Non Specific Urethritis Nsu Health And Social Care Essay

Often abbreviated to NSU for convenience, non-specific urethritis is a condition with some unpleasant symptoms. In this article we take a broad look at NSU and the ins and outs of the condition.

Introduction to NSU

NSU is also known as non-gonococcal urethritis for reasons soon to be discussed, and the condition affects a particular part of the body called the urethra. Both men and women possess a urethra, which is essentially the tube running from the bladder and out of the body. As you might imagine, the purpose of the urethra is to carry urine out of the body, and so it is an important part of our natural waste disposal system.

NSU involve a painful inflammation of the urethra, and the condition fits under a broader category of conditions called urethritis. NSU in particular earns its name from the fact that no distinctive cause for the condition can be determined. The condition is often referred to as non-gonococcal urethritis (NGU) because one of the more common causes of urethritis is gonorrhoea, and instances where the condition is not caused by gonorrhoea can be classed as NGUs.

While no specific, determinable cause of NSU is one of the hallmarks of the condition, we do have some understanding of what may be causing the condition. It is thought that even though an infection may not be detected in the course of looking into NSU, at least half of all male conditions are actually caused by the sexually transmitted disease chlamydia. In some cases NSU is caused by injury or blockage of the urethra, and the use of some products like creams and soaps can cause the urethra to become inflamed.

Interestingly women suffering from NSU will rarely present with any symptoms, while men will often suffer notably from the condition. An estimated 80,000 cases of NSU are reported by men in the UK every year, and the condition can be diagnosed through urine tests or swabs of the urethra.

Male sufferers of NSU will most often report a painful burning during urination, often alongside pain and irritation at the end of the penis. In some cases there can be a cloudy discharge from the end of the urethra.

Fortunately despite its prevalence and unpleasant symptoms, NSU is very treatable. Antibiotics are prescribed to combat the infection responsible for the symptoms and the condition itself. The treatment can last about two weeks, and it is important that former sexual partners are spoken to about the condition in case it has been caused by an STI. These steps are taken to address the issue of sexually transmitted disease and prevent the spread of STIs, as well as to provide infected peoples with any treatment they might need.

Safe sex is one of the best ways to prevent the unwanted spread of NSU as the majority of cases stem from infection with chlamydia. This means using a barrier method of contraception like a condom to prevent the unwanted exchange of bodily fluid that can result in the transmission of NSU causing sexually transmitted infection.

Symptoms of Non-Specific Urethritis

Non-Specific Urethritis is the inflammation of the tube responsible for carrying urine from the bladder and out of the body. The condition has become an issue in the UK as many incidences can be attributed to sexually transmitted infections, many of which have been on the rise in the country. Often abbreviated to NSU, non-specific urethritis can have some unpleasant effects, and in this article we look specifically at the symptoms of the condition.

Signs and symptoms of NSU in men

A diagnosis of non-specific urethritis is given when no specific cause for urethritis can be found and disclosed to the patient. Despite this being the case, we do have an understanding of a number of different injuries and infections which can lead to the condition, and as such despite its vague nature, the disease does have distinctive symptoms.

In men the symptoms of NSU are far more obvious, and in most cases, painful. One of the most prevalent symptoms of NSU is a painful burning sensation during urination which can often be experienced alongside irritation or pain at the tip of the penis. This pain and discomfort is often compounded by an increased frequency of urination, and some men will find a milky white discharge from the end of their penis.

These symptoms can typically begin days, weeks, or even months after the actual infection, and this can be indicative of the cause of the disease. Many cases of NSU are actually due to some kind of injury or exposure to some soaps and creams, and in these instances symptoms develop within a couple of days of the incident responsible. Where an infection is responsible, which is often the case amongst men suffering from NSU, the nature of the infection will determine how long it can be before symptoms arise. It is important to point out that if you have symptoms a few days after sex then it is unlikely the condition is caused by a sexually transmitted infection as these will take much longer to manifest with urethritis. That being said, you should still pursue any necessary STI testing where possible.

