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Urethritis in Men

Medical Author:Lisa D. Mills, MD


Coauthor:Trevor Mills, MD, MPH
Medical Editor:Melissa Conrad Stppler, MD, Chief Medical Editor

Overview
Urethritis is inflammation of the urethra. The urethra is the tube that connects the urinary bladder to the
outside of the body and includes the opening at the end of the penis. Both urine and semen pass through
the urethra.

Urethritis may be caused by the germs that cause sexually transmitted diseases(STDs) or the germs that
cause urinary tract infections (also called bladder infections), and the symptoms of these conditions may
be similar.

Men between 20-35 years of age are most at risk for developing infectious urethritis, as are men who
have multiple sexual partners or those who engage in high-risk behaviors such as not using condoms or
anal intercourse.

Causes

The sexually transmitted diseases gonorrhea and chlamydia cause the majority of cases of
infectious urethritis. The virus that causes herpes and other infections transmitted during sexual
activity can also cause urethritis.
Chemical irritation caused by soaps, lotions, and colognes can cause temporary pain in the
urethra. Spermicide in condoms and contraceptive jelly, cream, or foam can also cause irritation.
Mechanical manipulation of the penis or minor trauma may lead to urethritis. Medical
procedures, rubbing on rough clothing, as well as vigorous sexually activity or masturbation can cause
a temporary irritation of the urethra.
Sometimes ejaculation can cause a temporary feeling similar to urethritis. This usually goes
away in a brief period without any specific treatment.
Chronic urethritis (when the condition lasts for weeks or months or goes away and comes back)
may be caused by bacteria. But it can also be caused by a narrowing of the tube (urethra) itself.

Symptoms and Signs

Burning and pain when urinating are classic symptoms of urethritis. You may also feel the urge to urinate
more often than normal. Other symptoms can include itching, tenderness, or swelling in the penis, pain
with sexual intercourse, or blood in the urine or semen.
Some infections also may be associated with discharge from the penis. Painful ulcers on the
genitals can be present with herpes urethritis, another sexually transmitted disease.
Simple urethritis does not cause fever or severe illness. If the disease spreads to other organs in
the genital or urinary tract or into the bloodstream, however, it may result in the following:

o Back pain

o Abdominal pain
o High fevers

o Nausea

o Vomiting

o Swollen joints and other symptoms of disease throughout the body

When to Seek Medical Care

For temporary, mild urethritis that comes from using a new soap or lotion, you may not need to see your
health-care provider. But other cases of urethritis may need to be checked.

If you are experiencing pain with urination following a medical procedure, contact your health-
care provider to discuss the need for evaluation or treatment. The pain may be an expected side effect
of the procedure, or it may signify the beginning of an infection.

All other cases of burning with urination require medical attention within 24 hours.

Urethritis is probably not an emergency, but you will want to get relief promptly. If you are experiencing
other signs of illness, such as fever, nausea, vomiting, back and abdominal pain, you may need
emergency care. These symptoms could mean the infection has moved beyond the urethra. These
potentially serious conditions require immediate evaluation by your doctor or in an emergency
department.

If you have an object lodged in your urethra, or another injury to your penis, seek immediate medical care
at a hospital's emergency department. These situations can progress rapidly into a life-threatening
infection.

Urethritis in Men Diagnosis

If your health-care provider thinks you may have urethritis, you will be asked to give a urine specimen.
The specimen will be examined for signs of infection and inflammation. The doctor will perform a thorough
examination of your penis and testicles and do a rectal exam to evaluate your prostate for signs of
infection. The doctor may use a thin swab to collect a specimen from the urethra. If the doctor suspects
you have a sexually transmitted disease, a blood sample may be tested.

Treatment - Self-Care at Home

Home care for urethritis relieves its symptoms.

Drink fluids to dilute your urine. This will lessen the pain you feel when urinating.

You may take nonsteroidal anti-inflammatory medications (such as ibuprofen)


and acetaminophen (for example, Tylenol) for pain control.
Sitz baths can help with the burning associated with chemical irritant urethritis. To take a sitz
bath, fill the tub with 6-8 inches of warm water, just enough to cover your genitals when you sit in the
tub. Try these a few times a day. Don't use soap or anything else in the bathtub that may irritate
already sore areas.

Medical Treatment

Infections cause most cases of urethritis.

If you seem well otherwise, antibiotics are used.

o Various treatments are available.

o Sometimes you will get a shot (or antibiotic injection).

o The duration of treatment ranges from one to 14 days.

In cases of a sexually transmitted infection, antibiotics are used routinely.


o In this situation, all sexual partners also require treatment.

o You should not have sex or you should use condoms until all partners have completed
medical therapy.

Anyone with signs of infection throughout the body may require admission to a hospital for IV
antibiotics.

Prevention

Prevention of sexually transmitted diseases, including urethritis, involves abstinence (no sexual relations)
and the use of condoms, or other forms of barrier protection.

Irritants that cause skin or urethral inflammation should be avoided. If a soap, lotion, cologne, or detergent
leads to urethral irritation, stop using it.

Prognosis

When treated early, simple urethritis has few complications. If allowed to progress, you may develop a
bladder infection, kidney infection, or infection involving your testicles or prostate. Long-term problems
might lead to infertility.

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