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Non-specific urethritis contents

Essential facts

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Diagnosis and management

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Chlamydia information

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Urethritis, Non-Specific Urethritis and Urethral Irritation
Essential facts

What is it?

Symptoms

Diagnosis

Treatment

Non-Specific Urethritis

Recurrent or Persistent Urethritis

Urethral Irritation

Urethritis is inflammation of the urethra (the passage in the penis that urine and semen pass through). It has several causes, the most common are chlamydia or gonorrhoea, but other bacteria may be involved. Often the cause is not identified.

Symptoms

There are no symptoms at all. When symptoms are present, they may include:

• discharge (milky or pus-like) from the penis

• stinging or burning during urination

• itching, tingling, burning or irritation inside the penis.

Diagnosis

If someone has any of the symptoms described above, special tests are required to find out if the person has urethritis. The doctor gently inserts a swab into the urethra. The swab is then examined in the laboratory for signs of infection. Swabs should be taken 3 or 4 hours after the person last passed urine.

At the STD clinic, if an infection is present, it can sometimes be detected on the same day. However, it usually takes several days for chlamydia and gonorrhoea results to become available.

Treatment of urethritis

Urethritis is usually treated with doxycycline (Doryx, Vibramycin, Doxylin) or azithromycin (Zithromax). 

Doxycycline

Directions for taking doxycycline

• Doxycycline capsules must be taken after a meal
• Take a single dose of two capsules daily for 10 days
• Drink a full glass of water after taking the capsules, and do not lie down for at least half an hour.

Side effects

The main side effects of doxycycline are irritation of the stomach and increased sensitivity of the skin to sunlight. Stomach irritation is less likely if you avoid alcohol. 

Do not have sex until all results of your tests are back and you have finished taking all the tablets. 

Azithromycin

Directions for taking azithromycin

• Take 1 gram as a single dose
• this may be 2 or 4 tablets (depending on their strength).

Side effects

Azithromycin may cause abdominal pain and nausea. If this happens, eating sometimes helps. The symptoms usually settle within a few hours. 

Do not have sex until all results of your tests are back and at least one week has passed. 

Symptoms of discharge, stinging or irritation will settle down much more quickly if you rest the urethra by not having sex (vaginal, oral or anal) and not masturbating. Squeezing or milking the penis to look for a discharge will irritate the urethra and the symptoms will take longer to disappear.

• Return to the clinic to obtain the final results of all your tests.

• Never share your treatment with anyone else.

• Partners do not automatically require treatment. They should be examined by a doctor first.

Non specific urethritis (NSU)

Urethritis not caused by either gonorrhoea or chlamydia is called non specific urethritis, or NSU. The cause of NSU is not known, however antibiotic treatment is effective.

Although NSU does not cause symptoms in women, female partners of men with NSU may need to be examined.

Recurrent or persistent urethritis

Sometimes the symptoms of urethritis are slow to settle, or they may return after a week or two. If you have taken antibiotics and there has been no further sex, it is unlikely that any infection is still present. The symptoms are likely to resolve in a week or two and you should not need further treatment. If you have had further sex or did not take all of the medication as directed, you may need further tests and should consult a doctor.

Urethral Irritation

Occasionally, a man may experience a discharge, or burning on urination but there is laboratory tests show no evidence of infection. This condition is called urethral irritation, and it means that the urethra has been affected by something other than an infection.

Possible causes of this condition include:

• repeated squeezing or milking of the urethra

• very frequent or vigorous masturbation or sexual activity

• concentrated urine caused by dehydration

• caffeine and/or alcohol, some medications

• general illness

• allergies.

Urethral irritation is not a sexually transmitted condition and it always settles without antibiotic treatment. It will settle faster if you avoid - sex, masturbation, squeezing the penis, alcohol and caffeine consumption.

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