cleaning and protecting
of the urethra and bladder. In men it is the prostate gland that acts as the
first line of defense against genito-urinary tract infection. In conjunction
with the bulbourethral glands, the prostate secretes a thin, milky substance,
high in Vitamin C and zinc, prior to and following ejaculation to clean the male
urethra.
     There are about one million new cases of gonococcal
urethritis (GU) (i.e., caused by gonorrhea) and two million cases of non-gonococcal
urethritis (NGU) every year. The discharges of each are fairly characteristic
of the respective infections. Careful observation of the discharge coupled with
subjective symptoms can lead the clinician to the correct homeopathic medicine.
Because of the considerable variation in the types of discharges seen with NGU
or non-specific urethritis, the clinician or patient can often miss them. Discharges
are usually a clear to whitish mucus and will be present in varying amounts depending
upon the time of day and severity of the infection. Symptoms of GU in men are
usually much more noticeable, and can be very painful. Discharges are typically
purulent, and of a yellow to greenish color. The severity of symptoms may range
from severe to mild to totally unnoticeable. Here, too, the severity of the symptoms
is more a function of the individual's susceptibility, constitutional tendencies,
and miasmatic make-up that predispose them to developing the disease. Symptom
severity, past medical history, and concomitant mental-emotional symptoms can
help the clinician determine the probable miasm, which helps with homeopathic
remedy selection.
     Non-gonococcal organisms/contributing factors to
NGU are:
     Chlamydia trachomatis, which is difficult
to eradicate with antibiotics. In general, if gonorrhea is present, so is Chlamydia
about 80% of the time.
     Ureaplasma urealyticum, which becomes a
problem in persons with lowered immune function.
     Trichomonas vaginalis, which is not as often
seen in males as in females.
     Herpes simplex, which is a rare etiological
agent for urethritis. External lesions must be present to make a diagnosis.
     Eschericia coli, which is more often seen
in women than men but increases in prevalence in older men with enlarged prostates,
and urinary and fecal incontinence.
     Yeast, which can be difficult to diagnose
but is more prevalent than most people think.
     Unknown etiology, which is a category now
recognized as a contributing factor to NGU 20% of the time. Allergens from specific
foods or environmental exposure are the typical causes.
     Complications from untreated infections can range
from very few to further infection of the genito-urinary tract such as epididymitis,
orchitis (inflammation of the testis), disseminated gonococcal infection, periurethral
abscess, prostatitis, stricture (narrowing of the urethra), and lymphangitis
(inflammation of the lymph glands) in men. Salpingitis (inflammation of the fallopian
tube), cervicitis (inflammation of the cervix), vaginitis, or ovaritis is seen
in women. Both sexes can become permanently sterile from chronic or repeated
infections.

Conventional treatment
Most patients receive one or several courses of antibiotics. Even if the correct
antibiotic is prescribed and the "organism" is eradicated, however, the body's
healing process is often disrupted so that the infection either reoccurs or goes
deeper into the body, with patients developing chronic urethritis, cervicitis,
or prostatitis. Homeopaths view this driving of the illness into deeper areas
of the body as "suppression" of an illness.

Homeopathic treatment
Homeopaths often see these patients many years after the initial infection, when
they come for treatment of chronic disease. Patients frequently report that they
have never been well since the original urethritis and antibiotic treatment.
In my experience, careful homeopathic treatment is very effective in treating
these patients and can fully eradicate the disease. As homeopathic treatment
progresses, the patients will typically re-experience some of their disease symptoms,
according to Hering's Law of Cure. As every disease has a beginning, middle,
end, and recovery period, so healing will occur in a reverse process, according
to the Law of Cure. Homeopathic medicine allows for this process to complete
itself and is the reason why it is so effective in treating chronic disease.

Sidebar:
Making sense of UTIs
Urinary tract infections (UTIs) have different names depending on which part
of the urinary tract is affected.
Urethritis is an inflammation or infection of the urethra, the tube leading
from the bladder to the outside of the body.
It is often accompanied by a discharge, pain, and frequent or difficult urination.
It usually produces more severe symptoms in men than in women. In women, it often
accompanies a vaginal infection. Urethritis is almost always sexually transmitted
and caused by bacteria and/or Chlamydia. If left untreated, it may spread to
other areas of the genito-urinary tract and cause sterility.
Cystitis is an inflammation or infection of the bladder, the reservoir
for urine (although the urethra, kidneys, or prostate may also be involved).
It is most commonly found in women, and there are many predisposing factors including
mechanical irritation, poor hygiene, chemical irritants, and variations in estrogen
levels. Symptoms include frequent urination, intense urging, burning, and possibly
a slight fever
and tenderness over the bladder.
Pyelonephritis is an inflammation
or infection of the kidneys, the organ where urine is formed. Symptoms include
sudden onset of chilliness with dull pain over the kidneys.

