What is urethritis?

Causes and Symptoms

Urethritis
is most often contracted through intercourse with a partner infected with a sexually transmitted disease (STD), particularly gonorrhea and chlamydia. It will usually appear a few days after sex. Urethritis may also be caused by a variety of other organisms, including Escherichia coli (E. coli) and Mycoplasma genitalium bacteria, Trichomonas vaginalis
protozoa, and herpes simplex viruses. Another source of the disease is irritation of the urethra produced by soaps, lotions, or spermicides. Trauma produced by medical instruments, such as urinary catheters or cystoscopes, can also generate urethritis. Complicated urethritis may be associated with kidney stones, a weak immune system, or malformations of the urinary tract. There are cases of nonspecific urethritis that have no known cause.

General symptoms for males and females include burning or pain when urinating, unusually frequent urination, and chills or fever. In males, pus and cloudy discharges may come from the penis, and the opening to the penis may stick together from dried-up secretions and may be red, sore, and itchy. In females, vaginal discharge may be present, as well as discomfort in the rectal area and pain or bleeding during sexual intercourse. In some cases, no accompanying symptoms are associated with urethritis.

Treatment and Therapy

To assess possible bacterial sources of urethritis, urinalysis and urine culture laboratory tests are performed. Abnormal genital discharges and, in some cases, urethral swabs are also examined. If urethritis is diagnosed, then antibiotics are usually administered. The most common ones used are doxycycline, azithromycin, erythromycin, roxithromycin, and tetracycline. Even for cases of nonspecific urethritis, antibiotics have provided an effective treatment. Drinking copious fluids can help dilute bacteria and flush the urinary system. Acupuncture and homeopathic therapies sometimes help relieve the effects of urethritis.

If symptoms of urethritis are present, then the urethra should be rested by abstaining from sexual intercourse and masturbation until medical treatment has been received. When treated quickly and correctly, the symptoms are usually resolved in one to two weeks. Without proper treatment, serious complications might include infection spreading into the bladder or kidneys, as well as transmission of the causative organism to a sexual partner.

When it is not associated with a general urinary tract infection, urethritis is more common in males than females, probably because males have a longer urethra. In some individuals, nonspecific urethritis can have a high recurrence rate. Burning during urination can be reduced by adding a small amount of baking soda to drinking water to reduce the acidity of urine. Cranberry juice contains a compound that prevents bacteria from sticking to the urethra and growing there.

Bibliography

Beers, Mark H., et al., eds. The Merck Manual of Diagnosis and Therapy. 18th ed. Whitehouse Station, N.J.: Merck Research Laboratories, 2006.

Kasper, Dennis L., et al., eds. Harrison’s Principles of Internal Medicine. 16th ed. New York: McGraw-Hill, 2005.

Schmitt, Barton D. Your Child’s Health: The Parents’ One-Stop Reference Guide to Symptoms, Emergencies, Common Illnesses, Behavior Problems, Healthy Development. Rev. ed. New York: Bantam Books, 2005.