Urethritis (NSU / NGU) Treatment

Urethritis is inflammation of the urethra, the tube that carries urine from the bladder to the outside of the body. It is a very common problem in men, particularly sexually active men, and is one of the most frequent reasons for attending a sexual health clinic.

Urethritis may be caused by sexually transmitted infections (STIs), other infections, or non-infectious irritation. Early diagnosis and treatment are important to prevent complications and reduce transmission to partners.

What Is NSU / NGU?

Urethritis is often referred to as:

• NGU (Non-Gonococcal Urethritis)

• NSU (Non-Specific Urethritis)

These terms are used when inflammation of the urethra is present but is not caused by gonorrhoea.

In many cases, a specific organism is identified. However, in a significant proportion of cases, no clear cause is found.

What Causes Urethritis?

The most common infectious causes include:

• Chlamydia trachomatis

• Mycoplasma genitalium (M. Gen)

• Ureaplasma urealyticum

• Trichomonas vaginalis

• Adenovirus

• Herpes simplex virus

Chlamydia remains one of the most frequent causes in young men. Mycoplasma genitalium is increasingly recognised as an important cause, particularly in recurrent or persistent cases.

In some cases, urethritis may be non-infectious, caused by:

• Irritation from soaps or shower gels

• Lubricants

• Condom materials

• Foreign bodies

• Recent instrumentation

Identifying the underlying cause helps guide treatment.

Symptoms of Urethritis

Some men have clear symptoms, while others may have mild or no symptoms at all.

Common symptoms include:

• Dysuria (painful or burning urination)

• Clear or cloudy urethral discharge

• Penile or urethral discomfort

• Irritation at the tip of the penis

Some men are asymptomatic, meaning they have inflammation detected on testing but no noticeable symptoms.

Because symptoms can be mild, the infection may go untreated without testing.

Possible Complications

If untreated, urethritis can lead to complications.

In men, these may include:

• Epididymo-orchitis (inflammation of the testicles)

• Prostatitis

• Sexually acquired reactive arthritis

Reactive arthritis is an inflammatory condition affecting joints and sometimes the eyes and skin, triggered by infection.

In female partners, the same organisms that cause urethritis in men can lead to:

• Cervicitis

• Pelvic inflammatory disease (PID)

• Fertility problems

For this reason, partner testing and treatment are essential.

Urethritis in Women

Although urethritis is more commonly diagnosed in men, the organisms responsible can infect women as well.

Women may present with:

• Pelvic pain

• Abnormal discharge

• Pain during sex

• Irregular bleeding

An untreated infection in women can lead to PID, which can have long-term reproductive consequences.

Testing for Urethritis

Accurate diagnosis requires appropriate laboratory testing.

We typically perform:

Urine STI Screening

A first-catch urine sample is tested for common organisms, including chlamydia and gonorrhoea.

White Blood Cell (WBC) Count

This helps confirm inflammation of the urethra.

Extended Screening

In recurrent or persistent NSU, we may test for:

• Mycoplasma genitalium

• Ureaplasma

• Trichomonas

• Herpes

We may also rule out other conditions, such as prostatitis, particularly if symptoms persist despite treatment.

Testing is discreet and straightforward.

Treatment for Urethritis

Urethritis is usually treated with oral antibiotics, which we can dispense onsite.

The choice of antibiotic depends on:

• Identified organism

• Local resistance patterns

• Whether symptoms are recurrent

Treatment is highly effective in most cases.

Abstinence and Partner Management

To prevent reinfection and onward transmission:

• Abstain from sexual contact for 14 days after treatment

• Ensure all recent sexual partners are tested and treated

Even if a partner has no symptoms, they may still carry the infection.

Partner notification is an important part of responsible sexual health.

Recurrent or Persistent NSU

A minority of patients experience persistent or recurrent symptoms.

In these cases, we:

• Offer additional screening for less common organisms

• Review compliance with medication

• Assess for reinfection

• Rule out prostatitis or other underlying causes

Mycoplasma genitalium is increasingly identified in recurrent cases and may require specific antibiotic regimens.

Early reassessment improves outcomes.

When Should You Seek Medical Advice?

You should book an appointment if you experience:

• Burning when passing urine

• Unexplained penile discharge

• Persistent penile discomfort

• Testicular pain

• Symptoms after unprotected sex

Even if symptoms are mild, early treatment prevents complications.

Confidential Urethritis Care in Canary Wharf

At our private clinic in Canary Wharf, we provide:

• Comprehensive STI screening

• Rapid diagnosis

• On-site antibiotic treatment

• Partner management advice

• Extended screening for recurrent NSU

• Follow up if symptoms persist

Our approach is discreet, professional, and non-judgmental.

Protecting Your Long-Term Sexual Health

Urethritis is common and treatable, but it should not be ignored. Early testing and appropriate antibiotics prevent complications such as epididymo-orchitis, reactive arthritis, and pelvic inflammatory disease in partners.

If you are experiencing symptoms or have concerns following sexual contact, a confidential sexual health assessment is available.