Male urethritis

Inflammation of the male urethra can be either infectious, caused by sexually transmitted diseases, or due to trauma following urological procedures, intermittent catheterization, insertion of foreign bodies, anatomical abnormalities or following accidental injury. Traditionally, the infectious causes have been divided into gonococcal urethritis, caused by N. gonorrheae, or non-gonococcal (also known as ‘non-specific’ urethritis, NSU). Chlamydia trachomatis is the most common agent of NSU, but other agents include Ureaplasma urealyticum, Mycoplasma hominis and Trichomonas vaginalis. Mixed infections can occur in a minority of cases. Other rare causes include lymphogranuloma venereum, herpes genitalis, syphilis, mycobacterium and typical bacteria (usually gram-negative rods) that are associated with cystitis in the presence of a urethral stricture. In vitro experiments have demonstrated that some bacteria, in particular the urogenital pathogens, can adhere to spermatozoa; this property might be an important mechanism by which infections may be spread throughout the female reproductive tract, with sperm acting as vectors of disease (Hosseinzadeh et al., 2000). Urethritis may also be seen in association with other infectious syndromes such as epididymitis, orchitis, prostatitis, proctitis, Reiter's syndrome, iritis, pneumonia, otitis media or urinary tract infection.

Signs and symptoms

Infections may be asymptomatic; patients sometimes present following partner screening. Symptoms may include urethral discharge, urethral itch, and dysuria. Urinary frequency and urgency are typically absent and, if present, should suggest prostatitis or cystitis.