Sidebar:
Remedies for urethritis
If you suspect you have urethritis, seek professional help for diagnosis and
treatment. It can be a very damaging illness if left untreated. If you do not
have access to a qualified homeopathic professional but have a supportive conventional
practitioner who will monitor your case, you may wish to try the following remedies.
Please see the "Home Prescribing Guidelines on page 20 for specific dosage recommendations.—ed.

Here are some of the more commonly-used medicines in cases of urethritis, along
with indications for their use.
Argentum nitricum. Sensation of swelling in urethra; ulcerations in urethra
with the sensation as if there is a splinter; difficulty passing the last drops
of urine, feels as if the last drop remains behind; early stages of gonorrhea
with a profuse discharge; urging to urinate but difficulty in passing urine;
burning and itching pains in urethra.
Cannabis sativa. Burning with urination, that travels to the bladder;
sensation as if the urethra is knotted up; burning pain in fore part of urethra
when not urinating; urge to urinate constantly; very sensitive urethra, patient
walks with legs wide apart; urethra plugged up by mucus and pus, especially in
the morning, plug painlessly dislodged with urination; constant thoughts of sex.
Cantharis. Violent burning pains in neck of bladder that move to urethra,
worse before and after urination; bloody mucus discharge; burning pains when
urinating and not urinating; constant desire to urinate which does not relieve;
bloody semen; increased sexual thoughts and desire.
Copaiva. Urethra feels wide open; burning pressure and painful urination
drop by drop; bladder spasms in morning at about the same time; purulent or acrid
milky discharge; urine smells of violets; frequent desire to urinate with violent
pains in neck of bladder; swelling and dilation of orifice of penis; gonorrhea
in first or second stages with moderate discharges; urinary irritation but little
difficulty passing urine; cases of chronic gleet with muco-purulent discharges.
Chimaphila umbellata. Urine is loaded with ropy, muco-purulent sediment;
must strain to urinate, must stand with feet wide apart and body bent forward;
profuse, purulent, thick, bloody, ropy discharge; acute prostatitis from sitting
on a cold surface; excessive itching and painful irritation of the urethra from
end of penis to neck of bladder.
Cubeba. Profuse discharge of glutinous mucus and thick pus, which leaves
linen stiff after drying; scalding pain during urination; excessive urgency;
thick, yellowish-green discharge which frequently obstructs the urethra; following
urination, a sensation as if some urine remained; sensation of warmth and slight
burning in urethra when urinating.
Digitalis. Nightly emissions, with great weakness of genitals after intercourse;
gonorrhea; inflammation of the glans penis, with swelling of foreskin; dropsical
swelling of genitals; continued urging to urinate, in drops, dark, hot, burning
with sharp cutting or throbbing pain at neck of bladder, as if a straw were being
thrust back and forth; full feeling after urination; constriction and burning
as if urethra too small; swollen prostate; gonorrhea with a profuse, thick, yellow-white
discharge; consider in men with accompanying heart disease and enlarged prostates.
Medorrhinum. Nocturnal emissions followed by great weakness; impotence;
gleet; whole urethra feels sore; enlarged and painful prostate with frequent
urging and painful urination; painful tenesmus with urinating; nocturnal enuresis;
urine flows very slowly; scalding urine.
Mercurius corrosivus. Extremely swollen penis and testis; gonorrhea; red
urethral orifice, swollen; sore and hot glans penis; thick greenish and/or bloody
discharge; intense urethral burning; stabbing pain from urethra to bladder; perspires
after urinating, which is passed only in drops causing much pain; fine, painful
stinging in left testicle; gonorrheal discharges thin at first, then thick; greenish
discharge, worse at night.
Sulphur. Stitching pain in penis; involuntary emissions; genitals cold,
relaxed, impotent; mucus and pus in urine; burning in urethra during urination
which lasts for a long time afterwards; urgency, urinates large amounts of colorless
urine; awakes early morning to urinate.
Thuja. Inflammation of foreskin and glans penis, with meatus especially
affected leading to formation of scar tissue; pain in penis; gonorrhea; gonorrheal
rheumatism; pain and burning near neck of bladder, with frequent and urgent desire
to urinate; prostatic enlargement; profuse discharge; watery discharge; yellowish
discharge; burning, sticking, numbing, drawing or wandering pains; urine burns;
sensation of trickling after urination; small split stream; urethra swollen,
inflamed; wart-like excrescences, fig warts, condylomata; severe cutting pains
after urination.

About the author:
Thomas A. Kruzel, ND, is a naturopathic physician in private practice in Scottsdale,
Arizona. A graduate of the National College of Naturopathic Medicine, Dr. Kruzel
is also a board-certified Medical Technologist. He has been an Associate Professor
of Medicine at National College of Naturopathic Medicine where he has taught
Clinical Laboratory Medicine, Geriatric Medicine, and Clinical Urology. He is
the author of the Homeopathic Emergency Guide A Quick Reference Handbook to
Effective Homeopathic Care
published by North Atlantic Books and has published
numerous articles in The Journal of Naturopathic Medicine as well as other
publications. He is also the past president of the American Association of Naturopathic
Physicians.