Urethritis

Urethritis (yoor-uh-THRI-tis) is inflammation in your urethra. Your urethra is the tube that takes pee from your urinary bladder to the outside of your body. Typically, a bacterial infection causes urethritis. Sexually transmitted infections (STIs) are the most common type of infections that cause it.

Urethritis is common. Anyone can get it. About 4 million people in the U.S. get it each year. And throughout the world, around 151 million people get it annually. These numbers may be low. It’s possible to have urethritis without having any symptoms (asymptomatic).

Types of urethritis

The different types of urethritis include:

• Gonococcal urethritis: Gonorrhea causes gonococcal urethritis. There are about 600,000 new cases of gonococcal urethritis each year in the U.S.
• Nongonococcal urethritis (NGU): Something other than gonorrhea causes NGU. It could be another type of STI or repeated irritation in your urethra. There are about 3 million new cases of NGU each year in the U.S. Males are more likely to have symptoms of NGU than females.
• Nonspecific urethritis: This type doesn’t have a known cause.

Symptoms of urethritis

Signs and symptoms of urethritis include:

• Blood in your pee (hematuria)
• Itchiness at the tip of your urethra
• Pain during sexual intercourse (dyspareunia)
• Pain while peeing (dysuria)
• Pelvic pain

Pus, blood or a cloudy yellow or white fluid (discharge) may leak from the tip of your penis. You may also have blood in your semen (hematospermia).

How do you get urethritis?

STIs are a common cause of urethritis. Besides gonorrhea, other STIs that can cause urethritis include:

• Chlamydia
• Genital herpes
• Trichomoniasis (trich)

Other urethritis causes include:

• Activities that put pressure on your urethra, like riding a bicycle or some sexual acts
• Irritants like spermicides, scented tampons and pads, douches, scented soaps and lubricants (lube)
• Squeezing your penis tightly
• Trauma to your urethra, like an injury or the use of a urinary catheter or sounds for urethral dilation
• Yeast infections

Is it a UTI?

Not always. But urinary tract infections (UTIs) can sometimes cause urethritis.

Is it contagious?

Urethritis itself isn’t contagious. But the infections that cause it can be contagious. If an STI causes urethritis, you should get treatment for it as soon as possible. Anyone else you have sexual intercourse with should also get treatment. If only one person gets treatment, you may keep passing the STI to each other.

Risk factors

You’re more likely to get urethritis if you:

• Are between 15 and 24
• Have more than one sexual partner
• Have unprotected sexual intercourse

Complications of urethritis

Without treatment, urethritis can spread and affect other parts of your urinary system and male or female reproductive systems. You’re at a greater risk of:

• Bladder infection
• Cervix infection
• Epididymis inflammation (epididymitis)
• Pelvic inflammatory disease
• Prostate infection
• Testicle infection

It can also cause:

• A fertilized egg to implant outside of your uterus (ectopic pregnancy)
• An abscess in your urethra
• Infertility
• Reactive arthritis
• Scar tissue in your urethra
• Swelling in your penis
• Swelling in the lymph channels of your penis

How doctors diagnose it

A healthcare provider will review your medical history and ask you questions about your symptoms and sexual history. They’ll also perform a physical exam of your genitals (which may include a digital rectal exam for males and a pelvic exam for females).

They’ll also recommend tests, like:

• Blood tests
• Gonorrhea test or other STI tests
• Pee tests (urinalysis)

These tests help confirm a urethritis diagnosis. They also help find out if a certain type of infection is the cause.

How is urethritis treated?

Antibiotics are the main treatment for urethritis. You may only need one antibiotic, or you may need a combination of different ones. Antibiotics that healthcare providers commonly prescribe to treat urethritis include:

• Azithromycin (Zithromax®)
• Cefixime (Suprax®)
• Ceftriaxone (Ceftrisol Plus®, Rocephin®)
• Doxycycline (Acticlate®, Doxal®, Morgidox®)

If they believe you have an infection, your provider may start you on antibiotics even before getting your test results back. They may also suggest taking a pain reliever.

Can it resolve on its own?

For most infectious causes, no. But for some noninfectious causes, it may go away on its own. Your healthcare provider may recommend that you:

• Stop using products that have irritating chemicals
• Avoid tight clothing
• Cut back on activities that cause irritation

Recovery time

You should start to feel better a few days after taking antibiotics. Usually, you’ll need to take the medications for a week to 10 days.

When should I see my healthcare provider?

Call a healthcare provider if you have symptoms of urethritis. Contact them again if you’ve already started treatment and:

• Still have symptoms after a week
• Feel worse
• Develop new symptoms
• Have a bad reaction to your medication

They may recommend additional tests or prescribe a different antibiotic.

During your appointment, you may wish to ask the following questions:

• If I don’t have urethritis, what other condition could be causing my symptoms?
• How long do I need to take my antibiotics?
• Do I need to take my antibiotics at a particular time of day?
• Are there any directions for storing my antibiotics?
• When do you think I’ll feel better?
• Should I schedule a follow-up appointment?

What can I expect if I have urethritis?

With proper diagnosis and treatment, the prognosis for urethritis is good. Make sure to take all your medicine, even if you feel better. If you don’t finish your full course of antibiotics, the infection may come back and be harder to treat.

Tell your sexual partner(s) if you have urethritis. They must also take antibiotics. If only one of you receives treatment, you can pass the infection back and forth to each other.

Can I have sex if I have it?

Avoid having sexual intercourse until you and your partner(s) receive treatment and no longer have symptoms.

How can you soothe an irritated urethra?

If you have urethritis, you can help relieve discomfort and pain by:

• Taking over-the-counter (OTC) pain relievers to help with pain
• Drinking lots of water
• Peeing when you need to — don’t try to stop yourself, even if it hurts
• Taking a sitz bath two to three times per day

Can it be prevented?

You can help lower your risk of developing urethritis by:

• Reducing your risk of STIs by using condoms and limiting your number of sexual partners
• Getting regular STI tests if you’re sexually active
• Avoiding chemicals or activities that may irritate your urethra