If you have had unprotected sexual intercourse with someone who has been diagnosed with an STI and potentially NSU, you should get yourself tested regardless of whether or not you have shown any symptoms. Again, signs of the disease can take much longer to develop, and getting tested can allow you to get any treatment you need before the symptoms of urethritis, which are unpleasant in men, can begin.

Even if your symptoms pass, you should still go to your doctor and try and determine the cause of the condition. In some cases symptoms can come and go, and getting tested and treated can spare you some considerable discomfort.

Signs and symptoms of NSU in women

While most women won’t develop any symptoms of their NSU, the condition is still cause for concern. Left unchecked, the infection responsible for NSU can spread into other parts of the reproductive tract, which include important structures like the womb (uterus). Infections that make their way into the rest of the female track become classified as PID or pelvic inflammatory diseases, and these are serious conditions that can cause chronic pain issues and potentially influence fertility.

PID will typically involve pain around the pelvis and abdomen, some pain or at the very least discomfort during sex, irregular bleeding between periods and after intercourse, in some cases distinctive vaginal discharges and a fever.

The lack of symptoms in the early stages of infection (NSU) can make it difficult to treat the condition before it progresses to cause PIDs, which is why it is important to practice safe sex and avoid one of the causes of urethritis: sexually transmitted infection. If you have had unprotected sex and are worried about developing NSU you should speak to your doctor about potentially getting tested. If you are told that a former or current sexual partner is carrying an STI you should definitely get testing to ensure that you don’t bear the condition or get the treatment you need if you do.

Despite the discomfort of the symptoms of NSU (for men), the condition is very treatable, so if you do think you suffer from non-specific urethritis you should speak to your doctor who will be able to diagnose you and provide you with the antibiotics that can resolve the condition within a couple of weeks.

Causes of Non-Specific Urethritis

Non-Specific Urethritis is often referred to as either NSU or NGU (standing for non-gonococcal urethritis). The condition can have unpleasant symptoms for men and lead to serious medical consequences in women, which is why its diagnosis and treatment is so important. In this article we look at the potential causes of non-specific urethritis.

Infectious causes of NSU

Sexually transmitted infections are thought to be one of the major causes of non-specific urethritis, particularly amongst men. In cases where STIs are responsible for the illness, your diagnosing physician will have been unable to detect which specific infection is responsible for the inflammation of the urethra involved in urethritis, this lack of a specific causative effect of the condition is what causes urethritis to be classed as non-specific.

Chlamydia is a relatively common sexually transmitted infection which is thought to cause at least half of all cases of non-specific urethritis in men, and about 40% in women. Chlamydia is a bacterial infection transmitted through any unprotected sex, including anal and oral intercourse. The bacteria responsible is called Chlamydia trachomatis, and infection with this bacteria can, if left untreated, cause more serious medical issues as well as urethritis.

This is why the practice of safe sex is an important method of avoiding NSU, and why you should have yourself tested for the condition if you or either a former or current partner are diagnosed with chlamydia.

Other bacteria and microorganisms can also potentially cause non-specific urethritis, and these can often be found living harmlessly in other parts of the body. Our throats, rectums, mouths, and digestive tract are rich in harmless bacteria which can cause urethritis should they come into contact with the urethra. In most cases exposure to these otherwise safe bacteria occurs through sexual intercourse.

Relatively common infections and infectious agents causing NSU here in the UK include bacteria like Mycoplasma, parasites like Trichomonas Vaginalis, and viruses like herpes which are responsible for herpes and cold sores. In these cases, as with chlamydia, it is important to be tested so that your doctor can provide you with any necessary treatment.

Non-infectious NSU

While infections may be one of the primary causes of non-specific urethritis, there are many examples of the condition being caused by injury or exposure to irritants. In these cases contact with a foreign object causes the urethra to become inflamed, and as this structure is responsible for the transport of urine from the bladder and out of the body, also causes the characteristic painful urination experienced by men suffering from NSU.

Inflammation is one of the body’s natural responses to foreign bodies and trauma, and while it can be painful and cause unpleasant effects, its purpose is important. Your body triggers inflammation when exposed to injury or a potentially harmful substance, and in doing so, isolates the affected site so as to better launch an immune response against it and to prevent the spread of potentially harmful substances or organisms to the rest of the body. In NSU, this inflammation restricts the size of the urethra and results in the painful expulsion of urine in men.

