Non- Specific Urethritis (NSU)
What is Urethritis?
- Urethritis affects mainly men and means inflammation of the urethra (the urine and semen passage).The urethra can be affected by various sexually transmitted infections (STIs).
- The most common causes are infection with gonorrhoea and chlamydia, however other bacteria or viruses may be involved.
- If tests for gonorrhoea and chlamydia are negative then the urethritis is usually called non-specific (or NSU for short).
How does Someone get Urethritis?
Urethritis can be caught by having vaginal, anal, or oral sex without a condom.
How do I know if I have Urethritis?
Sometimes there may be no symptoms, if present they may include:
- Discharge (pus or fluid) from the urethra
- Pain or discomfort passing urine
- Uncomfortable feeling in the urethra.
What do I do if I think I have Urethritis?
- The best way to find out if you have urethritis is to have a sexual health check.
- The diagnosis of urethritis is usually only made in men with symptoms or men who are a sexual contact of someone with gonorrhoea or chlamydia.
- Tests are best done when you have not passed urine (pee’d) for at least 2 hours.
- A small swab is inserted into the tip of the penis to obtain a sample of fluid – this is then examined under a microscope to check for signs of inflammation.
- At the same time the doctor or nurse will also do specific tests for gonorrhoea and chlamydia.
What is the Treatment?
- If the doctor or nurse confirms you have urethritis or NSU from the microscope test you will be given antibiotics.
- This may be either a course of tablets over several days, or a single dose – your doctor will advise what is best for you.
- The commonest cause of urethritis is chlamydia, so sexual partners also need testing and treatment.
- Even if your STI check is negative it is still advisable that your sexual partner(s) get treatment as current tests can occasionally miss chlamydia even when it is the cause of the urethritis or NSU.
- If there are signs of gonorrhoea at the time of examination then treatment is also given for this as well as treatment for NSU.
How do I know if my Partner(s) need Treatment?
- If you have had sex without a condom (including oral) with your sexual partner(s) it is likely that they also are infected with whatever is causing the urethritis/NSU.
- It is important that they have a sexual health check and treatment for sexually transmitted infections even if they have no symptoms.
- It is usually recommended that all sexual contacts within the previous 2 months are tested and treated.
What Advice should be given to a Person with Urethritis/NSU?
- Finish all the antibiotics even if symptoms get better in a few days as the infection may still be there.
- Do not have sex, or use a condom every time you have sex, until 7 days after single dose treatment or until all tablets from a course of treatment have been finished. This will prevent you passing on the infection to others and will also prevent you from being re-infected.
- You should not have sexual intercourse without a condom until your partner(s) have been treated.
- If symptoms remain after two weeks or return you may need further tests or treatment so please contact the Auckland Sexual Health Service.
- Do not keep squeezing the penis to check for discharge as it may worsen the problem.
What is Recurrent or Persistent Urethritis?
- Urethritis can very occasionally not get better or come back after the antibiotics have been taken.
- After treatment some men continue to experience mild discomfort that will usually get better within 2 weeks of treatment.
- If the symptoms go on for longer than 2 weeks or get worse again after treatment has ended you should go back to the sexual health clinic.
- Further tests and treatment are sometimes needed.
What is Urethral Irritation?
- Sometimes men experience urethral irritation when no inflammation or infection is present. This condition is called urethral irritation. It is not caused by infection and the symptoms are usually short-lived.
- Possible causes of irritation are:
- Frequent squeezing of the penis
- Topical irritants (e.g. soap, shampoo)
- Frequent or vigorous sex or masturbation
- Allergy (e.g. to spermicide)
- General illness
- Concentrated urine from dehydration
- Alcohol, caffeine and some medications.
- Urethral irritation is not a sexually transmitted infection and does not require antibiotic treatment.
- Symptoms should resolve quickly if you avoid the cause of the irritation i.e. avoid soaps, squeezing of the penis.
This information is not intended to replace the need for a consultation with your doctor. All clients are strongly advised to check with their doctor about any specific questions or concerns they may have. Every effort has been taken to ensure that this information is correct at the time of publishing (March 2009). Acknowledgement to Auckland Sexual Health Service for the use of this material.