Nongonococcal Urethritis in Men
What is nongonococcal urethritis?
Nongonococcal urethritis (NGU), sometimes called nonspecific urethritis (NSU), 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.
How does nongonococcal urethritis 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.
Symptoms and Causes
What causes nongonococcal urethritis?
NGU is caused by a bacterium called Chlamydia trachomatis. There are several other bacteria—including Ureaplasma urealyticum, _Mycoplasma, _and Trichomonas—that can cause symptoms similar to those of NGU.
What are the symptoms of nongonococcal urethritis?
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 in 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 the infection is not treated, it 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. A similar infection can occur in females and potentially lead to pelvic inflammatory disease (severe infection in the pelvis and reproductive organs) and sterility.
Diagnosis and Tests
How can I know if I have nongonococcal urethritis?
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. 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 also infected with chlamydia.) Testing for HIV and other STIs should also be done in confirmed cases of NGU because they can be acquired at the same time, or may already be present.
Management and Treatment
How is nongonococcal urethritis treated?
NGU is usually treated with antibiotics, which kill the germs that are causing the infection. The antibiotics most commonly used to treat NGU are doxycycline, which is taken twice a day for a week, or macrolide antibiotics, such as azithromycin, given as a single dose. This treatment cures the infection about 90% 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 for nongonococcal urethritis?
- 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.
- You can check yourself 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, contact to your healthcare provider for further treatment.