Irritants that can cause NSU are largely chemical products like certain soaps, spermicides, oils, lubricants, or deodorants. It is important to handle any such substance with care when near your genitals, and unless you are sure about the safety of the substance in question, you should not apply it to your penis.

NSU can also be caused by trauma to the urethra triggered by overly vigorous sexual activity. This includes both intercourse with a partner and masturbation, either of which can damage the urethra if performed unsafely.

A number of NSU cases are caused by the insertion of a material into the urethra. A relatively common example of NSU as a consequence of this is where catheters are inserted into the urethra. A catheter is essentially a bag into which urine can flow where a person is facing difficulties with bladder control or access to urinary facilities (e.g. because of movement issues or when bedbound for surgery). The application of a catheter involves inserting a lubricated tube into the urethra to access the bladder, and in some cases this process can damage the urethra and trigger an inflammatory leading to NSU.

Regardless of cause, a diagnosis of NSU is usually a good thing as it means your doctor can start administering the necessary treatment. Understanding why NSU has been caused influences treatment choices in some cases of course, for example NSU caused by an infection can be cleared up by addressing that underlying infection, which is why it is important that the necessary tests and patient history are provided by and to your doctor respectively.

Treatment of Non-Specific Urethritis

NSU, also known by its full name, non-specific or non-gonococcal urethritis, is a condition that has been on the rise in the UK alongside the spread of STIs which can cause it. Fortunately despite the discomfort and pain associated with the symptoms of the condition in men (NSU is largely asymptomatic in women), the condition is very treatable, and in this article we look at how non-specific urethritis can be treated once diagnosed.

Treatment of NSU

NSU is primarily treated through a short course of antibiotics your doctor will provide you once a diagnosis of NSU has been made. You can arrange to see medical health professionals at specialised sexual health or genitourinary medicine clinics, and these individuals are capable of prescribing any necessary medications.

Antibiotics are specially formulated drugs with an anti-bacterial action from which they derive their name. As most cases of NSU are caused by a bacterial infection of some sort, antibiotics are an effective and fast acting way of clearing up the condition. Antibiotics are actually also used where NSU isn’t caused by an infection, but by trauma or exposure of the urethra to irritants like soap, creams, or foreign objects. In these instances despite the non-infectious cause of NSU, there is often an element of infection which can be effectively addressed through antibiotics.

These antibiotics are not available over the counter, and you will need a prescription from one of the previously mentioned sources to gain access to the drugs. The two most commonly used antibiotics are azithromycin and doxycycline. The former is given as a single dose that you only need to take once, while the latter needs to be taken twice a day over the course of a week.

Following the instructions associated with the administration of the antibiotic in question will hopefully lead to the infection being treated. You won’t need to revisit the clinic, but you will have to make sure that you have informed your recent sexual partners about the condition as it is infectious and they might need treatment. You should also avoid any sex for at least a week to prevent any further transmission of the illness, and it can take up to three weeks for symptoms to completely clear.

It is absolutely critical that you avoid sex of any kind, be it vaginal, oral, or anal, whilst taking your medication (or in the week after taking azithromycin). During this time despite the antibiotics there will still be bacteria around your urethra which can be transmitted to someone else. Ideally you should avoid sex until you have no symptoms at all, even if this can take a couple of weeks.

There are cases where despite following the course of prescribed antibiotics, there is no resolution of symptoms two weeks after you have been given antibiotics. Should this occur, you should visit your local sexual health or genitourinary medical clinic to follow up on your care. In some cases, your symptoms might persist because the infection was passed back to you by a sexual partner.

You will probably be asked to go through a number of tests to look for any sexually transmitted infections that might underlie your NSU and contribute to it. Your doctor may prescribe a different set of antibiotics and follow up on your treatment in that way.

Prognosis of Non-Specific Urethritis

NSU (non-specific urethritis) is a condition that has become a bigger concern in the UK in recent years alongside the spread of sexually transmitted infections, one of the more common causes of NSU. NSU’s symptoms can be particularly unpleasant for men, how will experience pain while urination and an increase in their need to do so. While women don’t often experience any overt symptoms of the condition, NSU can become a more serious and complex condition affecting the reproductive tract if left untreated.

