Nongonococcal Urethritis

Definition

Any inflammation of the urethra not due to gonorrhea, almost always contracted through sexual intercourse and found far more often in men.

Description

Men between the ages of 15 and 30 who have multiple sex partners are most at risk for nongonococcal urethritis (NGU), which is believed to be the most common sexually transmitted disease in the United States.

Causes and symptoms

NGU is spread almost exclusively via sexual contact, and appears most often in men because a woman's urethra is less easily infected during sex. The infection is most often due to Chlamydia trachomatis, the organism that causes chlamydia. Those that aren't caused by Chlamydia trachomatis are usually due to another bacterium, Ureaplasma urealyticum. In 10% to 20% of NGU cases, the cause is unknown.

Symptoms appear within one to five weeks after infection, and include a slight clear discharge (the color of the discharge can vary from one patient to the next), and itching or burning during or after urination.

However, some men never develop symptoms, and women almost never show signs of infection. However, it's possible that symptoms of burning or itching in or around the vagina may be due to NGU.

The disease is communicable from the time of first infection until the patient is cured. Past infection doesn't make a person immune.

Diagnosis

Nongonococcal urethritis is diagnosed by excluding other causes, since inflammation that is not caused by gonorrhea is classified as NGU. A microscopic and/or culture test of the discharge or urine can reveal the infection.

Since many people are infected with both NGU and syphilis at the same time, infected patients also should have a test for syphilis before treatment for NGU begins, and three months after treatment ends.

Treatment

Antibiotics such as tetracycline or azithromycin will cure NGU; both sexual partners should be treated at the same time.

Patients taking tetracycline should avoid milk or milk products and take the medication at least one hour before or two hours after meals. On the last day of treatment, a male should have a urine test to make sure the infection has cleared. If it hasn't, he should take a second course of therapy. Men should use a condom during treatment and for several months after treatment is completed.

If urine tests indicate the infection is gone but symptoms persist, the doctor will check for signs of prostate inflammation.

KEY TERMS

Chlamydia— One of the most common sexually transmitted diseases in the United States. It causes discharge, inflammation and burning during urination. About half of the cases of nongonococcal urethritis are due to chlamydia.

Gonorrhea— A sexually transmitted disease that affects the genital mucous membranes of men and women.

Urethra— The tube that carries urine from the bladder through the outside of the body.

Prognosis

NGU is completely curable with proper antibiotic treatment. Untreated, NGU can lead to sterility in both men and women, inflammation of the mouth of the uterus, and infections of the woman's internal sexual organs. An infection during pregnancy may lead to pneumonia or eye infections in the newborn child. Untreated men may develop swelling of the testicles and an infected prostate gland.

Prevention

People can prevent the spread of NGU by:

• using a condom
• limiting the number of sex partners
• washing the genital area after sex
• if infected, avoid sexual contact; take antibiotics, notify all partners

Resources

ORGANIZATIONS

American Social Health Association. P.O. Box 13827, Research Triangle Park, NC 27709. (800) 227-8922. 〈http://www.ashastd.org〉.

OTHER

Sexually Transmitted Diseases Hotline. (800) 227-8922.

Urethritis, Nonspecific

What Is Nonspecific Urethritis?

What Are the Symptoms of NSU?

How Is NSU Diagnosed and Treated?

What Are the Possible Complications from NSU?

How Can NSU Be Prevented?

Resources

Nonspecific urethritis (NSU) is an inflammation * or infection of the urethra (yoo-REE-thra) in which the cause is not defined. The urethra is the tube through which urine passes from the bladder to the outside of the body.

* inflammation

(in-fla-MAY-shun) is the body’s reaction to irritation, infection, or injury that often involves swelling, pain, redness, and warmth.

KEYWORDS

for searching the Internet and other reference sources

Inflammation

Sexually transmitted diseases

Urinary tract

What Is Nonspecific Urethritis?

