Urethritis

Urethritis refers to the inflammation of the urethra where it becomes irritated and swollen.

The urethra is the thin tube that carries urine from the bladder to the outside of the body.

Urethritis can occur in men and in women and may last for weeks or months.

Urethritis can be divided into two main groups depending on the causes:

• Gonococcal urethritis: Caused by the bacteria responsible of gonorrhea (neisseria gonorrheae).
• Non-gonococcal urethritis: Not related with gonorrhea.
  • Due to infection by other bacteria or viruses (Chlamydia trachomatis, mycoplasma genitalium, etc.).
  • Urethral stricture (narrowing of the urethra caused by injury or structural problems).

Almost all the viruses, bacteria and parasites responsible of STDs (Sexually Transmitted Diseases) can cause urethritis (for example gonorrhea, chlamydia, etc.).

It is called urethral syndrome when symptoms are present but there is no evidence of infection by viruses or bacteria.

The main symptoms of urethritis are:

• Excessive urgency and frequency of urination.
• Dysuria: Pain, discomfort or burning in the urethra and lower abdomen when urinating.
• Urethral discharge that can be bloody (with blood) or purulent (with pus).

For a proper diagnosis of the disease the following screening tests are available:

• Urinalysis, that may reveal the presence of an infection
• Urine culture with antibiogram to confirm the infection, to know the virus or bacterium involved and to prescribe the appropriate antibiotic.
• Urethral discharge culture or genital culture to detect any STD (Sexually Transmitted Disease)
• Cystoscopy, to look inside the urethra and bladder using a thin camera. This procedure is not always necessary. It is usually performed when the urethritis cannot be cured or the cause is unknown.

Once diagnosed, the treatment requires antibiotics (ceftriaxone, doxycycline, azithromycin) and after the full course of medication, a culture is performed to confirm the efficacy.

When urethritis does not clear up after treatment and last for more than 6 weeks is called chronic urethritis.

Women with recurrent episodes of urethritis or cystitis may be prescribed with a postcoital dose of antiseptic (to be taken shortly before or after sexual intercourse).

People with urethral syndrome (symptoms without evidence of infection) may be treated with phenazopyridine to decrease discomfort with urination.

In most cases, it is possible to know the causal agent and start the treatment with a good prognosis.

It is advisable to drink much water.

Women with urinary tract infection associated with intercourse (the symptoms appear within 24 hours of intercourse) should urinate right after intercourse.

It is also important to follow good hygienic practices by the affected person and by their partner. Hygiene should be adequate, neither excessive nor deficient. Soaps suitable for the genital area (not excessively aggressive) are the appropriate ones.

Safer sex practices may reduce the risk of transmission of STDs (Sexually Transmitted Diseases) related to urethritis.

As soon as the first symptoms appear, it is important to follow a proper care in order to avoid a persistent damage to the tissues.

Urethritis infections may have long-term consequences when left untreated, such as pyelonephritis (kidney infection) or a structural damage to the urinary tract.