In this article we look at the prognosis of non-specific urethritis both without and with treatment.

Prognosis of NSU without treatment

The prognosis of NSU without treatment varies depending on gender. Men who don’t receive treatment from the infection will have to put up with the symptoms for some time, but in most cases will resolve over time. In cases where the NSU is actually a consequence of an underlying sexually transmitted infection it is important to seek treatment where possible to prevent the further spread of the STI or complicating effects of the infection.

Women who don’t receive treatment for their NSU can often suffer the progression of NSU to PID, or pelvic inflammatory disease. This is a more serious condition which involves the spread of non-specific urethritis to other structures of the female reproductive tract like the womb. PID can have more serious consequences and needs to be treated quickly. In the long term PID can increases the risk of infertility and a pregnancy complication where an embryo implants somewhere that isn’t the uterus (referred to as ectopic pregnancy).

If left untreated NSU in both men and women can result in a condition called persistent urethritis, where there NSU seemingly resolves and then recurs. Recurring NSU can occur after receiving treatment for the condition as well, and is thought to affect about 20% of male NSU sufferers anda number of women as well.

Prognosis of NSU after treatment

NSU is very effectively treated with antibiotics, antibacterial drugs which attack the bacteria most often responsible for urethritis. The drugs are also administered in cases where urethritis is a consequence of injury as there is sometimes an infectious component in these instances as well.

It is important to follow the instructions provided with any course of antibiotics. The two most often applied to NSU are a seven day course of doxycycline (with two doses a day), or the substantially simpler single dose required for azithromycin. If the instructions are followed then the prognosis for NSU is very good, with symptoms resolving within 2-3 weeks. If symptoms don’t clear up then it may become necessary to seek further treatment and testing, and you should speak to a specialist at either a sexual health clinic or a genitourinary medicine clinic. In some cases alternative antibiotics may be prescribed, and most of the time some further testing for STIs will be performed.

Diagnosing Non-Specific Urethritis

Non-Specific Urethritis in Men

While urethritis is a concern for both sexes, the infection itself is a completely different experience for men and for women. In this article we look at how non-specific urethritis can affect men in particular.

Symptoms of male NSU

Often abbreviated to NSU for convenience’s sake, non-specific urethritis is a condition that has become increasingly prevalent alongside the rise and spread of sexually transmitted infections in recent years.

Men experience NSU differently because of the anatomy of the affected structure, the urethra, in the male body. The urethra is the tube which because inflamed (swollen and painful) during NSU. The urethra is the structure responsible for carrying urine out of the bladder, through the penis, and finally out of the body. When inflamed, the urethra causes a number of unpleasant symptoms in men because of the association of this tube with the penis.

One of the major differences between men and women experiencing NSU lies in the symptoms experienced. Most women with NSU won’t experience any symptoms at all, while men suffering from the disease will often suffer a painful burning sensation whilst urinating, pain at the end of the penis, and in some cases a milky discharge is released from the end of the penis. These unpleasant symptoms are also compounded by an increase in the frequency of urination, and in some cases pain in the abdomen.

Causes of NSU in men

About 50% of cases of male NSU are thought to be attributed to chlamydia, a sexually transmitted infection with a number of other effects including the inflammation of the urethra. A number of cases are also attributed to injury, either through exposure to irritant materials like certain soaps and creams or through objects being inserted into the end of the penis. A good example of the latter is the insertion of a catheter tube into the urethra, which is more likely to cause injury to men than women because of our differences in anatomy.

Prognosis, treatment, and Complications of NSU in men

One of the differences in the condition as experienced by the sexes is also the long term effects of NSU. In men the condition can often resolve, even without treatment, however if left unattended in women NSU can quickly become a much more insidious and serious condition. Untreated non-specific urethritis progresses to form a condition called pelvic inflammatory disease, an affliction which spreads to important structures in the female reproductive tract and can affect fertility.

Men can still suffer some unpleasant complications of NSU. Recurrent urethritis is a condition which can affect about 20% of men compared to a very small number of female incidences. Recurrent NSU is essentially just a repeat infection, which will often warrant further testing and treatment to address what is usually an underlying infectious cause.

