Causes and Risks:

Urethritis may be caused by the same organisms that cause bladder or kidney infections (for example, E coli or Klebsiella) and some sexually-transmitted diseases (for example, Chlamydia, gonorrhea, and Ureaplasma urealyticum infections). Urethritis may also develop because of a chemical sensitivity that results in irritation (such as spermatocide in condoms, contraceptive jelly, cream, or foam). Trauma from insertion of an object into the urethra may also cause urethritis. Increased risk is associated with men between 20 and 35 years old, multiple sexual partners, and those who engage in high-risk sexual behavior (such as lack of condom use or anal intercourse).

Prevention:

Some causes of urethritis may be avoided with good personal hygiene and by practicing safer sexual behaviors (such as monogamy and the use of condoms).

Symptoms:

• dysuria (pain with urination)
• increased urinary frequency or urgency
• tenderness or swelling in penis and/or groin area
• fever
• discharge from penis
• pain with intercourse or ejaculation
• blood in the urine and/or semen

Signs and Tests:

A physical examination may reveal tender and enlarged inguinal lymph nodes (groin area), discharge from the penis, a tender and enlarged penis.

Tests and findings:

• triple-void urine specimens for urinalysis and culture
  • #1 initial stream
  • #2 mid-stream
  • #3 post (after) prostatic massage by examiner
• increased WBCs and bacterial growth on culture in urine #1
• blood may be noted in urine #1
• cultures are obtained for gonorrhea and Chlamydia

Treatment:

Treatment is usually on an outpatient basis. Antibiotics are prescribed for bacterial urethritis. Because of the common association of sexually transmitted diseases, medications that will adequately treat Chlamydia and gonorrhea are most frequently used. Abstinence from intercourse or use of condoms should be recommended throughout the course of treatment. Partners may be treated as well.

Urethritis caused by trauma or chemical irritants is treated by avoiding the precipitating factors.

Analgesics (pain relievers) and urinary tract-specific analgesics (such as phenazopyridine) may be used as concurrent therapy for urethritis of any cause.

Prognosis:

With prompt and accurate diagnosis and treatment, urethritis usually clears up without any complications. However, urethritis can lead to permanent damage to the urethra.

Complications:

Urethritis may proceed up the genito-urinary tract to develop cystitis (bladder infection), pyelonephritis (kidney infection),epididymitis, orchitis, or prostatitis.

Call your health care provider if urethritis symptoms occur.