What is urethritis?

Urethritis refers to irritation or inflammation of the urethra. The urethra is the tube that empties urine from the bladder. In men the urethra extends the full length of the penis. The female urethra is much shorter, about an inch long, and the opening is just above the vagina. Because the opening of a woman's urethra is so close to the vagina and anus, bacteria can easily enter it from these areas.

How does it occur?

Urethritis may at times simply be an irritation caused by rubbing or pressure on the groin area. For example, tight clothing can cause urethritis. It may also result from an irritant such as soap, powder, or spermicides. Some people are unable to use spermicides for this reason.

Sometimes vaginal infections (for example, a yeast infection) will cause women to have symptoms of urethritis.

Most commonly, however, especially in males, urethritis results from a sexually transmitted disease (STD). The two most common STDs associated with urethritis in males are chlamydia and gonorrhea. However, other STDs can cause these symptoms as well, including herpes simplex virus and the human papilloma virus. Less serious STDs such as trichomonas can cause symptoms also.

What are the symptoms?

In men, symptoms are painful urination or discharge from the urethra. The opening of the urethra (the meatus) may be irritated.

In women the symptoms are similar to the symptoms of a bladder infection: painful urination, frequency of urination, and a sensation of incomplete emptying of the bladder.

How is it diagnosed?

Your health care provider will ask about exposure to possible irritants and your recent sexual history.

If you are a man and have a discharge from the penis, the discharge may be examined for white blood cells and bacteria. Samples will be tested to find out if gonorrhea or chlamydia is the cause. If the usual tests for STDs are negative, your provider may conclude that you have nonspecific urethritis (NSU). There are a few bacteria associated with NSU, but it is not easy to test for them.

In women the diagnosis can be more difficult than in men. Urethritis almost never causes a discharge from a woman's urethra. Occasionally the urethra is inflamed. Your health care provider will examine the urethra and area around it and will obtain a urine sample. He or she may also swab the urethral area. The cervix may be swabbed to test for chlamydial infection in the pelvis.

What is the treatment?

If you are a woman and there is no evidence for chemical irritation and no evidence of infection in the urine, you may be treated for chlamydial infection as the cause of urethritis. Whether you are a man or woman, if lab tests show that the urethritis is caused by an STD, your provider will prescribe an antibiotic for the infection. You may be treated with an antibiotic even before lab results are available.

If your health care provider finds or suspects that you have a sexually transmitted infection, your sexual partner(s) must obtain prompt treatment, too. To avoid reinfection, use latex condoms if you have sexual intercourse during the time you are taking the antibiotic.

How long will the symptoms last?

You should stop having symptoms caused by a chlamydial or gonorrheal infection within just a few days of starting the antibiotic.

Men who have nonspecific urethritis may continue to have a small amount of discharge from the urethra that is clear to slightly cloudy in color. Usually there is no persistent discomfort. If you do have discomfort, it is important to visit your health care provider again.

What can be done to help prevent urethritis?

Avoid irritants and chemicals that cause redness, burning, or itching in the area of the urethra. Use condoms during every sexual activity.