Urethritis: Causes, Symptoms, Treatment

Inflammation of urethra is called urethritis. The urethra is the tube that carries urine from the bladder to flush out from the body. 

Urethritis can be due to an infection which is sexually transmitted (STI). Less likely, you may suffer from this condition due to an injury from an instrument called urinary catheter or exposure to an irritating chemical like a spermicide or an antiseptic.

Urethritis can be classified into two: gonococcal urethritis – caused by gonorrhea and nongonococcal urethritis – caused by bacteria other than gonorrhea. 

Let’s look at each type individually and understand the terms.

Types of Urethritis

Gonococcal urethritis

This condition is caused by Neisseria gonorrhoeae bacteria. This condition can easily be transmitted from person to person via sexual activity. A woman can also pass gonococcal urethritis to her baby during childbirth. 

This condition can be experienced by both men and women. If left untreated, this condition can cause problems like:

• Pelvic inflammatory disease in women
• Problems with the prostate and testicles in men

Nongonococcal urethritis

This condition is caused by sexually transmitted bacteria other than N. gonorrhoeae. Most frequently, nongonococcal urethritis is caused by chlamydia trachomatis bacteria, resulting in sexually transmitted infection Chlamydia. 

Ureaplasma urealyticum, Trichomonas vaginalis, and Mycoplasma genitalium can be other possible infectious causes of this condition.

Symptoms of Urethritis

You may experience the following symptoms of urethritis such as:

• Irritation and itchiness in the urethra
• Pain or burning feeling while passing urine
• Redness or swelling at the tip of the penis in men
• Clear or mucus-like fluid from the vagina or penis

Other symptoms that adults and children may also experience are:

• Loss of bladder control 
• Abdominal pain
• Unwillingness to urinate

Causes of Urethritis

Urethritis can be caused by both bacteria and viruses. A few bacteria that can be responsible for this condition are E. coli, N. gonorrhoeae, Chlamydia trachomatis, Ureaplasma urealyticum, Trichomonas vaginalis, and Mycoplasma genitalium. These bacteria and parasites can cause UTIs and some sexually transmitted diseases. Viral causes include cytomegalovirus and herpes simplex virus.

Other causes of this condition include:

• Sensitivity to the chemicals used in foams, spermicides, and contraceptive jellies
• Injury to urethra

However, sometimes the cause behind the urethra inflammation is unknown.

Risk Factors of Urethritis

The following increases the risk of developing urethritis:

• High-risk, unsafe sexual behavior
• You have a history of sexually transmitted diseases

According to a study published in the Journal of Infectious Diseases, oral sex may increase risks for nongonococcal urethritis (NGU).  

Although this condition is not always transmitted by sexual activity, a person with multiple sexual partners can be at greater risk. 

The Centers for Disease Control and Prevention (CDC) recommends undergoing chlamydia and gonorrhea tests to patients with confirmed or suspected urethritis. This can help you inform your partner to get tested and treated.

People who are at the risk of developing this condition are:

• Women
• Men between the ages of 20 and 35
• Having several sexual partners
• Those practicing unprotected sex

Diagnosis

When you experience the symptoms of urethritis, ensure you visit the doctor’s clinic immediately. 

Your doctor will undertake a physical examination and may ask questions related to your sexual health and unprotected sexual activities. Also, your doctor may look at your sexual history and family medical history. 

Your doctor will look for any abnormal discharge from your urethra. In women, the doctor will examine the pelvic area and look for tenderness, redness, or abnormal discharge from the vagina and cervix. 

In men, the doctor will examine the abdomen, bladder area, scrotum, and penis. The doctor will look for the discharge from the penis. Also, your doctor will examine if there are enlarged lymph nodes in the groin area. 

As this condition is caused due to STIs, your doctor will look at the signs of other infections like syphilis and genital warts caused by HPV and HIV. 

Urethra inflammation caused by injury or chemical irritation is ruled out on the basis of your medical history and the absence of an infectious cause. 

Your doctor may suggest a few tests to confirm urethritis, such as:

• Urinalysis and urine culture
• Ultrasound
• Urethral swab
• C-reactive protein test
• Nucleic acid test (NAT)
• Tests for gonorrhea, chlamydia, and other sexually transmitted illnesses (STIs)
• Complete blood count (CBC)
• Cystoscopy

Treatment

Treatment for urethritis depends on your condition and the test results. 

Your goal for this condition is to get rid of the infection, improve symptoms, and prevent the spread of the infection.

Your doctor will prescribe antibiotics if you have a bacterial infection. You may also use both antibiotics and pain relievers for general body pain and localized urinary tract pain.

You will be advised to avoid sexual activity for a few weeks and use condom during sex. If you are diagnosed with urethritis, your sexual partner should be treated too.

And in the event that the antibiotics do not help improve the condition, inform your doctor immediately. If this condition lasts for 6 weeks or more, it is called chronic urethritis. 

For chronic urethritis, your doctor will prescribe different medicines to treat this condition. 

Ensure you visit the doctor’s clinic immediately if you still experience discharge from the vagina or penis or see no difference in your condition. Also, if you have a high fever, visit the doctor’s clinic.

Lifestyle Changes

As most cases of urethritis are said to be due to sexual activities, your doctor may suggest a few tips to prevent this condition.

Your doctor may give a few suggestions on condoms such as:

• Use external or internal condoms (male or female condoms) to prevent the spread of STIs during vaginal, anal, and oral sex. 
• Check the condom package properly. Do not use a damaged condom.
• Do not use condoms before checking the expiration date. Outdated condoms should be discarded immediately. 
• Remove the condom from the packet carefully. Do not use a torn condom.
• Store condoms at room temperature.
• Always use a new condom every time you have sex. So do not reuse a condom.
• Always use water-based lubricants with male latex condoms. Oil-based lubricants like petroleum jelly, baby oil, or lotion can weaken or destroy latex. 
• For water or oil-based lubricants, use polyurethane/nitrile condoms.

Your doctor may give the following tips to prevent sexually transmitted infections (STIs):

• Avoid sharing towels or clothes
• Wash your genitals after sexual intercourse
• Avoid multiple sexual partners
• Prevent indulging in sexual activity when suffering from any STIs or STDs

Ensure you always use a condom as it protects you and the partners against STIs and STDs like syphilis, herpes simplex virus, and genital warts spread via skin-to-skin contact.