What is Urethritis?

Urethritis is the inflammation and swelling of the urethra - the narrow tube that carries urine from the bladder out of the body.
Urethritis is caused by either a bacterium or a virus - it is classed as either gonococcal urethritis which is caused by Neisseria gonorrhoeae, or non-gonococcal urethritis (NGU), caused by Chlamydia trachomatis - one of the most common sexually transmitted diseases affecting both men and women.
The most common viral causes of urethritis are herpes simplex virus and cytomegalovirus.
The main symptom of urethritis is difficulty urinating and painful urination. Urethritis is typically treated with antibiotics.

Causes of urethritis

The majority of urethritis cases are due to infection resulting from bacteria entering the urethra.
Bacteria that cause urethritis include:

Chlamydia is one of the main causes of urethritis.

• E. coli
• Gonococcus
• Chlamydia trachomatis

Other causes are:

• Herpes simplex
• Reiter's syndrome
• Adenoviridae
• Cytomegalovirus
• Mycoplasma genitalium
• Ureaplasma urealyticum
• Trichomonas vaginalis
• Uropathogenic Escherichia coli

According to the National Institutes of Health, urethritis can also be caused by injury or sensitivity to chemicals used in contraceptive jellies, creams or foams, as well as spermicides.

Risks for urethritis

• Having multiple sexual partners
• History of sexually transmitted diseases
• Engaging in high-risk sexual behavior
• Oral sex could be a major risk factor for nongonococcal urethritis (NGU), according to a study published in the Journal of Infectious Diseases.

Symptoms of urethritis

For men:

• Blood in urine or semen
• Pain ejaculating
• Discharge from penis
• Burning sensation while urinating
• Itching
• Fever (not common)

For women:

• Vaginal discharge
• Pelvic discomfort
• Fever and chills
• Stomach pain
• Itching

Diagnosis of urethritis

Diagnosis of male patients typically involves examining the abdomen, scrotum, penis, and bladder for any swelling or discharge. The doctors may spread the urinary meatus apart to see if there are any abnormalities. A swab is inserted into the urethra which is then examined under a microscope. The urinary meatus is the hole from which urine leaves the body.
Women usually undergo abdominal and pelvic exams to check for tenderness of the urethra and lower abdomen. The doctor will also check for any urethral discharge.
The doctor may recommend cystoscopy - a tube with a camera on the end is inserted into the bladder.
The following diagnostic tests may also be recommended by the health care professional:

• CBC (complete blood count)
• C-reactive protein test
• Tests to check for sexually transmitted diseases, such as gonorrhea or chlamydia
• Urine test
• Pelvic ultrasound (only female patients)

Treatment

Medications are prescribed to treat the root cause of the patient's urethritis, and to prevent the spread of infection.
If the patient has a bacterial infection, an antibiotic will be prescribed. Below are the most commonly prescribed medications for urethritis:

• Doxycycline
• Azithromycin
• Levofloxacin
• Tinidazole
• Erythromycin
• Metronidazole

The patient may also take a non-steroidal anti-inflammatory drug, such as naproxen, along with the antibiotics for symptoms of pain.
Pyridium (phenazopyridine) is effective in treating pain, burning, frequent urination and the increased urge to urinate.

Prevention

Some effective ways of preventing urethritis, include:

• Not engaging in unprotected and risky sexual activity (multiple sexual partners)
• Avoiding chemicals that can irritate the urethra - such as detergents or spermicides
• Good personal hygiene

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