Nonspecific urethritis (yoo-re-THRY-tis) is a common urinary tract infection. It is also called nongonococcal (non-gon-o-KOK-al) urethritis. “Nongonococcal” means that the urethritis is not caused by gonococcus, the bacterium (bak-TEE-ree-um) that causes gonorrhea (gon-o-REE-a), a sexually transmitted disease (STD). However, nonspecific or nongonococcal urethritis also is considered to be an STD. It may be caused by Chlamydia (kla-MID-ee-a), yeast*, herpesvirus*, intestinal bacteria*, or any of a number of other microorganisms. Although classified as an STD, nonspecific urethritis is not always caused by sexual activity. For example, it can be caused by an infection from intestinal bacteria that enters the urethra from skin around the anus*, or it may result from insertion of an object into the urethra. NSU is more common in females than in males, but it occurs in people of both sexes and of all ages.

* yeast

is a general term describing single-celled fungi that reproduce by budding.

* herpesvirus

(HER-peez-VY-rus) is a virus of the family Herpesviridae (HER-peez-VY-ri-dee), which includes the viruses that cause chickenpox, shingles, genital herpes, and cold sores.

* bacteria

(bak-TEER-ee-a) are single-celled microorganisms, which typically reproduce by cell division. Some, but not all, types of bacteria can cause disease in humans.

* anus

(AY-nus) is the opening at the end of the digestive system, through which waste is discharged.

What Are the Symptoms of NSU?

A common symptom of NSU is a tingling or burning sensation while urinating. Sometimes, there is also a slight, usually clear discharge. This discharge may be present only in the morning, before urination.

Signs and symptoms of NSU usually appear 2 to 3 weeks after infection. Sometimes, symptoms are very mild or absent, especially in females.

How Is NSU Diagnosed and Treated?

The diagnosis of NSU is made by taking urine and discharge samples and conducting laboratory tests to identify the infecting organism. In many instances, however, the cause cannot be determined.

NSU is treated with antibiotics*. It is extremely important to finish the prescribed amount of these medications. Otherwise, the infecting organisms may not all be killed, and the disease can come back.

* antibiotics

(an-ty-by-OT-iks) are drugs that kill bacteria.

Usually, treatment of NSU lasts 2 to 3 weeks. During this time, sexual activity must be avoided to keep from spreading the infection. Relapses are common, and follow-up visits may be needed to confirm a cure.

What Are the Possible Complications from NSU?

Sometimes, treatment of NSU is unsuccessful, especially if the cause is not found. Possible complications may include chronic* urethritis and cystitis (sis-TY-tis), a bladder infection. The infection sometimes may reach the kidneys*.

* chronic

(KRON-ik) means continuing for a long period of time.

* kidneys

are the pair of organs that filter blood and get rid of waste products and excess water as urine.

How Can NSU Be Prevented?

General measures that can decrease the likelihood of NSU include frequent bathing. Especially good hygiene is needed in the genital area. Bubble baths should be avoided, because they can irritate the urethra.

With regard to sexual transmission, as for any STD, not having sex is the only sure means of prevention. The risk of getting NSU is lowered by limiting the number of one’s sexual partners. Condoms can decrease the rate of transmitting the infection.

NSU and other urinary tract infections are not contagious* in people who are not sexually active.

* contagious

(kon-TAY-jes) means transmittable from one person to another.

See also

Bacterial Infections

Chlamydial Infections

Fungal Infections

Gonorrhea

Infection

Sexually Transmitted Diseases

Viral Infections

Resources

The Nemours Foundation has information concerning NSU and other urinary tract infections at its website. http://kidshealth.org/teen/bodymind/body/infection/uti.html http://kidshealth.org/parent/common/urinary.html

The Wardenburg Health Center has information on NSU at its website. http://www.colorado.edu/wardenburg/healthbrochure/std/nsu.html

The Health Library has information on NSU at its website. http://thriveonline.aol.com/health/Library/illsymp/illness542.html