Urethritis involves inflammation of the urethra, often due to bacterial or other infections. It commonly causes pain or burning during urination, discomfort in the genital area, and discharge that may contain pus.
Urethritis can be caused by bacteria passed during sexual contact, including Neisseria gonorrhoeae and Chlamydia trachomatis. It can also happen after use of a urinary catheter.
If urethritis is suspected, consult a urologist, gynecologist, or primary care provider promptly for proper diagnosis. Treatment typically begins with antibiotics selected according to the most probable underlying cause.
Common symptoms
The main symptoms of urethritis are:
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Yellow-green, whitish, bloody, or pus-like discharge from the urethra;
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Itching in the genital area;
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Pain when urinating (dysuria);
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Burning or discomfort in the genital region;
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Redness around the urethral opening;
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Swollen lymph nodes in the groin;
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Blisters or sores in the genital area, in some cases.
In men, urethritis may also cause discomfort or pain when touching the testicles and redness at the tip of the penis. In women, bleeding after sex or pain during sex (dyspareunia) may also occur.
Sometimes, urethritis symptoms can be mistaken for urethral syndrome. Urethral syndrome is inflammation of the urethra that can cause abdominal pain, urinary urgency, pain and irritation when urinating, and a sensation of pressure in the abdomen.
Confirming a diagnosis
A urologist, gynecologist, or primary care provider can diagnose urethritis based on symptoms. A urine test may also be requested to help confirm the diagnosis.
Testing of urethral discharge and/or urine is commonly recommended to identify the cause of urethritis. This helps guide the most appropriate treatment.
Possible causes
The main causes of urethritis are:
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Bacterial infection, such as Neisseria gonorrhoeae and Chlamydia trachomatis;
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Viral infection, such as herpes simplex virus;
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Protozoal infection, such as Trichomonas vaginalis.
The infectious agents most often linked to urethritis are commonly transmitted through sexual contact.
Different types
Depending on the cause, urethritis can be classified as:
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Gonococcal urethritis, when caused by Neisseria gonorrhoeae,
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Nongonococcal urethritis, when inflammation is caused by other microorganisms.
Confirming the type of urethritis is important so the most appropriate treatment can be started.
Treatment options
Urethritis treatment depends on the cause and typically involves antibiotics based on the type of urethritis.
For nongonococcal urethritis, the most commonly used options are:
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Azithromycin: 1 g by mouth as a single dose, or;
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Doxycycline: 100 mg by mouth twice daily for 7 days.
For gonococcal urethritis, the following is usually recommended:
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Ceftriaxone: 500 mg as a single intramuscular injection, and;
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Azithromycin: 1 g by mouth as a single dose
Non-infectious urethritis from urinary catheters, antiseptic products, or friction can often improve by removing or replacing the irritating source. Wearing looser clothing or removing the urinary catheter may also be recommended.
Can urethritis go away on its own?
Urethritis usually does not go away on its own, because most cases are due to bacterial infection and require antibiotics. However, when treatment is followed as directed by a healthcare provider, the condition can be fully cured.