Symptoms of urethritis are different for men and women. The following symptoms are experienced [6]:

Symptoms in men with urethritis

• Experiencing burning sensation while urinating
• Itching and burning sensation near the penis region
• Blood in urine or semen
• Pain during intercourse or while ejaculation
• Development of fever
• Lymph nodes in the groin region enlarge

Symptoms in women with urethritis

• Development of abdominal pain, along with fever 
• Increase in frequency of urination
• Pain during intercourse
• Discharge 
• Burning sensation during urination
• Pain in the pelvic region if the infection has spread to the pelvic area

• Inguinal Lymphadenopathy

  Urethritis caused by HSV or adenovirus is associated with insertive oral sex among men who have sex with men. 15 Diagnosis Men presenting with urethral symptoms should be examined for inguinal lymphadenopathy, ulcers, or urethral discharge. [aafp.org]

• Perineal Pain

  Perineal pain, scrotal masses. Difficulties initiating and maintaining stream. [canada.ca]

• Suprapubic Pain

  Both cystitis and urethritis may present with pain or difficulty on urination (dysuria), frequency, urgency, and/or suprapubic pain or heaviness. A careful history may help differentiate between the two diseases. [clinicaladvisor.com]

• Jaundice

  The other clinical findings which are observed rarely in Kawasaki disease include restlessness, diarrhea, bile tract inflammation, hepatitis, gallbladder hydrops, jaundice, pancreatitis, aseptic menigitis, anterior uveitis, arthralgia and arthritis, respiratory [medical-dictionary.thefreedictionary.com]

  If hepatitis has occurred, patients may be jaundiced with hepatomegaly and hepatic tenderness in addition to other stigmata of cirrhosis. [infectiousdiseaseadvisor.com]

• Arthralgia

  The other clinical findings which are observed rarely in Kawasaki disease include restlessness, diarrhea, bile tract inflammation, hepatitis, gallbladder hydrops, jaundice, pancreatitis, aseptic menigitis, anterior uveitis, arthralgia and arthritis, respiratory [medical-dictionary.thefreedictionary.com]

• Urethral Discharge

  Urethral discharge is muco-purulent or haemorrhagic. Periurethral induration may be palpable in some cases. Diagnosis rests on finding tubercle bacilli in the urine and the urethral discharge. [stdpioneer.org]

  METHOD: From May 2007 to June 2011, men presenting to the clinic with self-reported symptoms of dysuria and/or urethral discharge were identified and underwent urethral swab, which was microscopically assessed for objective non-gonococcal urethritis. [ncbi.nlm.nih.gov]

• Dysuria

  Case 1: a 55-year-old man came to our observation in July 2012 referring a 5-day-history of intense dysuria and scant mucoid urethral discharge. [ncbi.nlm.nih.gov]

  Some men report only dysuria or discomfort without discharge. Urethritis can be classified as gonococcal or non-gonococcal urethritis (NGU), or non-specific urethritis (NSU), when no specific pathogen is identified. [sahealth.sa.gov.au]

• Painful Ejaculation

  For women, symptoms include: Unusual vaginal discharge Pelvic and abdominal pain Pain with intercourse Frequent or urgent urination Fever and chills Stomach pain Itching Symptoms in men include: Blood in urine or semen Painful ejaculation Penile discharge [medicalnewstoday.com]

• Dyspareunia

  Dyspareunia Dyspareunia is the medical term for painful sexual intercourse. It’s often confused with vaginismus, but dyspareunia could be due to cysts, pelvic inflammatory disease, or vaginal atrophy. There’s not always a reason for vaginismus. [healthline.com]

  They are closely interrelated and commonly overlooked in clinical practice.1 Pain may be experienced at vaginal entry, (superficial dyspareunia) or deep in the pelvis (deep dyspareunia). [ncbi.nlm.nih.gov]

  A medical history and complete physical exam are needed to look for other causes of pain with sexual intercourse (dyspareunia). Treatment A health care team made up of a gynecologist, physical therapist, and sexual counselor can help with treatment. [m.ufhealth.org]

