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 mans own skin, not
through sexual transmission. The bacterium that causes a severe form of meningitis, Neisseria
meningitides, causes urethritis in about 1% of men. Other rare causes of urethritis exist.

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 opening of the urethra,
the tip of the penis, 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 can vary depending on the cause of the infection. Gonorrhea typically causes
a thick creamy discharge. A clear or white mucus-like discharge may be due to chlamydia. A
clear watery discharge accompanied by painful sores or blisters is typical of a herpes infection.
Discharge may occur throughout the day or may only occur first thing in the morning. Discharge
from chlamydia tends to decline several days after infection, while discharge from gonorrhea
tends to persist and may even stain underclothing.

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 chlaymdia. 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 HIV and syphilis may be recommended either at the time of the initial evaluation
or at some point in the future, depending on the time of possible exposure to infection.

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, 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.

CAN COMPLICATIONS OCCUR?
Yes. 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 Reiters 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, adhering to safe sexual practices 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. Never engage 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 is a reasonable option once a year if you are not in a committed
relationship or if you have other risk factors for STI exposure. 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




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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 8/11