Most episodes of urethritis are caused by infection by bacteria that enter the urethra from the skin around the urethra's opening. Bacteria that commonly cause urethritis include:
E. coli and other bacteria present in stool.
Gonococcus. It is sexually transmitted and causes gonorrhea.
Chlamydia trachomatis. It is sexually transmitted and causes chlamydia.
The herpes simplex virus (HSV-1 and HSV-2) can also cause urethritis. Trichomonas is another cause of urethritis. It is a single-celled organism that is sexually transmitted.
Sexually transmitted infections like gonorrhea and chlamydia are usually confined to the urethra. But they may extend into women's reproductive organs, causing pelvic inflammatory disease (PID).
In men, gonorrhea and chlamydia sometimes cause epididymitis, an infection of the epididymis, a tube on the outside of the testes. Both PID and epididymitis can lead to infertility.
The main symptom of urethra inflammation from urethritis is pain with urination (dysuria). In addition to pain, urethritis symptoms include:
Feeling the frequent or urgent need to urinate
Difficulty starting urination
Urethritis can also cause itching, pain, or discomfort when a person is not urinating.
Other symptoms of urethritis include:
Pain during sex
Discharge from the urethral opening or vagina
In men, blood in the semen or urine
Diagnosis of Urethritis
You may get a diagnosis of urethritis when your doctor takes your medical history and asks you about your symptoms.
If you are having painful urination, your doctor may assume an infection is present. He or she may treat it with antibiotics right away while waiting for test results.
Tests can help confirm the diagnosis of urethritis and its cause. Tests for urethritis can include:
Physical examination, including the genitals, abdomen, and rectum.
Urine tests for gonorrhea, chlamydia, or other bacteria.
Examination of any discharge under a microscope.
Blood tests are often not necessary for the diagnosis of urethritis. But blood tests may be done in certain situations.
Antibiotics can successfully cure urethritis caused by bacteria. Many different antibiotics can treat urethritis. Some of the most commonly prescribed include:
Adoxa, Monodox, Oracea, Vibramycin (doxycycline)
Zithromax, Zmax (azithromycin)
Urethritis due to trichomonas infection (called trichomoniasis) is usually treated with an antibiotic called Flagyl (metronidazole). Tindamax (tinidazole) is another antibiotic that can treat trichomoniasis.
Urethritis due to herpes simplex virus can be treated with:
Often, the exact organism causing urethritis cannot be identified. In these situations, a doctor may prescribe one or more antibiotics that are likely to cure infection that may be present.