Urethritis is a condition in which the urethra, or the tube that carries urine from the bladder to outside the body, becomes inflamed and irritated. Semen also passes through the male urethra.
Urethritis typically causes pain while urinating and an increased urge to urinate. The primary cause of urethritis is usually infection by bacteria.
Urethritis is not the same as a urinary tract infection (UTI). Urethritis is an inflammation of the urethra, while a UTI is an infection of the urinary tract. They may have similar symptoms, but require different methods of treatment depending on the underlying cause of the urethritis.
Urethritis affects people of all ages. Both males and females can develop the condition. However, females have a greater chance of developing the condition than males. This is partly because men’s urethras, which are the length of the penis, are much longer than women’s. A woman’s urethra is typically one and a half inches long. That makes it easier for bacteria to enter the urethra.
According to Antimicrobe, urethritis occurs in approximately 4 million Americans each year. Nongonococcal urethritis accounting for 80 percent of the cases.
Symptoms in men
Males with urethritis may experience one or more of the following symptoms:
- burning sensation while urinating
- itching or burning near the opening of the penis
- presence of blood in the semen or urine
- discharge from the penis
Symptoms in women
Some symptoms of urethritis in women include:
- more frequent urge to urinate
- discomfort during urination
- burning or irritation at the urethral opening
- abnormal discharge from the vagina may also be present along with the urinary symptoms
People who have urethritis may also not have any noticeable symptoms. This is especially true for women. In men, symptoms may not be apparent if the urethritis developed as a result of chlamydia or occasionally trichomoniasis infection.
For this reason, it’s important to undergo testing if you may have been infected with a sexually transmitted infection (STI).
Generally, most cases of urethritis are the result of an infection from either a bacteria or a virus. Bacteria are the most common causes. The same bacteria that can cause bladder and kidney infections can also infect the lining of the urethra. Bacteria found naturally in the genital area may also cause urethritis if they enter the urinary tract.
According to the Centers for Disease Control and Prevention (CDC), bacteria associated with urethritis include:
- Neisseria gonorrhoeae
- Chlamydia trachomatis
- Mycoplasma genitalium
Pathogens are the biological agents that cause illness. The same pathogens that cause STIs can also cause urethritis. These include the bacteria that cause gonorrhea and chlamydia and the parasite that causes trichomoniasis.
There are also viruses that can lead to the development of urethritis. These include the human papillomavirus (HPV), the herpes simplex virus (HSV), and the cytomegalovirus (CMV).
There are different types of urethritis, classified by the cause of the inflammation. They are gonococcal urethritis and nongonococcal urethritis.
Gonococcal urethritis is caused by the same bacterium that causes the STI gonorrhea. It accounts for 20 percent of cases of urethritis.
Nongonococcal urethritis is urethritis caused by other infections that are not gonorrhea. Chlamydia is a common cause of nongonococcal urethritis, with other STIs also being a probable culprit.
It is possible, however, for irritation unrelated to STIs to occur. These causes can include injury, such as from a catheter, or other kinds of genital trauma.
While plenty of patients have either one type of urethritis or the other, it’s possible to have different causes of urethritis at once. This is especially true in women.
Your doctor will ask you about your symptoms. They’ll likely also examine the genital area for discharge, tenderness, sores and any signs of an STI. This can help them to make a diagnosis.
They may order tests to analyze a urine sample or a swab taken from the urethra or vaginal area. If the doctor suspects a specific STI, there will likely be a test that can allow the doctor to confirm or rule out that potential diagnosis. Blood tests may be taken to check for other STIs, like HIV and syphilis.
Depending on your doctor and their lab, you can get test results back in as soon as a few days. This allows them to start you on treatment as soon as possible, and to let you know whether your partner needs to be tested and treated, too.
Treatment for urethritis typically includes a course of either antibiotics or antiviral medication. Some common treatments for urethritis include:
- azithromycin, an antibiotic, typically taken as a one time dose
- doxycycline, an oral antibiotic that is typically taken twice a day for seven days
- erythromycin, an antibiotic that can be administered orally, four times a day for seven days
- ofloxacin, an oral antibiotic that is typically taken twice a day for seven days
- levofloxacin an oral antibiotic that is typically taken once a day for seven days
If an STI caused the infection, it’s vital that all sexual partners undergo testing and treatment if necessary. This prevents the spread of the STI and reinfection.
You may see improvement in your symptoms just a few days after beginning treatment. You should still finish out your prescription as recommended by your doctor, or the infection could come become worse. Those with urethritis should wait one week once they are completely finished with their prescription and their partner has finished treatment before resuming sexual activity.
Potential drug interactions for the medications used to treat urethritis include:
- blood-thinning medications
- heart medications
- seizure medications
Medication can often treat urethritis quickly. If the infection goes untreated, however, the effects can be lasting and quite serious. For example, the infection may spread to other parts of the urinary tract, including the ureters, kidneys, and bladder. These infections can be painful on their own. While they can be treated with more intensive rounds of antibiotics, they can cause damage to the organs if left untreated for too long. These untreated infections can also spread to the blood and result in sepsis, which can be deadly.
In addition, the STIs that frequently cause urethritis can damage the reproductive system. Women may develop pelvic inflammatory disease (PID), which is painful and can result in infertility, ongoing pelvic pain, or pain during sex. Women with untreated STIs are also at a higher risk for ectopic pregnancies, which can be life-threatening.
Men may develop painful inflammation or infection of the prostate gland, or the narrowing of a section of the urethra due to scarring, leading to painful urination. For these reasons, you should speak with a doctor as soon as possible if you notice any symptoms of urethritis.
Many of the bacteria that cause urethritis can pass to another person through sexual contact. Because of this, practicing safe sex is an important preventive measure. The tips below can help reduce your risk:
- Avoid having intercourse with multiple partners.
- Use condoms every time you have sex.
- Get tested regularly.
- Protect others. If you find out you have an STI, inform others who are also at risk of an infection.
Aside from safer sex practices, there are other ways to promote good urinary tract health. This can lower your risk of urethritis and some other conditions that affect this part of the body. Drink plenty of fluids and make sure to urinate shortly after intercourse. Avoid acidic foods. Also, avoid exposure to spermicides, particularly if you already know they irritate your urethra.