Urethritis

Overview

What is urethritis?

Urethritis is an inflammation (swelling and irritation) of the urethra, the tube that takes urine (pee) from your bladder to the outside of your body. Typically, urethritis is caused by an infection. Most commonly, but not always, the cause is a sexually transmitted infection (sexually transmitted disease) (STD/STI).

Are there different types of urethritis?

Yes, there are different types of urethritis. They include:

  • Gonococcal urethritis is caused by gonorrhea.
  • Nongonococcal urethritis (NGU) is caused by something other than gonorrhea. This could be from another type of STI or from repeated irritation of your urethra.
  • Non-specific urethritis (NSU) refers to urethritis that doesn’t have a known cause.

Who does urethritis affect?

Anyone can get urethritis. However, there are risk factors for urethritis. Some of them are:

  • Being between the ages of 15 and 24.
  • Having more than one sexual partner.
  • Having unprotected sex.
  • Using items that might contain irritants, such as deodorant tampons, douches, spermicides or personal lubricants.
  • Experiencing trauma to your urethra. This could happen in an injury or by having something put up into the urethra, like a urinary catheter.

How common is urethritis?

There are about four million people in the U.S. who get urethritis each year. About three million of these cases aren’t caused by gonorrhea (NGU). Globally, there are about 62 million new cases per year of urethritis caused by gonorrhea and about 89 million cases of NGU each year.

These numbers may be low because it’s possible to have the condition without having symptoms. If this is true, you’re said to be asymptomatic.

Symptoms and Causes

What are the signs and symptoms of urethritis?

Signs and symptoms of urethritis may include:

  • Pain while peeing (dysuria).
  • Pain during sexual intercourse (dyspareunia).
  • Itchiness at the tip of the urethra.
  • Penile discharge, including pus and/or blood.
  • Pelvic pain.

Men often have symptoms from nongonococcal urethritis, but women may not have symptoms.

What causes urethritis?

Sexually transmitted infections are a common cause of urethritis. Apart from gonorrhea, other STIs are related to urethritis, including:

However, you can also get urethritis from:

  • Urinary tract infections.
  • Yeast infections.
  • Exposure to irritants like spermicides, douches and soaps.
  • Squeezing your penis roughly.
  • Activities that put pressure on your urethra, like riding a bicycle or some sexual acts.
  • Putting something up inside your urethra, such as a catheter to help you pee.

Is urethritis contagious?

Urethritis itself isn’t contagious, but the infections that cause it can be contagious. If you have urethritis caused by an STI, you should be treated for the STI. Your partner or partners should also be treated. If only one of you is treated, you’ll just keep passing the infection between you.

Diagnosis and Tests

How is urethritis diagnosed?

Your healthcare provider will take a medical history and ask you questions, some of them about your sexual history. They will also do a physical examination to check for redness or discoloration, swelling and pain.

Your provider may order tests that may include:

  • Lab tests of discharge.
  • Blood tests.
  • Urine tests.

These tests may help your provider diagnose urethritis and the type of infection causing it.

Management and Treatment

How is urethritis treated?

Antibiotics are the main treatment for urethritis, either alone or in combination. Some of the antibiotics used to treat urethritis include:

  • Azithromycin.
  • Doxycycline.
  • Ofloxacin.
  • Levofloxacin.
  • Ceftriaxone.
  • Cefixime.

Your provider may start you on antibiotics even before getting results back if they believe you have an infection. They might also suggest you use a pain reliever.

If you have urethritis from friction or from using irritating chemicals like soap or spermicide, your provider will suggest that you stop wearing tight clothing, stop using the irritant and cut back on the time you spend doing the activity that causes friction.

Complications/side effects of the treatment

Many antibiotics do have side effects that can include nausea, diarrhea and stomach pain. Sometimes antibiotics may interact with other medications. Be sure to discuss all of your medications and over-the-counter treatments with your healthcare provider or pharmacist.

How soon after treatment will I feel better?

Make sure to take all of your antibiotics as instructed by your healthcare provider. Usually, you’ll need to take the medications for a week to 10 days. You’ll probably begin to feel better after a few days, but it’s important to make sure that you take the entire prescription.

Prevention

How can I prevent urethritis?

You can reduce your risk of developing urethritis by:

  • Doing things to avoid getting STIs, such as practicing safe sex and limiting the number of your sexual partners.
  • Getting regular tests for STIs if you’re sexually active.
  • Avoiding chemicals that may irritate your urethra.
  • Avoiding actions that may irritate your urethra.

Outlook / Prognosis

What can I expect if I have urethritis?

If you have urethritis and you’re treated with the correct medication, you should be cured entirely. It’s important to note that your sexual partners must also take the medication. If only one of you is treated, you can continue to pass the infection back and forth.

If you’re both treated, you should wait until neither of you has symptoms before resuming sexual activity. Your healthcare provider is likely to give you tips on safe sex, which may include using barrier methods of contraception and infection prevention. These include condoms, female condoms and dental dams.

What happens if you have urethritis and it’s not treated?

Urethritis may clear up on its own in time. However, if it’s caused by sexually transmitted infections, those germs will stay in your system. Untreated STIs can cause problems later. These conditions include:

Living With

How do I take care of myself?

If you have urethritis, you can:

  • Take over-the-counter pain relievers to help with the pain.
  • Drink lots of water so your pee is diluted and may hurt less.
  • Pee when you need to — don’t try to stop yourself.
  • Take “sitz” baths in warm water two or three times per day. These types of baths may use a special basin that fits on a toilet or can be done in a bathtub. Basically, you just use enough water to cover your genital area and you stay covered for about 10 to 15 minutes per bath.

When should I see my healthcare provider?

If you’ve been diagnosed with urethritis, call your provider if:

  • You aren’t feeling any better even though you’ve followed directions about taking your medication.
  • You feel like you’re getting worse.
  • You’ve developed new signs or symptoms that are worrying you.
  • You’re having a bad reaction to your medication.

A note from Cleveland Clinic

If you are feeling pain when you pee, or itchiness, you may have urethritis. This diagnosis is more likely if you’re sexually active and if you’ve had unprotected sex. You should make an appointment with your healthcare provider. Your provider will ask you questions about your sex life. It’s important to be honest with your provider about your sexual activity so they can provide the best diagnosis and treatment. Urethritis can be cured.

Last reviewed by a Cleveland Clinic medical professional on 04/05/2022.

References

  • Young A, Toncar A, Wray AA. Urethritis. (https://www.ncbi.nlm.nih.gov/books/NBK537282/) [Updated 2021 Jul 29]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Accessed 4/5/2022.
  • NHS. Nongonococcal urethritis. (https://www.nhs.uk/conditions/non-gonococcal-urethritis/#:~:text=Urethritis%20is%20inflammation%20of%20the,the%20sexually%20transmitted%20infection%20gonorrhoea.) Accessed 4/5/2022.
  • Merck Manuals. Urethritis. (https://www.merckmanuals.com/home/kidney-and-urinary-tract-disorders/urinary-tract-infections-utis/urethritis) Accessed 4/5/2022.
  • The Urinary System. In: Suneja M, Szot JF, LeBlond RF, Brown DD. eds. DeGowin’s Diagnostic Examination, 11e. McGraw Hill; 2020. Accessed 4/5/2022.

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