What is Urethritis?

Urethritis is a health condition that involves inflammation of the urethra, as well as possible swelling and irritation in the area that can make it difficult for affected individuals to pass urine.

Causes

It most often occurs as a result of an infection by bacteria or viruses. E. Coli bacteria, sexually transmitted diseases like chlamydia and gonorrhea and viruses such as herpes simplex virus and cytomegalovirus may all be responsible for the infection.

Other causative factors include injury to the area and chemicals used in the pelvic region, such as spermicides and contraceptive jellies and creams. As sexually transmitted diseases can cause urethritis, people who have unprotected sex with many partners usually have a higher risk of contracting the infection.

Symptoms and Complications

Due to differences in the anatomy of the urethra between males and females, the symptoms experienced by those affected by the condition often differ considerably.

Many women do not notice any symptoms at all, although may experience some abdominal pain and burning on urination. Fever may also occur and it is common to need to urinate more frequently.

Men more commonly report symptoms such as:

• Presence of blood in urine and/or semen
• Dysuria
• White discharge from penis
• Frequent urination
• Inflamed penis, including itching and swelling
• Lymph node enlargement
• Pain on ejaculation

A severe infection that is not treated adequately may lead to further complications such as an infection of the bladder, the testicles or the cervix, depending on the gender of the individual.

Diagnosis

When an individual presents with symptoms of urethritis, the initial diagnosis usually commences with a visual examination of the urethra to detect signs of redness, discharge and swollen lymph nodes.

A swab is then taken from inside the urethra, which can be a painful procedure for the patient as no lubricant is used, and is examined in a laboratory for evidence of infection.

If it is a male patient, a digital rectal exam may be needed to test the prostate gland for any associated swelling or inflammation that could be causing symptoms.

Treatment

The primary aim of treatment is to eradicate the infection, which will help to improve symptoms and prevent spread of infection.

The specific treatment for each individual depends on the cause of the infection. If it is caused by bacteria, for example, antibiotics are indicated to target the infection. Clotrimazole, fluconazole, metronidazole and trimethoprim are all appropriate antibiotic choices that are usually effective against the causative bacteria. If a chemical irritant is more likely to be the cause, avoiding the offender and waiting for symptoms to subside is the best course of action.

Pain relief medication such as acetaminophen, ibuprofen and phenazopyridine may also be indicated to provide an immediate analgesic effect before the antibiotics begin to take action.

While treatment is being undertaken, patients should avoid having sex, or use condoms during such activities, to prevent the spread of infection. Additionally, any regular sexual partner should also be treated; regardless of if they have symptoms, as they may also carry the infectious bacteria.

Once the infection has improved and symptoms have subsided, future infections may be prevented with several precautionary methods. It is important to maintain cleanliness standards, particularly around the opening of the urethra. Additionally, it is best if any sexual activity is adequately protected with the use of condoms, which is even more important if there are multiple partners with unknown sexual history.

References

• http://www.fpa.org.uk/sites/default/files/non-specific-urethritis-information-and-advice.pdf
• http://www.cdc.gov/std/treatment/2010/urethritis-and-cervicitis.htm
• http://www.nlm.nih.gov/medlineplus/ency/article/000439.htm
• http://www.ncbi.nlm.nih.gov/pubmed/20353145