What are the other Names for this Condition? (Also known as/Synonyms)

• Infection of the Urethra
• Inflammation of the Urethra
• Urethral Infection

What is Urethritis? (Definition/Background Information)

• Urethritis is an infection/inflammation (swelling or irritation) of the lining of the urethra. It is caused by a variety of bacteria, viruses, and protozoa
• The urethra is a narrow tube that carries urine from the bladder, to outside the body
• Urethritis may affect men and women of all ages; though, it is generally observed in women of reproductive age group and young men
• Common signs and symptoms associated with Urethritis include painful urination and urethral discharge
• The condition is diagnosed by a few tests that include urine analysis, culture, and examination of urethral discharge under a microscope
• With correct diagnosis and treatment, almost all the patients recover with no long-term complications

Who gets Urethritis? (Age and Sex Distribution)

• Urethritis is typically observed in women, who are in their child-bearing/reproductive age, and among young men (20-35 years age group)
• However, Urethral Infections may affect men and women of all ages
• Women are affected more often than men, because of the shorter length of their urethra; also, because of the proximity of female urethra to anus

What are the Risk Factors for Urethritis? (Predisposing Factors)

Common risk factors associated with Urethritis are:

• Women, who are in their reproductive ages
• Young men
• Having multiple sexual partners
• Unprotected sex (not using condoms)
• High-risk sexual behavior (such as anal sex)
• History of sexually transmitted diseases

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases ones chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.

Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.

What are the Causes of Urethritis? (Etiology)

Urethritis is an infection of the urethra that may be caused by several species of bacteria, viruses, and protozoa.

Common bacteria causing Urethritis include:

• Bacteria causing sexually transmitted infections, such as:
  • Neisseria gonorrhea:
  • Chlamydia trachomatis
  • Mycoplasma genitalium
  • Ureaplasma urealyticum
• Escherichia coli that is present in the anal canal/feces

Common viruses causing Urethritis include:

• Herpes simplex virus that causes sexually transmitted infections
• Adenovirus - especially, if the patient has red eye or discharge

Protozoa causing Urethral Infection include:

• Trichomonas vaginalis that causes sexually transmitted infections

A few other causes of Urethritis are:

• Injury to the urethra
• Sensitivity to the chemicals in spermicides or contraceptives creams or jellies

What are the Signs and Symptoms of Urethritis?

The signs and symptoms associated with Urethritis are the following:

In women the following may be observed:

• Pain in the lower abdomen and pelvis
• Burning pain while passing urine (dysuria)
• Frequent or urgent urination
• Urethral discharge (may be pus-filled, whitish, and mucoid)
• Fever and chills
• Pain during sex
• Urine that appear cloudy
• Blood in the urine
• Unusual vaginal discharge

In men the following may be observed:

• Blood in the urine or semen
• Burning pain while passing urine (dysuria)
• Pus or whitish mucus discharge from the penis
• Frequent or urgent urination
• Itching, pain, or discomfort, in the penis or groin area
• Pain during intercourse or ejaculation
• Fever (though this is rare)

Sometimes there may be no symptoms of Urethritis, particularly in women.

How is Urethritis Diagnosed?

In order to diagnose Urethritis, the physician shall initially perform a physical exam with evaluation of medical history.

In women, during physical examination, the physician will look for:

• Discharge from the urethra
• Tenderness of the urethra
• Tenderness in the lower abdomen

In men, during physical examination, the physician will look for:

• Discharge from the penis
• Tender and swollen penis
• Tender and swollen testes
• Rectal examination to inspect prostate gland for swelling and tenderness

Diagnostic tests that may be required include:

• Complete blood count (CBC): It may show an increased white blood cell (WBC) count indicating infection
• Urine analysis: The urine may appear cloudy or may have WBC (leukocyte) esterase or nitrites in the urine. A presence of these two substances indicates an infection
• Urine culture: Midstream urine(the urine that is collected after discarding the initial flow of urine) is sent to the laboratory, to observe the growth of any bacteria
• Urethral swab: A cotton swab is inserted into the urethra, rotated and then it is smeared on a glass slide, in order to be observed under a microscope (to look for the number of white blood cells)
• Specific tests may be performed for chlamydia, gonorrhea, and other sexually transmitted infections

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.

What are the possible Complications of Urethritis?

The complications of Urethritis may include:

• After a severe infection, the urethra may become scarred and then narrowed (a condition termed urethral stricture)
• Urethritis that is not treated properly may also cause urethral stricture and the infection might spread to the surrounding reproductive organs, causing permanent damage resulting in infertility
• Urethral stricture, if left untreated might cause damage to the kidneys in the long-term

Other complications of Urethritis include:

• In men, Urethritis may spread to the surrounding organs causing infections, such as:
  • Cystitis (infection of the bladder)
  • Epididymitis (infection of the epididymis)
  • Orchitis (infection of the testes)
  • Prostatitis (infection of the prostate)
• Women with Urethritis are at risk for the following infections:
  • Cystitis (infection of bladder)
  • Cervicitis (infection of the cervix)
  • Pelvic inflammatory disease (an infection of the uterus, fallopian tubes, and ovaries)

How is Urethritis Treated?

A treatment of Urethritis may be undertaken as:

• Antibiotics are used to treat Urethritis caused by bacteria. Some antibiotics are given as a single dose, while others are given over a period of 7-10 days
• Antivirals are used to treat Urethritis caused by viruses
• Metronidazole is usually given to treat Trichomonas vaginalis infection
• A suitable treatment has to be undertaken for sexually transmitted diseases (if any present)
• Sexual intercourse should be avoided for at least 7 days, or until the symptoms have resolved
• Urethritis caused by chemical irritants is generally treated by avoidance of the source of irritation

How can it be Prevented?

Some causal factors of Urethritis may be avoided by practicing the following measures:

• Maintaining good personal hygiene, such as proper wiping after urinary and bowel movements
• Limiting the number of sexual partners (practicing monogamy)
• Practicing safe sexual behavior (using condoms, avoiding anal intercourse)
• Avoiding irritants causing the condition, such as lotion, detergents, spermicides, and contraceptives

What is the Prognosis of Urethritis? (Outcomes/Resolutions)

• With correct diagnosis and suitable treatment, the prognosis for Urethritis is generally excellent
• If left untreated, Urethritis can cause permanent damage to urethra and other urinary, reproductive organs in both men and women
• Urethritis has a tendency to recur; thus, if symptoms persist after completion of the antibiotic course, a physician should be consulted

Additional and Relevant Useful Information for Urethritis:

Partners of patients affected by sexually transmitted infections should also be treated accordingly.