Definition of Urethritis

Urethritis – inflammation of an ureter. Infection, typically a sexually transmitted disease (STD), is the most common cause of urethritis though urethritis may occur as a result of inflammation or irritation from trauma such as occurs with bladder catheterization or cystoscopy.

Traumatic urethritis improves rapidly when the source of the trauma is gone, often without further treatment.

Urologists classify infectious urethritis as gonococcal urethritis (GU) or nongonococcal urethritis (NGU).

Symptoms may be vague and transient (disappear in a few days) or nonexistent, though the infection remains. In about 40 percent of women, urethritis progresses to pelvic inflammatory disease (pid)and infertility. Repeated or untreated urethritis in men may destroy testicular tissue, resulting in sterility. As well, untreated urethritis in men or women remains contagious through sexual contact.

Symptoms and Diagnostic Path

Often urethritis does not have symptoms, particularly in women. When symptoms are present they typically include

Laboratory analysis of discharge or swabs of the interior of the urethra identify the responsible pathogen. Generally no further diagnostic procedures are necessary unless other health concerns coexist.

Treatment Options and Outlook

Treatment is the appropriate antibiotic medication to kill the pathogen. It is important to take the full amount of the antibiotic as prescribed. Though tempting to stop the medication when symptoms abate, incomplete treatment allows the bacteria to surge back to reinfect. It also can permit bacteria to develop resistance to commonly prescribed antibiotics, requiring more powerful antibiotics for subsequent treatment.

Both GU and NGU can occur repeatedly when the person becomes reinfected. Each cycle of infection requires treatment. It is important (and in many states a legal requirement) to notify sexual partners so they also can receive treatment.

Risk Factors and Preventive Measures

The primary risk for GU and NGU infection is unprotected sex, particularly with multiple partners. Men who have sex with men are at highest risk. Safer sex methods, including the use of a new condom for each sex act, help reduce exposure to the bacteria that cause urethritis though are not foolproof.

Traumatic urethritis sometimes becomes chronic in people who must use longterm bladder catheterization, such as those who have spinal cord injury resulting in paraplegia. The urologist may prescribe prophylactic antibiotics and anti-inflammatory medications in such situations. Diligent personal hygiene further helps reduce irritation and infection.

See also CHLAMYDIA; CYSTITISEPIDIDYMITISGONORRHEAPROSTATITIS; REITER’S SYNDROMESEXUAL HEALTHSEXUALLY TRANSMITTED DISEASES (STDS).

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