Non-specific Urethritis in Men

Urethritis is inflammation (pain, redness and/or swelling) of the urethra (tube where urine comes out). Sometimes it is called non-specific urethritis (often known as NSU) or non-gonococcal urethritis (NGU). It is possible for both men and women to have non-specific urethritis, but it is more difficult to diagnose in women.

Causes of NSU include:

  • Sexually transmitted infections (especially Chlamydia)
  • Other tiny organisms (Mycoplasma genitalium, Ureaplasma urealyticum)
  • Damage to the urethra, often caused by friction during vigorous sex or masturbation
  • Topical application of antiseptic or disinfectant liquids
  • Sensitivity or irritation by latex (in condoms), spermicide or soap

NSU is passed on sexually during unprotected vaginal, anal or oral sex. However, not all cases are caused by having sex. You cannot get it from kissing, hugging, sharing baths/towels or from toilet seats.

Signs and symptoms

They usually show up within 2-4 weeks of contact with an infected partner, but they can sometimes appear within a day or two (depending on the cause of inflammation). In mild cases, symptoms may not show up for several months. These include:

  • A white or cloudy discharge from the tip of penis (sometimes seen only after massaging)
  • Difficulty, pain or a burning sensation when passing urine
  • The feeling that you need to pass urine frequently
  • Itching or irritation at the end of the urethra

It is important that you don’t delay getting a test if you think you may have an infection. You can do a test even if you do not have symptoms, within a few days of having sex. The test may involve a doctor using a swab to collect the specimen and also urine sample collection.

The table below summarizes what is known about timing (how soon the test can be done) and the accuracy of Chlamydia PCR tests in various body parts for people with no symptoms. It is not possible to know the test results straightaway, however your doctor will prescribe antibiotics to cover the infection while waiting for formal laboratory reports. Most men notice an improvement quite quickly, with discharge and pain improving within a week.

(Table contents referenced from stdcenterny.com)

Earliest testing time
(after exposure)
Ideal testing time
(after exposure)
Genital Swab2–7 days
Likely to detect (no stats on sensitivity)
2 weeks post exposure:
98.3% accuracy
Rectal swab2–7 days
Likely to detect (no stats on sensitivity)
2 weeks post exposure:
94.7% accuracy
Oral swab2–7 days
Likely to detect (no stats on sensitivity)
2 weeks post exposure:
80% accuracy
Urine test2–7 days
Likely to detect (no stats on sensitivity)
2 weeks post exposure:
94.3% accuracy

If NSU is detected and treated early there are no complications. If left untreated, some cases can have long-term consequences, although these are uncommon. They include:

  • Painful infection in the testicles
  • Possible reduced fertility
  • Inflammation of the joints (reactive arthritis)
  • Reiter’s syndrome if the inflammation of the eyes is present with arthritis and NSU

It is strongly advised that you do not have any sexual intercourse (including vaginal, anal or oral sex) until you AND your partner have both finished the treatment. One week of abstinence is generally recommended. This is to help prevent you from being re-infected or passing the infection on to someone else. If it is not possible to avoid sex, make sure you use a condom. This might reduce the risk of infection, but not totally eliminate it. In some men who are not responding to treatment, NSU may only clear up after their partner has received treatment as well.

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