  They may include: painful intercourse (dyspareunia), with tightness and pain that may be burning or stinging penetration being difficult or impossible long-term sexual pain with or without a known cause pain during tampon insertion pain during a gynecological [medicalnewstoday.com]

• Nocturia

  […] days instead of azithromycin Unprotected insertive oral intercourse in men who have sex with men Usual organisms, HSV, adenovirus 16 Test results often negative If a urinary tract infection is suggested by the history (e.g., severe dysuria, hematuria, nocturia [aafp.org]

  Frequency, nocturia, urgency. Perineal pain, scrotal masses. Difficulties initiating and maintaining stream. [canada.ca]

  If men have prostatic involvement, they may also complain of nocturia and urinary urgency. Common to both sexes is urethral tenderness, erythema, and pruritis. [infectiousdiseaseadvisor.com]

A preliminary physical examination would be carried out in men and women suffering from urethritis. In men, the abdomen, penis, scrotum and bladder will be examined. This would reveal tenderness and swelling in the penis region, abnormal discharge from penis and enlarged lymph nodes in the groin area.

In women, the abdominal and pelvic would be thoroughly examined. The examination would reveal tenderness of urethra accompanied by tenderness in the lower abdominal region and abnormal discharge from the urethra [7].

In many instances, a digital rectal examination would also be carried out. Some additional tests would also be required to confirm the condition of urethritis. These would include a complete blood count, urine culture to test for presence of bacterial infections, urethral swab and tests for sexually transmitted diseases [8]. In addition to these tests, women would also require a pregnancy test and pelvic ultrasound for diagnosing urethritis.

• Pyuria

  The laboratory studies revealed anemia, neutrophilic leukocytosis, elevated erythrocyte sedimentation rate (ESR), hypoalbuminemia, negative rheumatoid factor, pyuria, proteinuria, and the presence of HLA-B27. [ncbi.nlm.nih.gov]

  Diagnostics include urine dipstick (pyuria, positive leukocyte esterase), staining of a urethral sample, and nucleic acid amplification testing of first-void urine. [amboss.com]

  Acute urethral syndrome Dysuria, frequency Pyuria syndrome > 7 days No bacteria of symptom PID Lower abdominal pain, adenexal tenderness on pelvic examination evidence of MPC often present Cervical gramstaining positive for gonococcus, endometritis on [de.slideshare.net]

• Mycoplasma Hominis

  The pathogens that could be detected by the Rt-MPCR were Chlamydia trachomatis, Neisseria gonorrhoeae, Mycoplasma hominis, Mycoplasma genitalium, Ureaplasma urealyticum, Ueroplasma parvum, Gardnerella vaginalis, Trichomonas vaginalis, Candida albicans [go.gale.com]

  Elimination of Mycoplasma hominis by antibiotic treatment early in the course of the urethritis did not diminish the severity of his condition, which indicated that this mycoplasma was not a cause. [ncbi.nlm.nih.gov]

  Routine testing for Ureaplasma urealyticum and Mycoplasma hominis are not recommended. [sahealth.sa.gov.au]

The primary goal of treatment of urethritis includes eradication of infection, methods to prevent spread of infection and effective management of symptoms. The following methods are employed for treating urethritis [9]:

• In case of bacterial infections, antibiotics are administered.
• In order to relieve symptoms, non steroidal anti-inflammatory drugs are given for relieving the pain
• If the condition does not subside with antibiotics, then a combination of various antibiotics may be required to treat the chronic form of urethritis [10].
• Individuals are advised to refrain from sex during the treatment regime. It is also required that the partner also receives treatment if urethritis is caused due to infections.

If urethritis is diagnosed in the preliminary stages and appropriate treatment is initiated, then the condition recovers completely without causing further complications. However when the disease progresses to more advanced stages then a condition known as urethral stricture can develop. This primarily occurs when the disease continues for longer duration and the urethral tissue gets damaged. In women, if the infection spreads to the pelvic region, then it can lead to fertility problems [5].

