Urethritis

What is urethritis?

Urethritis refers to irritation or inflammation of the urethra. The urethra is the tube that empties urine from the bladder. In men the urethra extends the full length of the penis. In women the urethra is much shorter, about 1 and 1/2 inches long, and the opening is just above the vagina. Because the opening of the urethra is so just above the vagina and not far from the anus, bacteria can easily enter it from these areas.

How does it occur?

Most often urethritis results from a sexually transmitted disease (STD), such as chlamydia or gonorrhea.

In women urethritis may at times simply be an irritation caused by rubbing or pressure on the groin area. For example, tight clothing or sexual intercourse can cause urethritis. It can also be caused by physical activity such as long and frequent bicycle riding. Irritants such as soap, body powder, or spermicides are other possible causes.

Sometimes vaginal infections (for example, a yeast infection) cause women to have symptoms of urethritis.

In most older women, the tissues of the urethra and bladder become thinner and drier after menopause because of a lack of the female hormone estrogen. This is the usual cause of urethritis in older women.

What are the symptoms?

In men, symptoms are painful urination or discharge from the urethra. The opening of the urethra may be irritated.

In women the symptoms are similar to the symptoms of a bladder infection:

• pain when you urinate
• frequent urges to urinate
• the feeling that the bladder is never empty
• pain during sexual intercourse.

How is it diagnosed?

Your healthcare provider will ask about possible irritants and your recent sexual history.

If you are a man and have a discharge from the penis, the discharge may be tested in the lab. If tests for STDs are negative, your provider may conclude that you have nonspecific urethritis (NSU). There are several types of bacteria associated with NSU, but it is not easy to test for them.

In women the diagnosis can be more difficult than in men. Urethritis almost never causes a discharge from a woman's urethra. Sometimes the urethra is red or swollen. Your healthcare provider will examine the urethra and area around it and will get a urine sample. Your provider may also swab the urethral area and cervix. Your provider may look for drying and thinning of the tissues in your genital area.

How is it treated?

If lab tests show that the urethritis is caused by a treatable STD, your healthcare provider will prescribe an antibiotic. Your provider may recommend that you start taking the medicine before you get the lab results. Your provider may prescribe another medicine, Pyridium, to help relieve discomfort in the bladder.

For older women the most common treatment for genital tissue thinning and dryness is estrogen. Oral estrogen, estrogen cream for the genital area, or estrogen skin patches may be used.

If your healthcare provider finds or suspects that you have an STD, your sexual partner(s) may need to be treated too. To avoid reinfection, use latex or polyurethane condoms if you have intercourse while you are taking the antibiotic. Your provider may recommend that you avoid intercourse for a while.

How long will the symptoms last?

Symptoms caused by an infection should stop within a few days of starting the antibiotic. A woman starting to take estrogen for postmenopausal tissue changes may feel some relief from her symptoms after several days or weeks.

Men who have nonspecific urethritis may continue to have a small amount of discharge from the urethra. The discharge may be clear to slightly cloudy in color. If you keep having discomfort, tell your healthcare provider.

How can I help take care of myself?

Follow your healthcare provider's instructions. Take all medicine exactly as it is prescribed.

What can be done to help prevent urethritis?

• Avoid activities, chemicals, or other irritants that cause redness, burning, or itching in the area of the urethra.
• Menopausal and older women may consider using oral estrogen, estrogen vaginal cream, or estrogen skin patches to help prevent tissue thinning and dryness.
• Use latex or polyurethane condoms during sex to help prevent infection with an STD.