Infectious urethritis improves quickly with antibiotics

Dr. Anthony L. Komaroff

DEAR DOCTOR K: The doctor says I have urethritis. How did I get it?

DEAR READER: Urethritis is an inflammation of the urethra, the tube that carries urine from the bladder out of the body. Urethritis is quite common, both in men and women. It is more common in younger adults, because they are more likely to be sexually active with multiple partners.

Urethritis is usually caused by one of two types of sexually transmitted infections:

Gonococcal urethritis is caused by the bacteria that cause gonorrhea. Gonorrhea is sometimes called clap. Gonorrhea infections are passed from person to person during sexual activity. This includes vaginal, oral and anal intercourse.

Non-gonococcal urethritis is caused by all sexually transmitted bacteria other than gonorrhea. The most frequent cause is a particular type of bacteria called Chlamydia trachomatis.

You can prevent both of these infections by:

• not having sex;

• having sex with only one uninfected partner;

• consistently using male latex condoms during sexual activity.

Much less often, urethritis results from a physical injury from something like a urinary catheter. Or it may occur because of exposure to a chemical in an antiseptic or a spermicide that causes irritation of the lining of the urethra.

Urethritis usually causes pain or burning during urination and an urge to urinate more frequently. Another symptom is redness around the opening of the urethra. Men with infectious urethritis may have a yellow discharge from the urethra. Women are less likely than men to have symptoms from gonorrhea and chlamydia.

If you have infectious urethritis, you will be treated with antibiotics. Do not have sex until your antibiotic treatment is complete. Otherwise, you could spread the infection to your partner. (Your sexual partner or partners should be treated with antibiotics as well.)

Many people have gonorrhea and chlamydia at the same time. So if you are treated for gonorrhea, your doctor will probably also treat you for chlamydia. That means you may need to take two types of antibiotics.

Once you start taking antibiotics, infectious urethritis improves rapidly. Even without treatment, symptoms usually go away within three months. However, people continue to remain infectious and spread the bacteria to others, even when they have no symptoms.

Urethritis caused by injury or chemical irritation is rare. You do not need any specific treatment for this type of urethritis. The symptoms will go away if you avoid whatever it was that caused the problem. In the meantime, your doctor may prescribe medication to ease your symptoms.

The bacteria that cause both gonococcal and non-gonococcal urethritis can spread if they are not diagnosed and treated — from a woman's cervix to her fallopian tubes, for example. There, they can cause permanent scarring and infertility. They also can spread through the blood to other parts of the body, including the heart, liver and joints.

So if you have symptoms of urethritis, take them seriously and contact your doctor.
