Sexual Health Advice - Patient Information Leaflets

Non-Specific Urethritis (NSU)

What is non-specific urethritis?

The urethra is the tube that joins between the bladder and the end of the penis. Urethritis is the inflammation (redness, pain and/or swelling) of the urethra.

Gonococcal urethritis is caused by a germ called gonorrhoea. This is a type of sexually transmitted infection (STI) and the Lambda Clinic has a separate leaflet that describes gonorrhoea in more detail.
Non-specific urethritis (NSU) is due to causes other than gonorrhoea infection which is sometimes called non-gonococcal urethritis (NGU).
Some men can have both gonococcal and non-specific urethritis at the same time.

What causes non-specific urethritis?

There are many different causes. Some of these infections, but not all, are passed on through having sex. If you have non-specific urethritis there may be more than one cause. In about 25% of men no cause is found.

Causes of non-specific urethritis include:

Sexually transmitted infections

Chlamydia causes about half of the cases of non-specific urethritis
Herpes and trichomonas vaginalis are less common causes
Mycoplasma genitalium in 20% of cases
Other organisms
In 10% of cases Ureaplasma urealyticum causes non-specific urethritis
Bacteria that live in the rectum, mouth and throat that are passed on during sex can cause non-specific urethritis
Bacteria that cause infection in the urinary tract (kidneys, bladder and urethra) or the prostate gland
A vaginal infection in your partner, such as thrush or bacterial vaginosis may trigger non-specific urethritis in you
Damage to the urethra
Damage to the urethra can occur by friction during masturbation, vigorous sex or inserting objects into the urethra
Antibacterial liquids e.g. antiseptics or disinfectants can cause inflammation
Rarely, if your skin is sensitive to certain chemicals e.g. spermicide, latex or certain soap can cause inflammation

How is non-specific urethritis passed on sexually?

During unprotected anal, vaginal or oral sex, infections which cause inflammation can pass into the urethra.

Not all cases of non-specific urethritis are caused by having sex. However, you cannot get non-specific urethritis from kissing, hugging, sharing baths or towels or from toilet seats.

What are the symptoms of non-specific urethritis?

Some men may not have any symptoms

If symptoms do occur they usually show up within 2 – 4 weeks of contact with an infection, but sometimes earlier i.e. within a day or two (depending on the cause). In mild cases symptoms may not show up for several months.

If you do get symptoms these may include:

A white discharge (fluid) from the end of the penis

Irritation inside the penis.

Burning or pain when passing urine. This can sometimes be mistaken for a urine infection.

A feeling of wanting to pass urine frequently.

Pain and swelling in one or both testes in a small number of cases.

A rare additional complication is a type of arthritis which can be triggered by non-specific urethritis, possibly due to the immune system ‘over-reacting' to the infection that can cause non-specific urethritis.

Symptoms may clear over time, but, without treatment, infections that cause non-specific urethritis often remain in the urethra. Therefore, even if symptoms go, you can pass on the infection if you are not treated properly.

How will I know if I have non-specific urethritis?

You can only be certain if you have a test. Because the inflammation can be caused by sexually transmitted infections it is recommended that you have a test for chlamydia and gonorrhoea. Tests may include:

Examining your penis

Swab test from the entrance of the urethra

Urine sample

It is possible to be tested within a few days of having sex, but usually it is necessary to wait up to 2 weeks to be certain that you have a certain infection e.g. chlamydia. The results of the tests are usually known within 5 days.

What is the treatment for non-specific urethritis?

Usually a short course of antibiotics is sufficient to clear up non-specific urethritis. The type of antibiotic used depends on which infection is found, and whether other infections are also present.

If no bacteria are found by the tests, you may still be better off to take a course of antibiotics if you have symptoms of non-specific urethritis because infection is still the likeliest cause.

Most people get better with a single course of antibiotics. However, some men require repeated doses or a combination of different antibiotics.

What happens if non-specific urethritis is not treated?

Non-specific urethritis can cause long term complications including:

Reduced fertility

Painful infection of the testes

Reiter's syndrome which is a reactive arthritis (inflammation of joints) which occurs with inflammation of the eyes and urethra.

Untreated non-specific urethritis is a risk of being passed on to other sexual partners.

Does my sexual partner need treatment?

Yes. They should also be tested for infection, even if they do not have any symptoms. A course of antibiotics is usually advised for sexual partners, even if the tests are negative, because:

Many women who are infected with chlamydia do not have symptoms. If this is left untreated, it can cause complications at a later time such as serious infection of the pelvis (pelvic inflammatory disease) which can result in damage and blocking of the fallopian tubes resulting in infertility.
Not all tests for bacteria are guaranteed 100% of being accurate. A course of antibiotics helps to make sure that any possible infection is cleared.
The infection can be passed back to and fro if your sexual partner is infected and not treated adequately.

During treatment it is advisable to not have sexual encounters until a full course of treatments is completed for you and your sexual partner(s).

How will I know how long I have had the infection?

The tests cannot tell you how long the infection has been there for. If non-specific urethritis has been caused by a sexually transmitted infection and you have recently had more than one sexual partner, it may be impossible to determine which partner it has come from. This can be difficult to deal with. Do not be afraid to discuss this with the Lambda Clinic staff about how you feel.

Non-specific Urethritis PDF file pdf document or Text-only Version

The Lambda Clinic, 22 Somerset Road, Edgbaston, Birmingham, B15 2QQ, Tel: 0121 452 2815