Bacterial and viral infections are the major factors contributing towards development of urethritis. The bacteria responsible for causing sexually transmitted disease also cause inflammation of the urethra. The normal microflora that is present in the genital regions can also cause urethritis if they gain entry into the urinary tract. Certain viruses such as the human papillomavirus, cytomegalovirus and herpes simplex virus also causes urethritis.

Individuals who are sensitive to the chemicals which are used in spermicides, creams or foams are also predisposed to develop urethritis. Females who are in their reproductive age, males above 35 years, those having multiple sexual partners and those who practice unsafe sex are at an increased risk of developing urethritis [2].

Posttraumatic urethritis may occur following catheterization or foreign body insertion.

It has been estimated that about 4 million cases of urethritis occur in America each year. Gonococcoal urethritis strikes 700,000 individuals annually. The occurrence rate of gonococcal urethritis has undergone a significant decline from the year 2000. The incidence of nongonococcal urethritis is increasing and about 3 million cases occur annually. 

Statistics have also reported that across the globe, about 62 million and 89 million new cases of gonococcal and nongonococcal urethrtitis respectively occur each year [3].

There are 2 basic phenomenons that give rise to the condition of urethritis. Infections and traumatic events like catheterization or foreign body insertion can favor development of inflammation of the urethra. Of these, infections are known to be the major causative factor. Bacteria that cause sexually transmitted diseases are the major organisms that are known to play foul.

Patients who undergo catheterization and instrumentation are at an increased risk of contracting urethritis. Individuals who use latex catheterization are 10 times more likely to develop the condition than those who make use of silicone catheterization. In addition to these factors, individuals suffering from certain infectious syndromes such as otitis media, pneumonia, reactive arthritis, prostatitis, urinary tract infection, epididymitis and proctitis are also at an increased risk of suffering from urethritis [4].

Practicing safe sex is one of the major methods of preventing urethritis. In addition, following various ways to promote good urinary tract health would also go a long way in preventing the onset of urethritis. Individuals are advised to drink plenty of fluids and urinate shortly after intercourse. Such a practice would help in flushing out bacteria from the urinary system [11].

Urethra is a tube that is responsible for carrying urine and the removal of fluids from the body. Therefore, individuals suffering from urethritis, experience painful urination. The condition of urethritis, usually occurs due to inflammation caused by sexually transmitted diseases. In other words, individuals with sexually transmitted diseases are at an increased risk of contracting such a type of condition. Males and females are equally affected; however, it is thought that females have higher chances of being affected [1].

• Definition: Urethritis is a condition, characterized by inflammation of the urethra due to infection or underlying disease conditions. Males and female are at an equal risk of developing the condition.
• Cause: Bacteria that cause sexually transmitted disease also favor the development of urethritis. In addition, injury and allergic reaction to spermicidal can also increase the risk of inflammation of urethra.
• Symptoms: Common symptoms include burning sensation while urinating, pain during intercourse, abnormal discharge from the genital organs, blood in urine, abdominal pain and fever accompanied by chills.
• Diagnosis: A preliminary physical examination would be carried out for diagnosing urethritis. In addition, blood tests and urine culture tests are also indicated. A urethral or vaginal swab would also be required for analyzing presence of infections.
• Treatment: Antibiotics form the major part of the treatment regime if infections are the cause. Other medications to relieve the symptoms would also be required. 

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3. CDC. National overview of sexually transmitted diseases (STDs), 2012. 
4. Lee YS, Lee KS. Chlamydia and male lower urinary tract diseases. Korean J Urol. Feb 2013;54(2):73-7.
5. Centers for Disease Control and Prevention. CDC Division of AIDS, STD, and TB. Gonococcal Isolation Surveillance Project (GISP) Annual Report - 2007. Atlanta, Ga: Centers for Disease Control and Prevention.
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7. William M. McCormack. Urethritis. In: Mandell, Douglas, and Bennett's Principles and Practice of Infectious Disease, 7, Gerald L Mandell, John E. Bennet, and Raphael Dolin. (Eds), Elsevier, 2010. Vol I, p.1485.
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