Inflammation of the urethra (urethritis)

Explanation

Urethritis means inflammation of the urethra. The most common types of urethritis are mechanical urethritis, which occurs in people with a long-term indwelling catheter, and infectious urethritis. Infectious urethritis is usually transmitted through sexual activity, and the organisms responsible are often common sexually transmitted organisms such as gonococci, Chlamydia, Ureaplasma, Mycoplasma, trichomonads, and sometimes yeasts or the herpes simplex virus. (Sexually transmitted infections)

Symptoms and diagnosis

In the acute stage of the disease, there is often a urethral discharge, and the causative organism or inflammatory cells will usually be detectable in this discharge. In later stages these can be detected in either a swab of the urethra or in a ‘first-void urine’ sample (the first bit of urine you pass when you pass water).
As the disease progresses, patients complain of a burning sensation in the urethra, pain when passing water and in some cases blood in their urine. There is often redness at the external opening of the urethra.

Treatment

Due to increasing antibiotic resistance, antibiotic susceptibility testing should be carried out before treating both the patient and their partner with appropriate antibiotics. Antibiotic-resistant organisms can eventually cause scarring, resulting in narrowing of the urethra (urethral stricture).
Depending on risk status, it may be appropriate to perform HIV and syphilis tests. If untreated the disease is likely to be spread to the patient’s sexual partners and can cause long-term complications. Patients should refrain from having sex until the disease has been completely cured.