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Urethritis - chronic
Definition Chronic urethritis is long-term inflammation of the urethra, the tube that carries urine from the body. Chronic urethritis continues for weeks to months. Alternative Names Urethral syndrome Causes, incidence, and risk factors Chronic urethritis is usually caused either by a bacterial infection or structural problem that results in narrowing of the urethra. The condition is associated with a variety of systemic diseases, emotional disorders, and sexually transmitted diseases such as chlamydia and gonorrhea. E. coli, a common bacteria responsible for urinary tract infections, may also cause chronic urethritis. The use of personal hygiene products, especially feminine products, can cause chronic chemical urethritis. Chronic urethritis occurs in both women and men. Painful urination and urinary frequency are the most common symptoms. Symptoms - Urinary frequency/urgency
- Urination discomfort, burning, or stinging of the urethra or lower abdomen during urination (see painful urination)
- Urethral discharge (bloody or pus-like, and often foul-smelling)
Signs and tests - Urinalysis may show infection or inflammation.
- Urine culture (clean catch) confirms infection and can show what bacteria is causing the infection.
- Urethral discharge culture or vaginal culture specimen(s) can rule out sexually transmitted diseases.
- Cystoscopy and urethroscopy are used to directly examine the urethra. These tests may reveal a urethral stricture (narrowing), a urethral diverticulum (out-pouching), or a mass (such as a urethral tumor).
Treatment If there is an infection, you will be given antibiotics. A follow-up urinalysis or culture will be done after you finish all of the medicine. Women who have repeated episodes of intercourse-related urethritis or cystitis may be prescribed a dose of preventive antibiotics. Such therapy is called peri-coital treatment, and involves taking the medicine shortly before or after intercourse. Phenazopyridine (Pyridium) may be prescribed to decrease urinary discomfort. You should stop using any possible chemical irritants. Expectations (prognosis) In the majority of cases, the cause of the urethritis can be found and treatment will be given. Chronic urethritis, despite the cause, can lead to urethral strictures (narrowing) and may require surgery or another medical procedure to correct the problem. Complications Prolonged, untreated infection may progress to continued narrowing of the urethra, resulting in difficulty in completely emptying the bladder. Recurrent urinary tract infections may also occur. Less commonly, pyelonephritis (kidney infection) or structural damage to the urinary tract system, including impairment of renal (kidney) function can occur. Prevention Drinking plenty of water each day can help prevent urethritis. Women who have symptoms that occur within 24 hours of sexual intercourse should always urinate immediately after having intercourse. Taking a small dose of antibiotics after intercourse also decreases episodes of urethritis and cystitis. Good hygiene for yourself and any sexual partners is important. Safer sex behaviors can decrease the risk of developing sexually transmitted diseases, which can cause urethritis. Getting treatment as soon as symptoms appear is important in preventing damage to the urethra. Review date: 6/13/2006 Reviewed By: Neil D. Sherman, MD, Urologist, Essex County, NJ. Review provided by VeriMed Healthcare Network.
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