Urethritis is the inflammation of the urethra, the tube that transports urine from the bladder out of the body. This condition is common in men, particularly those under 25, and often presents with symptoms like discharge or painful urination. Timely treatment is important to resolve symptoms and prevent complications.
Understanding the Causes of Urethritis
Urethritis primarily stems from infectious agents, with sexually transmitted infections (STIs) being the most frequent culprits. Gonococcal urethritis (GU) is caused by Neisseria gonorrhoeae, while non-gonococcal urethritis (NGU) can result from other bacteria. Chlamydia trachomatis and Mycoplasma genitalium are common bacterial causes of NGU, accounting for 15-40% and 15-20% of cases, respectively.
Less commonly, viruses like herpes simplex virus (HSV) or cytomegalovirus can cause urethritis. Beyond infections, non-infectious factors can irritate the urethra, causing inflammation. These include physical injury, such as from catheterization or vigorous sexual activity, or chemical irritation from certain soaps, lubricants, or spermicides. Identifying the cause is important for effective treatment.
Primary Treatment Methods
Antibiotics are the primary treatment for urethritis caused by bacterial infections. The specific antibiotic regimen depends on the identified or suspected pathogen. For gonococcal urethritis, a single intramuscular dose of ceftriaxone, 1 gram, is recommended due to increasing antibiotic resistance patterns.
For non-gonococcal urethritis, doxycycline 100 mg twice daily for seven days is a first-line treatment, targeting Chlamydia trachomatis and Mycoplasma genitalium. An alternative is a single 1-gram oral dose of azithromycin, or 1.5 grams over five days, though resistance to azithromycin is increasing. In cases where both gonococcal and non-gonococcal infections are suspected, a combination of ceftriaxone and either azithromycin or doxycycline may be prescribed as empiric treatment. It is important to complete the entire course of medication, even if symptoms improve, to ensure the infection is eradicated and prevent recurrence. For non-infectious causes, treatment focuses on identifying and eliminating the irritating substance or activity.
Navigating Your Treatment Journey
Individuals undergoing treatment for urethritis should abstain from sexual activity until medication is completed and symptoms resolve. This prevents spread and re-infection. Sexual partners from the previous 60 days should also be notified and treated simultaneously, even if asymptomatic, to break the cycle of transmission.
Follow-up appointments are advised to ensure the infection has cleared and to monitor for persistent symptoms or complications. Symptoms begin to improve within three days of starting antibiotic treatment. If symptoms persist or worsen after completing medication, further evaluation is necessary to rule out antibiotic resistance, re-infection, or an alternative diagnosis. Testing for other sexually transmitted infections, including HIV and syphilis, is recommended at the time of diagnosis.
Strategies for Prevention
Preventing urethritis involves practicing safer sexual behaviors, as STIs are a leading cause. Consistent and correct use of condoms during vaginal, anal, and oral sex reduces transmission risk. Avoiding the sharing of sex toys or cleaning and covering them with a new condom before each use also helps.
Regular STI screening is advised, especially for individuals with multiple sexual partners or high-risk sexual behaviors. If non-infectious causes of urethritis have been identified, such as sensitivity to certain chemicals, avoiding those irritants prevents future episodes. Maintaining good genital hygiene contributes to urethral health.