Urethritis refers to is inflammation of the urethra, the tube that carries urine from the bladder out of the body. Urethritis is usually caused by an infection, and along with cystitis (infection of the bladder), it is known as a lower urinary tract infection (UTI).
The term non-gonococcal urethritis (NGU) is used when the condition is not caused by gonorrhoea. NGU may also be referred to as non-specific urethritis (NSU).
NGU can have a number of possible causes, including irritation to the urethra and STIs. Chlamydia causes up to 43 out of 100 cases of NGU.
Urethritis may be caused by several types of infections including:
- STIs such as Trichomonas vaginalis
- a urinary tract infection (UTI)
- the herpes simplex virus (HSV)
- an adenovirus (which usually causes a sore throat or an eye infection )
Non-infectious causes of urethritis include:
- irritation from a product used in the genital area (e.g. soap, deodorant or spermicide)
- damage to the urethra caused by vigorous sex or masturbation
- damage to the urethra caused by inserting an object into it (e.g. a catheter whilst in hospital)
Depending on the cause of the urethritis, symptoms may begin a few weeks or several months after an infection is established.
Urethritis does not usually cause noticeable symptoms in women, some have noted slight pain on urination. Symptoms are usually detected once the infection has spread to other parts of the female reproductive system, such as the womb or fallopian tubes; in which case the woman may develop pelvic inflammatory disease (PID). PID is a serious and painful condition that is associated with an increased risk of infertility.
Symptoms in men include:
- a painful or burning sensation when urinating
- the tip of the penis feeling irritated and sore
- a white or cloudy discharge from the tip of the penis
- a recurrent need to urinate
Diagnosis and Complications
Urethritis is usually diagnosed after urine and swab tests and treated with antibiotics.
The most common complication of NGU is persistent or recurrent urethritis. If you still have symptoms two weeks after starting a course of antibiotics, you should return to your GP for advice.
Reactive arthritis is an uncommon complication of NGU and is caused by the immune system attacking healthy tissue for an unknown reason, rather than the bacteria responsible for NGU.
This can result in joint pain as well as conjunctivitis (inflammation of the eyes).
Another complication is epididymo-orchitis (inflammation of the testicles).
Treatment and Prevention
Non-gonococcal urethritis (NGU) is usually treated with a short course of antibiotics to kill the bacteria that caused the infection. It can take two or three weeks for symptoms to disappear completely. It is important that:
- the entire treatment is completed as directed
- any recent partners have also been treated to prevent spreading or reinfection
- you do not have any sex (including vaginal, anal and oral sex) until a week after everyone has completed their treatment
The antibiotics used to treat NGU may interact with the combined contraceptive pill and the contraceptive patch. If you use these methods of contraception, your GP or nurse can advise you about which additional contraception is suitable.