What is NGU?

Nongonococcal urethritis (NGU) is sometimes called nonspecific urethritis (NSU). It is an infection of the urethra (the tube leading from the urinary bladder to outside the body). The symptoms of NGU are similar to gonorrhea, but the usual treatments for gonorrhea will not work.

What causes NGU?

NGU is caused by a bacterium called Chlamydia trachomatis. There are several other bacteria—including Ureaplasma urealyticum, Mycoplasma and Trichomonas—that can cause symptoms resembling those of NGU.

How does NGU spread?

NGU is a sexually transmitted infection (STI). It is passed from one person to another by unprotected sexual contact. It can be spread through vaginal sex, oral sex or anal sex.

What are the symptoms of NGU?

It usually takes one to three weeks after the infection occurs before a man develops any symptoms of NGU. The first symptom is usually a leakage of milky fluid (discharge) from the tip of the penis. The amount of discharge may vary from a little to quite a lot. There also may be mild burning of the penis during urination. If the symptoms are ignored, the discharge may decrease although the infection is still present. Sometimes there are no symptoms. If left untreated, the infection may move up around the testicles, causing pain, swelling and sterility. The infection also may spread to other parts of the body, causing severe illness.

How can I know if I have NGU?

If you think you have NGU, or any STI, contact your health care provider. He or she will examine you and perform tests, if necessary, to determine if you have an STI. A sample of fluid is taken from the penis and tested for the germs that cause gonorrhea and chlamydia. Notably, 20% of men with gonorrhea are co-infected with Chlamydia. Testing for HIV and other STIs should also be done in confirmed cases of NGU.

How is NGU treated?

NGU is most often treated with medicines known as antibiotics. Antibiotics kill the germs causing the infection. The most common antibiotics used to treat NGU are doxycycline, which is taken twice a day for a week, or macrolide antibiotics, such as azithromycin. This treatment cures the infection about 90 percent of the time. If you are allergic to doxycycline, or if doxycycline does not cure your infection, other medicines may be used.

What should I do after being treated?

  • Make sure you take all of the medicine you have been given. Do not stop taking the medicine, even if your symptoms go away. Do not share your medicine with others.
  • Do not have sex until you have taken all of the medicine and you are sure that the discharge is gone.
  • Men can check themselves for discharge by gently squeezing the penis. The best time to do this is when you get up in the morning before you urinate. Clear fluid from the penis is normal. A discharge that looks like milk or pus means that you still have an infection. Don't check for discharge more than once a day. Squeezing the penis more often may cause irritation and discharge even when there is not an infection.
  • Avoid re-infection by always using condoms for vaginal, oral and anal sex.
  • Contact all of the people with whom you have had sex during the last three months and advise them to get treated. Remember that there are other causes of NGU besides chlamydia. Even if your partner has a negative chlamydia test, he or she may still have given you the infection.
  • If the discharge doesn't go away, or if it goes away and then comes back, return to your health care provider for further treatment.

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This information is provided by the Cleveland Clinic and is not intended to replace the medical advice of your doctor or health care provider. Please consult your health care provider for advice about a specific medical condition. This document was last reviewed on: 1/26/2010...#4426