Urethritis in men

Cross-section diagram showing urethra and nearby structures in men

What causes urethritis in men?

Any man can develop urethritis. However, it's most common among sexually active men under 25 who have recently changed their sexual partner. It's also more likely if you have unprotected sex (without a condom). If you have, or have had any STI, you are at more risk of getting another.

• Gonorrhoea is one type of STI which can cause urethritis.

• Non-gonococcal urethritis (NGU) is the term used to describe urethritis caused by anything other than gonorrhoea. Infection with a germ (bacterium) - either Chlamydia trachomatis or Mycoplasma genitalium - is the common cause of NGU. It can also be caused by a variety of other germs (bacteria or viruses). NGU may rarely have a non-infective cause, such as trauma or blockage or a reaction to a soap or cream.

• Both. Some men have gonococcal and non-gonococcal urethritis at the same time, for example infection with both gonorrhoea and chlamydia.

• No obvious cause can be found in up to three out of ten men with urethritis.

Urethritis symptoms

• A fluid (discharge) from the end of the penis is common but does not always occur.

• Pain or burning when you pass urine. This may be confused with a urine infection.

• You may have soreness or irritation inside the penis, or a feeling of wanting to pass urine frequently.

• Some men with urethritis never develop any symptoms. For example, up to half of men with chlamydial infection (the most common cause of NGU) do not have any symptoms.

• Ulceration on the skin at the head of the penis - this may be caused by herpes simplex virus.

How does urethritis progress?

Occasionally, symptoms may clear without treatment but may take months to do so. If your condition has been caused by an infection, germs (bacteria) may still be present, even if the symptoms have gone. You are therefore likely to still be able to pass the infection on to a partner.

One bacterium that commonly causes inflammation of the urethra (urethritis) in men (chlamydia) can cause serious problems in women, including pelvic inflammatory disease (PID) and difficulties with getting pregnant in the future. It is important that you get tested, and treated if necessary, in order to prevent complications for yourself and others.

You can read about possible complications in the separate leaflets called Gonorrhoea and Non-gonococcal urethritis.

What should I do if I have symptoms of urethritis?

• If you suspect that you have urethritis, contact your local genitourinary (GUM) clinic - find one from the 'Find a sexual health clinic' link in Further Reading below. Alternatively, contact your GP.

• You are likely to be offered tests for HIV, hepatitis and syphilis, as people with inflammation of the urethra (urethritis) sometimes have these conditions as well.

• Men who have sex with men may also need to have swabs taken from the back of the throat (pharynx) and back passage (rectum).

• The GUM clinic will protect your confidentiality but, if they confirm you have an infection, they will suggest that you contact anyone you had sex with up to three months before you were diagnosed. This is called 'contact tracing'. The clinic can do this for you if you wish and they do not have to give your name.

• Medicines called antibiotics will usually clear an infection. The antibiotic prescribed depends on the cause. Make sure you complete the course.

• If your urethritis is due to gonorrhoea, it is vital that you have another test after you have been treated to make sure the infection has been cured. This will usually be done 7 - 14 days after treatment.

• Tell your sexual partner(s) to see their doctor or go to a GUM clinic, even if they have no symptoms. Many women with sexually transmitted infections do not have symptoms.

• Don't have sex (including oral and anal sex) until you and your sexual partner(s) have completed tests and treatment. You should wait seven days after you have had your treatment course to avoid passing on the infection: your doctor will advise.