Diseases Associated With Urethritis (inflammation of the urinary tube, the urethra)

Urethritis

What are the common causes and symptoms of urethritis?

The urethra is a canal in the penis through which urine from the bladder and semen are emptied. Urethritis (inflammation of the urethra) in men begins with a burning sensation during urination and a thick or watery discharge that drips from the opening at the end of the penis. Infection without and symptoms is common. The most common causes of urethritis are the bacteria Neisseria gonorrhea and Chlamydia trachomatis. Both of these infections are usually acquired through sexual exposure to an infected partner. The urethritis can extend to the testicles (orchitis) and the tube connecting the testicles to the urethra, the epididymis (epididymitis). These complicated and potentially severe infections can cause tenderness and pain in the testicles. For example, they occasionally develop into an abscess (pocket of pus) requiring surgery and can even result sterility.

How is urethritis diagnosed?

A person with symptoms of urethritis as described above should seek medical care. An evaluation for urethritis generally requires a laboratory examination of a sample of urethral discharge or of a first-in-the-morning urine sample. The specimens are examined for evidence of inflammation (white blood cells). Urethritis has traditionally been classified into two types: gonococcal (caused by the bacterium responsible for gonorrhea) and non-gonococcal. Chlamydia is the major cause of non-gonococcal urethritis. If evidence of urethritis is present, every effort should be made to determine if it is caused by Neisseria gonorrhea, Chlamydia trachomatis, or both. Several diagnostic tests are currently available for identifying these organisms, including cultures of the urethral discharge (obtained by swabbing the opening of the penis with a cotton swab) or of the urine. Other tests rapidly detect the genetic material of the organisms. Ideally, treatment should be directed towards the cause of infection.

If appropriate and timely follow-up is impossible on the patient's part, however, patients should be treated for both N. gonorrhea and C. trachomatis as soon as urethritis is confirmed, because these organisms commonly occur in the same people, produce similar symptoms, and can cause serious complications if left untreated.