URETHRITIS – Cause and Risk Factors, Clinical Manifestations, Diagnostic Evaluations, Management and Treatment 

URETHRITIS – Cause and Risk Factors, Clinical Manifestations, Diagnostic Evaluations, Management and Treatment
 

Urethritis is swelling and irritation (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.

CAUSES AND RISK FACTORS

Urethritis may be caused by bacteria or a virus. The same bacteria that cause urinary tract infections (E.coli) and some sexually transmitted diseases (Chlamydia, gonorrhea) can lead to urethritis. Viral causes of urethritis include herpes simplex virus, adeno virus and cytomegalovirus.

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.

 

Risks for urethritis include:

• Being a female in the reproductive years
• Being male, ages 20-35
  
• Having many sexual partners
  
• High-risk sexual behaviors (such as anal sex without a condom)
  
• History of sexually transmitted diseases
  

 

CLINICAL MANIFESTATIONS

In Men:

• Blood in the urine or semen
• Burning pain while urinating (dysuria)
  
• Discharge from penis
  
• Fever (rare)
  
• Frequent or urgent urination
  
• Itching, tenderness or swelling in penis or groin area
  
• Pain with intercourse or ejaculation
  

 

In Women:

• Abdominal pain
• Burning pain while urinating
  
• Fever and chills
  
• Frequent or urgent urination
  
• Pelvic pain
  
• Vaginal discharge
  

 

DIAGNOSTIC EVALUATIONS

• Medical history and physical examination
• Digital rectal exam
  
• Complete blood count (CBC)
  
• C-reactive protein test
  
• Pelvic ultrasound (women only)
  
• Pregnancy test (women only)
  
• Urinalysis and urine cultures
  
• Tests for gonorrhea, Chlamydia and other sexually transmitted diseases
  

 

MANAGEMENT

The goals of therapy are to:

• Eliminate the cause of infection
• Improve symptoms
  
• Prevent the spread of infection
  

 

Antibiotics may be prescribed to eliminate the organisms causing the infection. Administer nonsteroidal anti-inflammatory medications (such as ibuprofen) and acetaminophen (for example, Tylenol) for pain control along with antibiotics. Proper perineal hygiene should be stressed. This includes avoiding use of vaginal deodorant sprays and proper wiping after urination and bowel movements. Intercourse should be avoided until symptoms subside.

Urethritis caused by trauma or chemical irritants is treated by avoiding the source of injury or irritation. 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 genitals when 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. Sexual abstinence is recommended until treatment is completed, as disease can remain active even after symptoms have disappeared.

 

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, stops using it.