Urethritis

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What is urethritis?

Inflammation of the urethra, the small tube through which urine flows to exit the body, is called urethritis. Urethritis can be caused by irritation or infection. Sexually transmitted diseases, such as gonorrhea and Chlamydia, are common causes of urethritis. Other infectious agents that can cause urethritis include Mycoplasma genitalium, Trichomonas vaginalis, herpes simplex virus (HSV), and Escherichia coli (E coli).

Urethritis can also be associated with Reiter’s syndrome (form of arthritis), which is a complication of some types of infection. Non-infectious causes of urethritis include physical injury or trauma and chemical irritation from soaps, spermicides, lubricants, bubble baths, or other substances.

Urethritis can occur without symptoms in some people. Others may experience symptoms, such as burning with urination, the need to urinate frequently or urgently, penile or vaginal discharge, pain, or fever.

Treatment of non-infectious urethritis may include avoiding irritants or ongoing trauma. Infections are often treatable with antibiotics. Treating partners and avoiding sex during treatment is important when the condition is related to sexually transmitted diseases. Left untreated, urethritis can lead to complications, such as bladder infections; narrowing and scarring of the urethra; infection and inflammation of the testicles, prostate, epididymis or cervix; pelvic inflammatory disease (PID, an infection of a woman’s reproductive organs); and infertility.

Spread of infections causing urethritis to other organs can lead to serious, even life-threatening, complications. Seek immediate medical care (call 911) for symptoms, such as high fever (higher than 101 degrees Fahrenheit), severe nausea and vomiting, or severe pain in the pelvis or abdomen.

Seek prompt medical care if you have symptoms of urethritis or are being treated for it but symptoms recur or are persistent.

What are the symptoms of urethritis?

Some people who have urethritis do not have any symptoms. Some symptoms, such as burning with urination, urinary frequency or urgency, and lower abdominal or pelvic pain, resemble those of a bladder infection. Other symptoms can include discharge, pain during sexual intercourse, and fever.

Common symptoms of urethritis

Common symptoms of urethritis include:

  • Abdominal or pelvic pain
  • Blood in the semen (hematospermia)
  • Bloody or pink-colored urine (hematuria)
  • Frequent urination
  • Itching feeling of the penis or groin
  • Pain during sexual intercourse
  • Pain or burning with urination
  • Pain with ejaculation
  • Urgent need to urinate
  • Vaginal or penile discharge

Serious symptoms that might indicate a life-threatening condition

In some cases, complications of urethritis can be life threatening. Seek immediate medical care (call 911) if you, or someone you are with, have any of these life-threatening symptoms including:

What causes urethritis?

Urethritis has both infections and non-infectious causes. Non-infectious causes of urethritis include physical injury or trauma and chemical irritation from soaps, spermicides, lubricants, bubble baths, or other substances.

Neisseria gonorrhoeae and Chlamydia trachomatis infections are two common, sexually transmitted causes of urethritis. Urethritis caused by N gonorrhoeae is often called gonococcal urethritis; other forms of urethritis are often referred to as nongonococcal urethritis. In addition to chlamydial infections, Mycoplasma genitalium, Trichomonas vaginalis, herpes simplex virus (HSV), and Escherichia coli (E coli) can also cause nongonococcal urethritis. Additionally, urethritis, in combination with arthritis and eye inflammation, can be a complication of some types of infections.

What are the risk factors for urethritis?

A number of factors increase the risk of developing urethritis. Not all people with risk factors will get urethritis. Risk factors for urethritis include:

  • Female gender of reproductive age

  • Male gender and age between 20 and 35

  • Multiple sexual partners

  • Participation in activities that could traumatize the urethra

  • Personal high-risk sexual behavior (unprotected sex)

  • Personal history of a sexually transmitted disease, bacterial vaginosis, or recurrent candidiasis

  • Sexual contact with someone who engages in high-risk sexual behavior or who has had a sexually transmitted disease

  • Use of deodorant tampons or douches

  • Use of spermicides or lubricants with irritants

  • Young age at first sexual intercourse

Reducing your risk of urethritis

You may be able to lower your risk of urethritis by:

  • Avoiding known irritants

  • Avoiding sexual intercourse

  • Engaging in sexual intercourse only with a monogamous partner

  • Getting tested for sexually transmitted diseases annually if you have multiple sexual partners or a new sexual partner

  • Using condoms during sexual intercourse

How is urethritis treated?

