Urethritis - chronic

• Alternative Names

  Urethral syndrome

• Causes, incidence, and risk factors

  Chronic urethritis is usually caused by a bacterial infection or structural problem that leads to narrowing of the urethra.

  Causes include:

  • E. coli bacteria
  • Sexually transmitted diseases such as chlamydia and gonorrhea
  • Personal hygiene products, especially feminine products

  Chronic urethritis occurs in both women and men.

• Symptoms
  • Frequent and urgent urination
  • Painful urination
  • Urethral discharge (bloody or pus-like, and often foul-smelling)
• Signs and tests
  • Cystoscopy and urethroscopy
  • Urinalysis
  • Urine culture (clean catch)
  • Urethral discharge culture
  • Vaginal culture
• Treatment

  If there is an infection, you will be given antibiotics. A follow-up urinalysis or culture will be done after you finish all of the medicine to make sure the infection has cleared.

  Women who have repeated episodes of intercourse-related urethritis or cystitis may need to take a dose of preventive antibiotics before or after intercourse.

  Phenazopyridine (Pyridium) may be prescribed to decrease urinary discomfort.

  You should stop using any possible chemical irritants.

• Expectations (prognosis)

  In most cases, the health care provider can find the cause of the urethritis and treat it.

  Chronic urethritis can lead to narrowing (urethral strictures). Surgery or another medical procedure may be needed to correct the problem.

• Complications

  A long-term, untreated infection may cause the urethra to narrow even more, making it difficult to completely empty the bladder. Recurrent urinary tract infections may also occur.

  Other complications may include:

  • Damage to the urinary tract system, including impairment of kidney function
  • Kidney infection (pyelonephritis)
• Calling your health care provider

  See your health care provider if you have symptoms of chronic urethritis.

• Prevention

  Women who have symptoms that occur with intercourse may benefit from taking a small dose of antibiotics after intercourse to prevent urethritis and cystitis.

  It is important for you and your sexual partners to practice good hygiene. Safer sex behaviors can decrease the risk of developing sexually transmitted diseases, which can cause urethritis.

  Getting treatment as soon as symptoms appear can help prevent damage to the urethra.

• References

  Nickel JC. Inflammatory conditions of the male genitourinary tract: prostatitis and related conditions, orchitis, and epididymitis. In: Wein AJ, ed. Campbell-Walsh Urology. 9th ed. Philadelphia, Pa: Saunders Elsevier; 2007: chap 9.

  Frenkl T, Potts J. Sexually transmitted diseases. In: Wein AJ, ed. Campbell-Walsh Urology. 9th ed. Philadelphia, Pa: Saunders Elsevier; 2007: chap 11.

  Lentz GM. Urogynecology: physiology of micturition, diagnosis of voiding dysfunction, and incontinence: surgical and nonsurgical treatment. In: Katz VL, Lentz GM, Lobo RA, Gershenson DM, eds. Comprehensive Gynecology. 5th ed. Philadelphia, Pa: Mosby Elsevier; 2007: chap 21.

  Eckert LO, Lentz GM. Infections of the lower genital tract: vulva, vagina, cervix, toxic shock syndrome, HIV infections. In: Katz VL, Lentz GM, Lobo RA, Gershenson DM, eds. Comprehensive Gynecology. 5th ed. Philadelphia, Pa: Mosby Elsevier; 2007: chap 22.

Review Date: 9/7/2008

Reviewed By: Linda Vorvick, MD, Seattle Site Coordinator, Lecturer, Pathophysiology, MEDEX Northwest Division of Physician Assistant Studies, University of Washington School of Medicine; and Louis S. Liou, MD, PhD, Assistant Professor of Urology, Department of Surgery, Boston University School of Medicine. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.