Less than 1% of male sufferers of NSU will experience a complication of NSU called Epididymo-Orchitis, a combination of two inflammatory conditions called epididymitis and orchitis. The former is an inflammation of the epididymis, a tube which stores and transports sperm through the testicles, and the latter is the general swelling and inflammation of the testicls.

In terms of treatment men are provided with the same courses of antibiotics as women. In the UK this is typically either a single dose of azithromycin or a week long regimen of doxycycline. If taken as advised, these are extremely effective antibiotics which can treat male symptoms within 2-3 weeks of administration. There are instances where the treatment may not successfully clear up the condition, and in these cases you should go back to your doctor for further testing as it is likely that there is an underlying sexually transmitted infection which is causing recurring episodes of urethritis.

While the long term consequences of NSU are less severe amongst men, the condition does have painful symptoms which warrant quick treatment. Fortunately men who follow the treatment instructions will, in most instances, quickly recover from the condition.

Non-Specific Urethritis in Women

Non-specific urethritis goes by a number of different monikers, including NSU and NGU (non-gonococcal urethritis), and is a condition that has become a growing concern amongst the medical community as it is often linked to sexually transmitted infections. In this article we look at NSU in women as the condition is experienced differently by the sexes due to biological differences in the structure and functions of the urethra and reproductive system.

Causes of NSU in women

Women in the UK are thought to suffer NSU as a result of sexually transmitted infections (STI) or injury to the urethra. The urethra is the structure affected by the condition and from which the illness draws its name. This structure is a tube which runs from the bladder and out of the body, and in NSU it becomes inflamed as part of an immune response (the actions of our body’s natural defences) to infection or injury.

About 40% of cases of NSU are thought to be caused by chlamydia infections. Chlamydia is a relatively common sexually transmitted disease which spreads through unprotected sexual contact be it vaginal, oral, or anal.

While a large portion of infectious cases of NSU in women are thought to be a consequence of chlamydia, there are a host of other bacteria which may reside in the mouth, throat, or anus which can cause non-specific urethritis. These bacteria are usually harmless in their usual environment, and only cause harm once within the urethra. Examples of these bacteria include Mycoplasma and Trichomonas Vaginalis.

Viruses can also potentially cause an inflammation of the urethra in women, although cases of NSU caused by viral infection are less common than in men. The adenovirus, which will typically cause a sore throat, or the herpes virus are good examples of viral causes of urethritis.

In some instances NSU is caused by injury or exposure to irritant materials. A chemical product like a soap or cream used near the genitals can potentially cause the urethra to inflame, which is why it is always important that both men and women take care when applying any material to their genitals. Injury, most commonly through the insertion of a catheter, can also cause an inflammatory response and trigger NSU. Catheters are tubes which are lubricated and then run up the urethra and into the bladder to provide relief for people who might not be able to urinate normally for medical reasons. While care is taken in the application of catheters and a lubricant is used, their placement an cause urethritis.

Symptoms of NSU in women

Interestingly while most men will experience symptoms like a burning during urination or a discharge from the end of the penis, women very rarely demonstrate any symptoms or signs of non-specific urethritis. The condition is quite insidious in this respect as without any symptoms it is often left untreated, and can develop into a far more serious condition. If caused by a sexually transmitted infection, then the fact that NSU has no symptoms can lead to the unwitting transmission of the STI.

Prognosis and Treatment of NSU in Women

If left untreated, a severe cause of non-specific urethritis can develop into a pelvic inflammatory disorder, a condition with more serious implications for women. Men don’t develop PID, and in most cases NSU in men will resolve even without treatment. Because of how serious PID can be in women, diagnosing and treating NSU quickly and effectively is extremely important.

PID occurs when the infectious agent causing NSU spreads to the rest of the reproductive tract, including important and sensitive structures like the uterus or fallopian tubes (which link the uterus to the ovaries). Ultimately untreated PID can affect a woman’s fertility and cause what are known as ectopic pregnancies. An ectopic pregnancy is when a fertilised egg implants in an abnormal location rather than the womb, most commonly the fallopian tubes.

