Urethritis is inflammation of the urethra. That's the tube that carries urine from the bladder to outside the body.
Pain with urination is the main symptom of urethritis. Urethritis is commonly due to infection by bacteria, most often through sexual contact. It can typically be cured with antibiotics.
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:
- Gonococcus, which is sexually transmitted and causes gonorrhea.
- Chlamydia trachomatis, which is sexually transmitted and causes chlamydia.
- Bacteria in and around stool.
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. They 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, doxycycline (Vibramycin), Monodox, Oracea
- Azithromycin (Zmax), Zithromax
- Ceftriaxone (Rocephin)
Urethritis due to trichomonas infection (called trichomoniasis) is usually treated with an antibiotic called metronidazole (Flagyl). Tinidazole (Tindamax) is another antibiotic that can treat trichomoniasis. Your sexual partner should also be treated to prevent reinfection. It’s important to get retested after three months to make sure the infection is completely cleared. This includes even if your partner was treated.
Urethritis due to herpes simplex virus can be treated with:
- Acyclovir (Zovirax)
- Famciclovir (Famvir)
- Valacyclovir (Valtrex)
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.