Urethritis – Causes, Symptoms and Treatment
Urethritis is an inflammation of the urethra, most commonly caused by bacterial infection. Typical symptoms include a burning sensation during urination and urethral discharge.
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Urethritis is an inflammation of the urethra, most commonly caused by bacterial infection. Typical symptoms include a burning sensation during urination and urethral discharge.
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 is one of the most common infections of the urinary tract and can affect both men and women. Men are more likely to experience noticeable symptoms due to the greater length of the male urethra.
Causes
Urethritis can be caused by infectious agents or non-infectious irritants. It is generally divided into two main categories:
Gonococcal Urethritis
This form is caused by the bacterium Neisseria gonorrhoeae and is a sexually transmitted infection (STI), commonly known as gonorrhea.
Non-Gonococcal Urethritis (NGU)
This is the more common form and can be caused by several different pathogens, including:
- Chlamydia trachomatis (most frequent cause)
- Mycoplasma genitalium
- Ureaplasma urealyticum
- Trichomonas vaginalis
- Herpes simplex virus (HSV)
Non-infectious causes include mechanical irritation (e.g., from catheters), chemical irritation (e.g., soaps or antiseptics), and allergic reactions.
Symptoms
The most common symptoms of urethritis include:
- Burning or pain during urination (dysuria)
- Purulent or watery discharge from the urethra
- Redness and swelling at the urethral opening
- Itching or tingling inside the urethra
- Increased urge to urinate
In women, urethritis often causes fewer symptoms or may be mistaken for a bladder infection. In some cases – particularly with chlamydial infections – symptoms may be entirely absent.
Diagnosis
Urethritis is diagnosed through a combination of the following:
- Medical history: Questions about symptoms, sexual behavior, and risk factors
- Physical examination: Assessment of discharge and any visible inflammation
- Urine analysis: Detection of leukocytes (white blood cells) indicating inflammation
- Urethral swab: Sample collection for microbiological analysis
- PCR testing: Highly sensitive detection of pathogens such as chlamydia or gonorrhea
Treatment
Treatment depends on the causative pathogen:
Antibiotic Therapy
- For gonococcal urethritis: Ceftriaxone intramuscularly or intravenously (per current guidelines)
- For chlamydial infection: Doxycycline or azithromycin
- For Mycoplasma genitalium: Azithromycin or moxifloxacin
Non-Pharmacological Measures
- Sexual abstinence during treatment
- Treatment of sexual partners (partner notification)
- Adequate fluid intake
- Avoiding irritating substances in the genital area
Non-Infectious Urethritis
When urethritis is caused by mechanical or chemical irritation, removing the trigger is the primary step. Anti-inflammatory measures may provide additional relief.
Complications
If left untreated, urethritis can lead to serious complications, including:
- Ascending infections such as cystitis, prostatitis, or epididymitis
- Pelvic inflammatory disease (PID) in women
- Urethral scarring and narrowing (urethral stricture)
- Transmission of infection to sexual partners
Prevention
The following measures can reduce the risk of urethritis:
- Consistent use of condoms during sexual activity
- Regular STI screening for individuals with multiple partners
- Careful genital hygiene without harsh cleansing products
- Adequate fluid intake to flush the urinary tract
References
- Workowski KA, Bachmann LH et al. – Sexually Transmitted Infections Treatment Guidelines. MMWR Recomm Rep. 2021;70(4):1-187.
- World Health Organization (WHO): Global Health Sector Strategy on Sexually Transmitted Infections 2016-2021. Geneva, WHO Press.
- European Association of Urology (EAU): Guidelines on Urological Infections. 2023 Edition.
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Related search terms: Urethritis + Urethral Inflammation + Inflammation of the Urethra