Other complications of untreated NSU include persistent NSU, a condition where the inflammation of the urethra recurs regularly. If your symptoms recur following treatment, you are likely to suffer from persistent NSU and should consult your doctor for further testing and treatment. Persistent NSU is rarer in women than in men, but it does occur.

Reiter’s syndrome is also an extremely rare complication of NSU which may affect about 1% of sufferers. The condition is also described as reactive arthritis, and occurs when the body’s immune system chooses to attack its own, healthy cells rather than the infectious agent causing NSU. This type of faulty action is called an autoimmune condition, and is thought to be a result of a confusion in the immune system’s ability to perceive and identify ‘self’ and foreign materials. Reiter’s syndrome can cause pain in the joints, conjunctivitis, and recurring urethral inflammation.

The treatment of NSU in women is exactly as it would be amongst men and usually involves the administration of one of two first line antibiotic treatments. Doxycycline is given as a weekly regimen of 2 doses a day, while azithromycin is administered as a single dose you only need to take once. If your symptoms don’t clear up within 2-3 weeks of treatment (if you are experiencing any symptoms that is), then your doctor will usually run more tests and switch to alternative treatments.

While the condition shares some distinctive similarities in both men and women, there are fundamental differences in how the disease can be experienced by the sexes, and in the complications it can cause if left untreated. Because women rarely experience symptoms and the untreated infection can cause serious complications, it is important that unprotected sex with multiple partners be avoided as this hugely increases the risk of STI based NSU.

Complications of Non-Specific Urethritis

Many different infections can cause complications in certain cases, particularly if left untreated. Because of the nature of the site affected by non-specific urethritis, namely the urethra which is found near the genitals, complications of the condition can have serious consequences to men and women who suffer from the disease and develop complications.

The complications of NSU are a particular concern amongst women as many female sufferers of the condition do not experience any symptoms. This means that the condition can be difficult to pick up and therefore treat, increasing the chances of the infection progressing to cause a more serious disease which will be discussed later in this article.

General complications of NSU

Both men and women can develop recurring NSU, which is potentially the most common complication of the condition. In most cases NSU will clear up after a course of antibiotic treatment however, in some instances symptoms will return, indicating a repeated infection. This condition is also called persistent urethritis, and is thought to affect about 2 in every 10 male sufferers of NSU and a smaller number of women.

Persistent urethritis often requires further testing and another round of treatment. Recurring infections usually indicate that there might be another underlying condition, like a sexually transmitted infection, which requires attention before the urethritis itself can be completely cleared up.

Reiter’s syndrome is another potential consequence of NSU, albeit a much rarer one. The condition is also referred to as a type of reactive arthritis, and belongs to a class of conditions known as autoimmune diseases. These conditions are typified by a faulty reaction from our body’s natural immunity which results in an attack on the body’s own tissues and cells rather than an infectious agent. In this case, the autoimmune response is triggered by the presence of the infectious agents causing NSU.

Reiter’s syndrome will typically present with an inflammation and swelling of the joints which is quite painful, as well as conjunctivitis and potentially other symptoms. Reiter’s is quite rare, but can affect sufferers of urethritis. The best way to address the reactive arthritis is to properly treat the infectious cause of urethritis, and potentially providing treatments to alleviate the symptoms of Reiter’s. The former treatments will usually be a course of antibiotics which, upon clearing the NSU, will remove the stimulus causing the body’s autoimmune response. The latter will be pain killing medications and anti-inflammatories which will am to make the painful symptoms of Reiter’s manageable.

Complications of NSU in Male Patients

Because of the distinct differences in the anatomy of male and female genitals and urethras, men and women experience can potentially experience different complications of the condition as well as the more general complications disussed bove (persistent urethritis and Reiter’s syndrome).

Male patients can develop a condition called epididymo-orchitis, which is in fact a combination of two inflammatory complications. This occurs when the infection spreads from the urethra into the male reproductive tract to cause an inflammation of the testes (orchitis) and epididymis (a tube which stores and transports sperm cells). Less than 1% of male sufferers of NSU can develop the condition, and will experience a very painful enlargement of the scrotum. This will also be tender to the touch, and will often be experienced alongside the usual painful urination and other symptoms of NSU.

