If it hurts to pee you might be suffering from urethritis

Urethritis is inflammation of the urethra, the tube that carries urine from the bladder out of the body. It is usually caused by an infection. If you think you have urethritis, you should visit your local general practitioner for examination and tests.

Infective causes are gonorrhoea and chlamydia, which account for up to 43 out of 100 cases. There are many cases of urethritis where no infection is found. It is the most common condition diagnosed and treated among men in clinics – around 80 000 men are diagnosed with urethritis every year. It is more difficult to diagnose urethritis in women because it may not cause as many symptoms.

Symptoms
In women, urethritis rarely has any symptoms unless the infection spreads to other parts of the female reproductive system, such as the womb or fallopian tubes. If the infection does spread, a woman may develop pelvic inflammatory disease (PID), a serious health condition that can cause persistent pain. Repeated episodes of PID are associated with an increased risk of infertility.

Some women with PID don’t have symptoms. If there are symptoms, they include:

• Pain around the pelvis or lower part of your stomach (abdomen).
• Discomfort or pain during sexual intercourse that is felt deep inside the pelvis.
• Bleeding between periods and after sex.
• Pain when you urinate.
• Heavy or painful periods.
• Unusual vaginal discharge, especially if it is yellow or green.

A few women with PID become very ill with:

• Severe lower abdominal pain.
• A fever of 38o C or above.
• Nausea and vomiting.

Symptoms in men include:

• A painful or burning sensation when urinating.
• The tip of the penis feeling irritated and sore.
• A white or cloudy discharge from the tip of the penis.
• A frequent need to urinate. Depending on the cause of the urethritis, symptoms may begin a few weeks or several months after infection. If it has a non-infectious cause, such as irritation to the urethra, symptoms may begin after a couple of days.

Causes
Urethritis caused by gonorrhoea is called gonococcal urethritis. Other causes include:

• Chlamydia, which is caused by chlamydia trachomatis bacteria. It is a sexually transmitted infection and is spread during unprotected sex, including anal and oral sex.
• Other infections, which include other bacteria that usually live harmlessly in the throat, mouth or rectum. The spread can happen during oral or anal sex.
• Non-infectious causes, when  something else leads to the urethra becoming inflamed. These include irritation from a product used in the genital area, such as soap, deodorant or spermicide; damage to the urethra caused by vigorous sex or masturbation or by frequently squeezing the urethra, damage to the urethra caused by inserting an object into it, such as a catheter.
• Urethritis can be caused by an STI, which includes people who are sexually active, have had unprotected sex and have recently had a new sexual partner.

Diagnosis
Two tests are usually used – a swab test and a urine test.  You may also be offered tests for all STIs, including HIV.

Treatment

Take treatment as prescribed and make sure all your recent sexual partners get treatment. Do not have sex until a week after everyone has been treated. It is usually treated with a short course of antibiotics. Treatment with antibiotics may be started before you receive your test results. A c-reactive protein (CRP) test can be conducted to confirm whether the cause is infective or not, so that you are not given antibiotics unnecessarily.

Informing partners
Any sexual partners you have had since being exposed will need to be informed, so they can be tested and treated. It is suggested you inform any person you have had sex within the three months leading up to diagnosis, but this timeframe can vary. With your permission, the clinic can arrange for a letter to be given to former partner or partners.

Complications

• Persistent urethritis: When you still have urethritis one to three months after being treated. This affects one or two men in every 10 treated and can affect women, too.
• Reactive arthritis is an uncommon complication, estimated to affect less than one in 100 people with the condition. This can cause joint pain, conjunctivitis (inflammation of the eyes) and recurring urethritis.
• Epididymo-orchitis is a possible complication in men. It is a combination of inflammation of the epididymis (a long coiled tube in the testicles that helps store and transport sperm) and testicles.
• Pelvic inflammatory disease in women can be a result if left untreated. PID is a serious condition that can increase the risk of infertility and ectopic pregnancy.

Dr. Dulcy

About The Author:

Dr Dulcy holds an MBBCH degree from Wits University, a diploma in occupational health, a diploma in HIV management, a travel medicine diploma, masters of science in sports medicine, and a masters in business administration degree from GIBS. A social entrepreneur with a passion for providing healthcare and wellness solutions for low and middle-income communities in South Africa.

As the 2016 Social Entrepreneurship Regional Business Achiever award winner for Business Women’s Association, she started Accessible Quality Healthservices (AQH) in 2013 after being a general practitioner in Vryburg then Carletonville for 11 years.

In 2015, she partnered with Pascal Frohlicher and we founded U-Care Medical Centres which focused on building private medical centres and providing world-class health services at an affordable cost. This company evolved in 2019 to become Quadcare, which is a network of medical centres in areas where they are needed the most providing access to affordable healthcare. Currently, the centres are in Edenvale, Fox Street Johannesburg, Meadowlands, Carletonville, University of Johannesburg, and Park Station.

Dr Dulcy said her life’s purpose was to make an impact on how healthcare was delivered in this country, especially to the poor.

*Always consult your paediatrician, gynaecologist or health-care provider for all health matters relating to you and your children.

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