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Urethritis

By

Talha H. Imam

, MD, University of Riverside School of Medicine

Last full review/revision Jul 2021| Content last modified Jul 2021
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Urethritis is infection of the urethra, the tube that carries urine from the bladder out of the body.

  • Bacteria, including those that are sexually transmitted, are the most common cause of urethritis.

  • Symptoms include pain while urinating, a frequent or urgent need to urinate, and sometimes a discharge.

  • Antibiotics are usually given to treat the infection.

Causes of Urethritis

Sexually transmitted diseases Overview of Sexually Transmitted Diseases (STDs) Sexually transmitted (venereal) diseases are infections that are typically, but not exclusively, passed from person to person through sexual contact. Sexually transmitted diseases may be caused... read more Overview of Sexually Transmitted Diseases (STDs) are common causes of urethritis. Organisms—such as Neisseria gonorrhoeae, which causes gonorrhea Gonorrhea Gonorrhea is a sexually transmitted disease caused by the bacteria Neisseria gonorrhoeae, which infect the lining of the urethra, cervix, rectum, and throat or the membranes that cover the front... read more Gonorrhea —can spread to the urethra during sexual intercourse with an infected partner. Chlamydia and the herpes simplex virus are also commonly transmitted sexually and can cause urethritis (see Chlamydial and Other Infections Chlamydial and Other Nongonococcal Infections Chlamydial infections include sexually transmitted diseases of the urethra, cervix, and rectum that are caused by the bacteria Chlamydia trachomatis. These bacteria can also infect the membranes... read more Chlamydial and Other Nongonococcal Infections ). When men develop urethritis, the gonorrheal organism is a very common cause. Although this organism may infect the urethra in women, the vagina, cervix, uterus, ovaries, and fallopian tubes are more likely to be infected. Trichomonas, a type of microscopic parasite, also causes urethritis in men. Urethritis may also be caused by the bacteria that commonly cause other urinary tract infections, such as Escherichia coli.

Symptoms of Urethritis

In both men and women, there is usually pain during urination and a frequent, urgent need to urinate. Sometimes people have no symptoms. In men, when gonorrhea Gonorrhea Gonorrhea is a sexually transmitted disease caused by the bacteria Neisseria gonorrhoeae, which infect the lining of the urethra, cervix, rectum, and throat or the membranes that cover the front... read more Gonorrhea or chlamydia Chlamydial and Other Nongonococcal Infections Chlamydial infections include sexually transmitted diseases of the urethra, cervix, and rectum that are caused by the bacteria Chlamydia trachomatis. These bacteria can also infect the membranes... read more Chlamydial and Other Nongonococcal Infections is the cause, there is usually a discharge from the urethra. The discharge is often yellowish green and thick when the gonococcal organism is involved and may be clear and thinner when other organisms are involved. In women, discharge is less common.

Complications of Urethritis

Infections of the urethra that are not treated or are inadequately treated may cause a narrowing (stricture) of the urethra. Urethral Stricture A urethral stricture is scarring that narrows the urethra. A urethral stricture may be Present from birth Develop after an infection or injury A urethral stricture most commonly results from... read more A stricture increases the risk that infections will develop in the bladder or the kidneys. Untreated gonorrhea Gonorrhea Gonorrhea is a sexually transmitted disease caused by the bacteria Neisseria gonorrhoeae, which infect the lining of the urethra, cervix, rectum, and throat or the membranes that cover the front... read more Gonorrhea rarely leads to an accumulation of pus (abscess) around the urethra. An abscess can cause outpouchings from the urethral wall (urethral diverticula), which can also become infected. If the abscess perforates the skin, the vagina, or the rectum, urine may flow through a newly created abnormal connection (urethral fistula).

Diagnosis of Urethritis

  • Urinalysis

  • Sometimes urethral swab

  • Sometimes urine culture

Doctors can usually make a diagnosis of urethritis based on the symptoms and examination. A sample of the discharge, if present, is collected by inserting a soft-tipped swab into the end of the urethra. The urethral swab is then sent to a laboratory for analysis so that the infecting organism can be identified.

Prevention and Treatment of Urethritis

  • Antibiotics for common causes; antivirals for herpes simplex

  • For sexually transmitted infections, treatment of partners

Treatment depends on the cause of the infection. However, identification of the organism causing urethritis can take days. Thus, doctors usually begin treatment with antibiotics that cure the most common causes. For sexually active men, treatment is usually with a ceftriaxone injection for gonorrhea plus oral azithromycin or oral doxycycline for chlamydia. If tests exclude the possibility of gonorrhea and chlamydia, trimethoprim/sulfamethoxazole or a fluoroquinolone antibiotic (such as ciprofloxacin) may be used. Women may be treated as if they had cystitis. Bladder Infection Cystitis is infection of the bladder. Usually, bacteria are the cause of cystitis. A frequent need to urinate and pain or burning while urinating are the most common symptoms. Doctors can often... read more Bladder Infection An antiviral drug, such as acyclovir, may be needed for a herpes simplex infection. If the cause is suspected to be an STD, the person's sex partners should be evaluated for treatment. Men who receive a diagnosis of urethritis should be tested for HIV Human Immunodeficiency Virus (HIV) Infection Human immunodeficiency virus (HIV) infection is a viral infection that progressively destroys certain white blood cells and can cause acquired immunodeficiency syndrome (AIDS). HIV is transmitted... read more Human Immunodeficiency Virus (HIV) Infection and syphilis. Syphilis Syphilis is a sexually transmitted disease caused by the bacteria Treponema pallidum. Syphilis can occur in three stages of symptoms, separated by periods of apparent good health. It begins... read more Syphilis

More Information

The following is an English-language resource that may be useful. Please note that THE MANUAL is not responsible for the content of this resource.

Drugs Mentioned In This Article

Generic Name Select Brand Names
CILOXAN, CIPRO
ZITHROMAX
No US brand name
PERIOSTAT, VIBRAMYCIN
ROCEPHIN
ZOVIRAX
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Test your knowledge

Bladder Infection
Bladder infections (cystitis) are usually caused by bacteria. Most people with cystitis need to urinate frequently. Pain and/or burning on urination are also common. Which of the following groups of people with bladder infections may experience no symptoms or may develop confusion as their only symptom?
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