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UNIVERSITY STUDENT HEALTH SERVICES • Fact Sheet URETHRITIS WHAT IS IT? Urethritis refers to irritation and inflammation of the urethra, the tube which passes urine from the bladder to the outside of the body. Urethritis is usually caused by an infection of the urethra or the area where the urethra opens at the tip of the penis. This type of infection is commonly seen in young sexually active men. WHAT CAUSES IT? Common sexually transmitted infections (STIs), such as gonorrhea, chlamydia, trichomoniasis, and herpes, are the leading causes of urethritis in young sexually active men. A yeast infection by Candida does not cause true urethritis but can lead to similar symptoms at the tip of the penis. This type of infection is usually due to the spread of yeast from the man’s own skin, not through sexual contact. Neisseria meningitides, a bacterium that is also responsible for a severe form of meningitis, is the cause of urethritis in about 1% of men. Other rare causes of urethritis exist. WHAT ARE COMMON RISK FACTORS? Because urethritis is usually caused by an STI, common risk factors for infection include unprotected sex (especially with a new or casual partner), oral receptive sex, and anal sex. WHAT ARE THE SYMPTOMS? The main symptoms of urethritis are painful urination and penile discharge. Pain, tingling, or burning during or just after urination may occur at the tip or anywhere along the shaft of the penis. Infections or irritation of the prostate gland, bladder, and testicles can also cause discomfort with urination. Penile discharge varies depending on the cause of the infection. o Gonorrhea typically causes a thick creamy discharge, which tends to persist and may even stain underclothing. o A clear or white mucus-like discharge that decreases over several days may be due to chlamydia. o A clear watery discharge accompanied by painful sores or blisters is typical of a herpes infection. o Discharge may occur throughout the day or may only be noticed first thing in the morning. HOW IS IT DIAGNOSED? The medical evaluation begins with a careful history (including STI exposure risks) and an exam of the male genitals (and sometimes the prostate). Laboratory tests may include: Urine samples to test for gonorrhea and chlamydia. These tests are only reliable if the man has not urinated for at least one hour prior to giving the sample. Sometimes, a sample of discharge is taken from the urethra instead. A herpes culture may be sent if ulcerations are present. Unfortunately, the herpes blood test is not useful for initial diagnosis. A urine culture may also be obtained to rule out a urinary tract infection. Testing for other STIs, like HIV and syphilis, may be recommended either at the initial visit or at some point in the future, depending on the patient’s symptom history. WHAT IS THE TREATMENT? Treatment depends on the specific cause of infection: Gonorrhea and chlamydia are bacterial infections that can be treated and cured with antibiotics. Trichomoniasis is a protozoal infection that is also treated with antibiotics. Genital herpes is a viral infection that can be managed with antiviral medications but never completely eliminated. The goals of treatment are to reduce the duration of symptoms, the frequency of outbreaks, and the risk of transmission to others. Urethritis due to other causes is also treatable, depending on the specific diagnosis. If an STI is the cause of your symptoms: It is very important that your sexual partner(s) receive treatment, even if he or she does not have symptoms! Refrain from sexual contact for at least seven days after you and your partner(s) have completed treatment. Otherwise, you are at high risk of re-infecting each other. WHAT ARE POSSIBLE COMPLICATIONS? Complications can occur if: The signs of infection are ignored and treatment is delayed. Reinfection occurs and is not recognized. The treatment plan is not followed. Complications may include: Epididymitis. This is an infection and inflammation of the epididymis, a coiled structure located on the back of the testis that stores and transports sperm. Left untreated, this infection can cause painful ejaculation and/or problems with male fertility. Stricture (narrowing) of the urethra. Untreated infections can lead to scarring that causes permanent narrowing of the urethra. This can interfere with the ability to empty the bladder, cause pain with ejaculation or urination, and increase risks for bladder and kidney infections. Reactive Arthritis (formerly Reiter’s Syndrome). This condition can occur after certain bacterial infections of the intestines or genitals, most commonly due to chlamydia. Symptoms consist of inflammation of the joints (arthritis), eyes (conjunctivitis), and skin. HOW CAN URETHRITIS BE PREVENTED? Because most causes of urethritis are sexually transmitted, practicing safe sex is the best way to prevent infection: Know your partner. Avoid sex with casual partners or strangers. Ask your partner about his or her past sexual history before becoming intimate, and be prepared to share your history as well. Limit your number of partners. Your risk of getting an STI increases as your number of partners increases. Use latex barriers (eg. condoms, dental dams, finger cots) consistently. Using barriers from the beginning to the end of skin contact offers the best protection. Substitute a polyurethane condom if either you or your partner is sensitive to latex. Avoid engaging in unprotected sex with a new partner. What you do to protect yourself will also protect your partner. Get regular STI screening. Screening tests are used to detect infections in people without symptoms. STI screening should be completed at least annually in all sexually active individuals. Testing can prevent STI exposure if both partners are screened prior to becoming sexually intimate. However, if you have any symptoms of a possible infection or think you have been exposed to an STI, it is important to seek medical evaluation as soon as possible. RECOMMENDED WEBSITE: www.cdc.gov ____________________________________________________________________________ Published by VCU Division of Student Affairs and Enrollment Services University Student Health Services (804) 828-8828 - Monroe Park Campus (804) 828-9220 - MCV Campus Wellness Resource Center (804) 828-9355 - 815 S. Cathedral Place Revised 8/12