Treatment of urethritis begins with seeking regular medical care throughout your life. Regular medical care allows a health care professional to provide early screening tests. Regular medical care also provides an opportunity for your health care professional to evaluate your symptoms and your risks for developing urethritis promptly.

Urethritis due to trauma or irritation may resolve when you avoid further trauma or exposure to irritants. Urethritis due to infection is often treated with antibiotics. With sexually transmitted diseases, it is important that your partner be treated at the same time and that you refrain from sex during treatment to avoid reinfection.

Common treatments for urethritis

Common treatments for urethritis include:

  • Antibiotics, such as azithromycin (Zithromax), doxycycline (Vibramycin), erythromycin, levofloxacin (Levaquin), metronidazole (Flagyl), ofloxacin (Floxin), penicillin V, or tinidazole (Tindamax) for the treatment of infection

  • Avoidance of trauma or irritants

  • Non-narcotic pain relievers, such as acetaminophen (Tylenol), ibuprofen (Advil, Motrin), naprosyn (Naproxen, Aleve), or indomethacin (Indocin), to reduce pain

  • Phenazopyridine (Pyridium), a pain reliever that is specifically effective for urinary tract pain

What you can do to improve your urethritis

When a sexually transmitted disease, such as Chlamydia, gonorrhea, or trichomoniasis (sexually transmitted disease caused by a parasite), causes urethritis, following your treatment plan can help reduce your risk of reinfection and complications. Additional ways to improve your urethritis include:

  • Abstaining from intercourse until you and your partner(s) have completed treatment and have no symptoms

  • Finishing all medication as prescribed

  • Getting retested as directed after completing therapy

  • Referring your sexual partner(s) for testing and treatment

What are the potential complications of urethritis?

Complications of untreated urethritis can be serious, even life threatening in some cases. You can help minimize your risk of serious complications by following the treatment plan you and your health care professional design specifically for you. Complications of urethritis include:

  • Chronic pelvic pain

  • Epididymitis

  • Infertility

  • Pelvic inflammatory disease (PID, an infection of a woman’s reproductive organs)

  • Perinatal transmission of infection to newborn

  • Proctitis

  • Prostatitis (inflammation and infection of the prostate)

  • Reiter syndrome (joint and ocular inflammation)

  • Spread of infection (endocarditis, meningitis, sepsis)

  • Urethral scarring and narrowing

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Medical Reviewer: William C. Lloyd III, MD, FACS
Last Review Date: 2021 Jan 18
THIS TOOL DOES NOT PROVIDE MEDICAL ADVICE. It is intended for informational purposes only. It is not a substitute for professional medical advice, diagnosis or treatment. Never ignore professional medical advice in seeking treatment because of something you have read on the site. If you think you may have a medical emergency, immediately call your doctor or dial 911.
  1. Urinary tract infection - adults. Medline Plus, a service of the National Library of Medicine National Institutes of Health. http://www.nlm.nih.gov/medlineplus/ency/article/000521.htm.
  2. Urethritis. PubMed Health, a service of the NLM from the NIH. http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001475/.
  3. Manhart LE, Gillespie CW, Lowens MS, et al. Standard treatment regimens for nongonococcal urethritis have similar but declining cure rates: a randomized controlled trial. Clin Infect Dis 2013; 56:934.
  4. Bope ET, Kellerman RD (Eds.) Conn’s Current Therapy. Philadelphia: Saunders, 2013.
  5. Domino FJ (Ed.) Five Minute Clinical Consult. Philadelphia: Lippincott Williams & Wilkins, 2013.
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