Urethritis – Causes, Symptoms & Treatment
Urethritis is an inflammation of the urethra, most commonly caused by bacteria or viruses. It causes burning during urination and discharge from the urethra.
Things worth knowing about "Urethritis"
Urethritis is an inflammation of the urethra, most commonly caused by bacteria or viruses. It causes burning during urination and discharge from the urethra.
What is Urethritis?
Urethritis is an inflammation of the urethra – the tube that carries urine from the bladder to the outside of the body. It can affect both men and women, though symptoms are often more noticeable in men due to the longer length of the male urethra. Urethritis is frequently caused by sexually transmitted infections (STIs), but non-infectious causes are also possible.
Causes
Urethritis is broadly classified into two categories based on the underlying cause:
Infectious Causes
- Gonococcal urethritis: Caused by the bacterium Neisseria gonorrhoeae (gonorrhea), a common sexually transmitted infection.
- Non-gonococcal urethritis (NGU): Most often caused by Chlamydia trachomatis, Mycoplasma genitalium, Ureaplasma urealyticum, or herpes simplex virus (HSV).
- Trichomonas vaginalis: A parasitic infection that can also cause urethral inflammation.
Non-Infectious Causes
- Mechanical irritation, for example from urinary catheter use
- Chemical irritation from soaps, disinfectants, or contraceptive products
- Allergic reactions to latex or personal care products
Symptoms
Symptoms vary depending on the causative agent and may range from mild to severe. Common signs include:
- Burning or pain during urination (dysuria)
- Discharge from the urethra (purulent, mucous, or watery)
- Frequent urge to urinate
- Redness or swelling at the urethral opening
- Itching inside the urethra
- In women: possible vaginal discharge or pelvic discomfort
In some cases, particularly with chlamydial infections, urethritis may be asymptomatic, meaning no symptoms are present. This makes regular STI screening particularly important.
Diagnosis
Diagnosing urethritis typically involves:
- Medical history and physical examination: The healthcare provider asks about symptoms, sexual history, and risk factors.
- Urethral swab: A sample is taken from the urethra for laboratory analysis and pathogen identification.
- Urine analysis: A first-void urine sample is tested for signs of infection and inflammation.
- Nucleic acid amplification test (NAAT): A highly sensitive method used to detect chlamydia, gonorrhea, and other pathogens.
- Blood tests: Performed if systemic infection is suspected or to rule out other STIs such as HIV or syphilis.
Treatment
Treatment is tailored to the underlying cause of the infection:
Antibiotic Therapy
- Gonococcal urethritis: Treated with antibiotics such as ceftriaxone (intramuscular or intravenous) according to current clinical guidelines.
- Chlamydial urethritis: Doxycycline (7-day course) or a single dose of azithromycin are the standard treatments.
- Mycoplasma genitalium: Doxycycline or moxifloxacin, depending on antibiotic resistance patterns.
Antiparasitic and Antiviral Therapy
- Trichomonas vaginalis: Treated with metronidazole
- Herpes simplex virus: Treated with acyclovir or valacyclovir
General Measures
- Abstaining from sexual intercourse during treatment
- Partner notification and treatment to prevent reinfection
- Drinking adequate fluids
- Avoiding irritating personal care products in the genital area
Complications
If left untreated, urethritis can lead to serious complications:
- Spread of infection to the bladder, kidneys, or reproductive organs
- Prostatitis (inflammation of the prostate) in men
- Epididymitis (inflammation of the epididymis)
- Pelvic inflammatory disease (PID) in women
- Increased risk of infertility if chlamydial infections are not treated
- Urethral stricture (narrowing of the urethra)
Prevention
- Use of condoms during sexual intercourse
- Regular STI testing, especially with multiple or new sexual partners
- Gentle intimate hygiene without harsh chemical products
- Prompt medical evaluation when symptoms appear
References
- World Health Organization (WHO): Global health sector strategies on sexually transmitted infections 2016–2021. WHO Press, Geneva.
- Centers for Disease Control and Prevention (CDC): Sexually Transmitted Infections Treatment Guidelines (2021). Available at: www.cdc.gov
- Horner P. et al. – 2016 European guideline on the management of non-gonococcal urethritis. International Journal of STD & AIDS, 2016;27(11):928–937.
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