Urethritis

What Is It?

Urethritis is an inflammation of the urethra, which is the tube that carries urine out of the body. It can be caused by:

• Mechanical injury from an instrument such as a urinary catheter or a cystoscope, which is used to examine the urethra
• An irritating chemical such as an antiseptic or a spermicide
• Infection

Doctors usually classify infectious urethritis into two categories: gonococcal urethritis, caused by gonorrhea bacteria, and nongonococcal urethritis, caused by bacteria other than gonorrhea.

Gonococcal urethritis, commonly called clap, is a sexually transmitted disease (STD) that is caused by bacteria called Neisseria gonorrhoeae. These bacteria can be passed from person to person during sexual activity (vaginal, oral and anal intercourse). In addition to urethritis, these bacteria can cause cervicitis and vaginitis. If untreated, these gonorrhea infections in the lower portions of the reproductive tract can spread to higher portions of the reproductive tract, causing prostate inflammation (prostatitis) and inflammation of the epididymis and testes (epididymo-orchitis) in men and pelvic inflammatory disease in women. Less commonly, gonorrhea can spread through the bloodstream, causing fever, rash and arthritis. In very rare cases, it can cause serious infections such as endocarditis (infection of a heart valve), meningitis, or osteomyelitis. If a pregnant woman has untreated gonorrhea, bacteria can spread to the eyes of her baby during childbirth, causing gonococcal ophthalmia, a severe eye infection in newborns. Approximately 600,000 people in the United States are diagnosed with gonorrhea every year. However, the total number of cases might be much higher because many people with gonorrhea do not seek treatment.

Nongonococcal urethritis is diagnosed if laboratory tests show that a person with urethritis has no signs of gonorrhea bacteria. The most frequent cause (in 20 percent to 50 percent of cases) is chlamydia. Chlamydia is an STD that is caused by Chlamydia trachomatis, a species of bacteria that can be found in the urine and in genital-tract secretions of infected people. In addition to causing urethritis, chlamydia can affect several other areas of the reproductive tract, resulting in vaginitis, cervicitis and pelvic inflammatory disease. Chlamydia bacteria also can cause eye infections and pneumonia in newborns who have been delivered to mothers with chlamydia. Nongonococcal urethritis is the most common form of STD in the United States, with an estimated 4 million new cases occurring each year. In addition to chlamydia, other possible infectious causes of nongonococcal urethritis include Ureaplasma urealyticum, Mycoplasma genitalium and Trichomonas vaginalis.