by Alison O'Donoghue

Created on: July 12, 2008   Last Updated: July 16, 2008

INTRODUCTION

Urethritis is an inflammation of the urethra, the tube that carries urine from the bladder to the outside of the body. In men, the urethra is longer, travelling within the penis, and opening at the tip. In women, the opening of the urethra is just above the opening to the vagina. Usually the inflammation occurs as a result of a sexually transmitted infection (STI), which can be caused by several different organisms.

The bacteria Neisseria gonorrhoeae (gonococcus), causes gonococcal urethritis (GU). Non-gonococcal urethritis (NGU) is caused by the bacterium Chlamydia trachomatis, the protozoal parasite Trichomonas vaginalis, or sometimes other bacteria or viruses. The gonococcus and the chlamydia bacterium are the most common causes of urethritis. If tests for these two organisms are negative, and the cause of the urethritis is not identified, the term non-specific urethritis (NSU) is used.

Another possibility is that the inflammation results from the passage of a catheter (a plastic tube to drain the bladder), or application of a spermicide which irritates the lining of the urethra.

WHAT ARE THE SIGNS AND SYMPTOMS?

Some people with urethritis probably about a quarter have no symptoms. If symptoms are present they may include the following: a urethral discharge that can be white, yellow, green or brown in colour, itching around the opening of the urethra, burning during urination, especially when the bladder is first emptied in the morning, or pain during sexual intercourse. Sometimes men experience heaviness, pain or swelling of the testicles and occasionally, men or women can experience symptoms in other parts of the body, including joint pain, fever or a rash.

Urethritis may sometimes be associated with complications such as spread of the infection to other organs such as the kidney, narrowing of the urethra leading to problems with urination, or damage to the fallopian tubes, which can lead to infertility. A pregnant woman can also transmit an infection to her baby as it passes through the birth canal.

HOW IS IT DIAGNOSED?

If a sexually-transmitted urethritis is suspected, it is important to visit a family doctor, specialist or sexual health clinic so that appropriate tests can be performed. Following an examination, a sample is taken by inserting a swab into the end of the penis or into the vagina, and tested for the presence of the gonococcus or other bacteria, viruses or parasites. A urine sample is usually requested and sometimes blood tests or a scan of the pelvis or testicles. It is important to identify which organism has caused the urethritis, as they are not all treated in the same way. It is also important to examine the partner of the person with urethritis, as it is quite likely that they will also be infected and require treatment.

HOW IS IT TREATED?

Usually a person with urethritis is given a course of antibiotics which treat those organisms most likely to cause the problem the gonococcus and the chlamydia bacterium. The specific antibiotics given vary from location to location, as some organisms are more prevalent in specific regions and some have developed a resistance to certain antibiotics. Sometimes, a single large dose of antibiotic is given before leaving the clinic. Once the results from the swabs become available, it is possible that a different medication will be required. Both partners must complete all prescribed courses of treatment, even if they have no symptoms, in order to prevent reinfection.

WHERE CAN YOU FIND OUT MORE?

Information about urethritis can be found on the internet, or in leaflets or books. The Centers for Disease Control and Prevention website (www.cdc.gov) provides comprehensive information.

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