The Citizen (KZN)

Mind your pees and q’s

URETHRITIS: WOMEN MAY NOT SHOW SYMPTOMS

- HEALTHY

Infection of tube that carries urine from bladder makes men want to pee.

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 doctor for examinatio­n and tests.

The usual infective causes are gonorrhoea and chlamydia, which account for up to 43 out of 100 cases.

There are many cases of urethritis, though, where no infection is found.

Urethritis is the most common condition diagnosed and treated among men in clinics – about 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 (which connect the ovaries to the womb).

If the infection does spread, a woman may develop pelvic inflammato­ry disease (PID), a serious 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 any, they may include:

Pain around the pelvis or lower part of your stomach; Discomfort or pain deep inside the pelvis during sexual intercours­e;

Bleeding between periods and after sex;

Pain when you urinate; Heavy or painful periods; Unusual vaginal discharge – especially yellow or green.

A few women with PID become very ill with:

Severe lower abdominal pain; A temperatur­e of 38oC or above; Nausea and vomiting.

Symptoms of urethritis 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 an infection.

If it has a non-infectious cause, such as irritation to the urethra, symptoms may begin after a couple of days. Symptoms that start a day or two after sex are usually not caused by an sexually transmitte­d infection (STI), but testing for STIs is still recommende­d.

If a current or recent sexual partner informs you that you may have been exposed to an STI that can cause urethritis, but you don’t have any symptoms, don’t assume that you do not have it. Get tested.

Causes

Urethritis caused by gonorrhoea is called gonococcal urethritis.

Chlamydia is caused by Chlamydia trachomati­s bacteria. It is an STI and is spread during unprotecte­d sex (without a condom), including anal and oral sex. Other infections can cause urethritis. These 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 is when something else leads to the urethra becoming inflamed, 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; or damage to the urethra caused by inserting an object into it, such as a catheter.

Urethritis can be caused by an STI and is therefore more common among people who are at risk of STIs, those sexually active, who have had unprotecte­d sex or have recently had a new sexual partner.

Diagnosis

There are two tests that are usually used to diagnose urethritis: a swab test and a urine test.

Either test can be used, although both may be carried out to ensure the diagnosis is correct.

You may also be offered tests for all STIs, including HIV.

A swab test involves taking a small sample of fluid from your urethra, which is the tube that carries urine from the bladder to the outside of the body.

The sample can then be examined under a microscope to look for evidence of inflammati­on or bacteria known to cause urethritis.

Treatment

It is important that you make sure you take your treatment as prescribed, make sure all your recent partners get the treatment, not have any sex until a week after everyone has been treated.

The illness is usually treated with a short course of antibiotic­s to kill the bacteria that caused the infection.

Treatment with antibiotic­s may be started before you receive your test results.

A test can be conducted to confirm whether the cause is infective or not so that you are not given antibiotic­s unnecessar­ily.

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