Urethritis in Men

Picture of Kidney Stone, Bladder, and Urethra.

Urethritis is an 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.

Facts

• 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.
• Burning and pain are common symptoms of urethritis.
• Long-term problems might lead to infertility or urethral blockages (strictures).

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 may also 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:
  • Back pain
  • Abdominal pain
  • High fevers
  • Nausea
  • Vomiting
  • Swollen joints and other symptoms of disease throughout the body

8 Potential causes of urethritis include:

• 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 sexual activity or masturbation can cause 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, or it can also be caused by a narrowing of the tube (urethra) itself.

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

• If you are experiencing pain with urination following a medical procedure, contact your physician 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, or 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 life-threatening infections.

If your physician 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.

Infections cause most cases of urethritis.

• If you seem well otherwise, antibiotics are used.
• Various treatments are available.
• Sometimes you will get a shot (or antibiotic injection).
• The duration of treatment ranges from one to 14 days.
• In cases of a sexually transmitted infection, antibiotics are used routinely.
• In this situation, all sexual partners also require treatment.
• You should not have sex or you should use condoms until all partners have completed medical therapy.
• Anyone with signs of severe infection that has spread throughout the body may require admission to a hospital for IV antibiotics.

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.

If you are treated for urethritis with antibiotics, you may be asked to follow up with your physician after you have taken all the pills. Do not stop taking the pills even if you are feeling better.

You should seek care if your symptoms return or worsen while taking antibiotics.

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.

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 or urethral blockages (strictures).