by Alan R

Urethritis

(Urethral Infection)

Definition

Urethritis is an inflammation, infection, or irritation of the urethra. The urethra is the tube that carries urine out of the body from the bladder.
Female Urethra
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Causes

Urethritis is usually caused by bacteria or viruses, including:
  • Organisms that cause bladder or kidney infections
  • Organisms that cause sexually transmitted diseases (STDs)
  • Other bacteria

Risk Factors

Urethritis is more common in women. Other factors that may increase your chance of urethritis include:
  • Multiple sexual partners
  • Recent change in sexual partners
  • Unprotected sex (without use of a condom)
  • History of other STDs
  • Bacterial infection of other parts of the urinary tract (bladder, kidney, prostate)
  • Medications that lower resistance to bacterial infection
  • Having catheters or tubes placed in the bladder
  • Acidic foods
  • Spermicides

Symptoms

People with urethritis may not have symptoms, especially women. About half of men infected with chlamydia have no symptoms.
Urethritis may cause:
  • Pain and/or burning while urinating
  • Blood in the urine
  • Increase in urinary:
    • Frequency
    • Urgency
  • Itching, swelling, and/or tenderness in the groin
  • Pain during sex
Urethritis symptoms specific to men may include:
  • Discharge from the penis
  • Blood in the semen
  • Pain during ejaculation
  • Swollen and/or tender testicles
If left untreated, urethritis can spread and cause infection in other parts of the urinary tract such as the bladder, ureters, or kidneys.

Diagnosis

Your doctor will ask about your symptoms and medical history. A physical exam will be done. It will include a pelvic exam. Urethritis is usually diagnosed from its symptoms. Tests to confirm the diagnosis and identify the organism causing the condition may include:
  • Urethral swab for microscopic study or culture
  • Blood and urine tests
  • Specific tests for gonorrhea, chlamydia, or other STDs

Treatment

Urethritis is usually treated with medication. The type of medication will depend on the cause of the urethral infection:
  • Antibiotics—to treat urethritis caused by bacteria
  • Antiviral drugs—to treat urethritis caused by a some viruses
Refraining form sexual activity recommended until 7 days after initiation of therapy.
If urethritis is caused by an STD, all sexual partners should be tested and treated.

Prevention

To help reduce your chance of urethritis::
  • Practicing safe sex by using condoms and barrier methods of contraception
  • Urinating immediately after having sexual intercourse
  • Treating all sexual partners who are infected or exposed
  • Regularly drinking plenty of fluids

RESOURCES

Centers for Disease Control and Prevention http://www.cdc.gov

Urology Care Foundation http://www.urologyhealth.org

CANADIAN RESOURCES

Canadian Urological Association http://www.cua.org

Women's Health Matters http://www.womenshealthmatters.ca

References

Centers for Disease Control and Prevention. Sexually Transmitted Diseases Treatment Guidelines, 2010. MMWR. 2010;59(No. RR-12):1-110.

Diseases characterized by urethritis and cervicitis. Centers for Disease Control and Prevention website. Available at: http://www.cdc.gov/std/treatment/2010/urethritis-and-cervicitis.htm. Updated August 18, 2014. Accessed September 30, 2014.

Diseases characterized by urethritis and cervicitis. MMWR Recomm Rep. 2006;55(R11):1-94.

Miller KE. Diagnosis and treatment of Chlamydia trachomatis infection. Am Fam Physician. 2006;73:1411-1416.

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