The treatment for this complication is antibiotic treatment which can reduce the pain experienced within a few days, although it can take longer for the swelling and tenderness to completely subside. The same antibiotics used for the treatment of NSU can be used.

While in most cases quick treatment can clear up epididymo-orchitis, there are potential comlications of this condition as well. In sme instances an abcess (concentration of puss) can form and may need to be removed surgically. This operation is a small one and no major cause for concern.

Testes affecte by epididymo-orchitis can also demonstrate reduced fertility in some cases, this is most often where the condition is caused by a mumps virus as opposed to NSU, however there is still a risk of this happening.

In extremely rare causes the infection can cause dead tissue and a condition called gangrene. Gangrene is extremely serious and spreads quickly, and the only treatment available is to surgically remove the affected tissues.

Complications of NSU in women

Women suffering from NSU can potentially develop a serious condition called pelvic inflammatory disease, which is often shortened to PID. PID is a major concern because of its potential effects on female fertility and pregnancies.

PID occurs where the infectious agent causing NSU works its way up the urethra and into the female reproductive tract, a system rich in sensitive organs like the womb (uterus) and ovaries. Unfortunately because the symptoms of NSU are often not present in women suffering from the illness, it can be all too easy for the condition to progress to PID, which is why safe sex is such an important practice. In cases where there are symptoms of PID, these will often include distinctive symptoms like fever, a yellow/green discharge from the vagina, unusual bleeding following sexual intercourse or periods, discomfort or pain in the abdomen or pelvis, and pain during intercourse.

If you experience any of these symptoms you should always contact your GP straightaway for the necessary treatment. It is very important that you receive a diagnosis and treatment for this condition as soon as possible as it can have severe consequences.

PID itself will involve, as the name suggests, the inflammation of reproductive structures within the pelvis. PID is, in a sense, an umbrella term which encompasses the infection of any of the organs within the pelvis and female reproductive tract. The structures most often affected by the condition can include:

The endometrium: Is the lining of the womb or uterus which is essential to its good health. The inflammation of this structure during PID is called endometriosis.

Fallopian tubes: Structures linking the ovaries to the womb and through which a fertilised egg will travel to implant into the womb wall. The inflammation of this part of the reproductive tract during PID is called salpingitis.

Ovaries: The ovaries are the structures housing the female reproductive cells, the eggs. The inflammation of these is called oophoritis.

Womb: The womb is where a pregnancy takes place, and is responsible for protecting and nurturing an embryo as it progresses to form a fully developed unborn child. Inflammation of the womb more specifically affects cells around it and is called parametritis.

Peritoneum: This is the lining of the abdomen which is inflamed during pelvic peritonitis as a consequence of PID.

Salpingitis in particular can have lasting consequences as the swelling of the fallopian tubes makes the passage through which fertilised egg pass to access the womb much smaller. This can result in the implantation of said eggs into the fallopian tubes rather than the uterus to cause a condition called an ectopic pregnancy. Ectopic pregnancies pose a number of risks to both the unborn child and the mother, and can be one of the more severe consequences of PID.

Testing for PID will often involve a blood test ultrasound, and swab test, and in some instances a laparoscopy is necessary. If the condition is diagnosed then treatment can be administered, and at its early stages the condition is very treatable. A 14 day course of antibiotics can effectively cure the condition, provided you follow your doctor’s instructions to the letter. During this time you must not have sex as this can disrupt your body’s attempts to repair itself. In about 20% of cases a second episode can occur within 2 years of treatment, and should this occur you must seek treatment as soon as possible.

PID is a major concern because about 20% of sufferers will become infertile as a consequence of the condition. In most cases, this will follow a second episode of the condition.

The complications of NSU can be serious, which is why it is so important to practice preventative measures like safe sex to avoid the condition, and any associated STIs, in the first place. As always, prevention is better than cure, and considering the gravity of some of the more severe conequences of NSU’s complications, these measures are extremely important.

VIRAL NSU

Managing the Symptoms of Non-Specific Urethritis

While it can be asymptomatic, particularly for women, many incidences of non-specific urethritis can cause unpleasant and painful symptoms. These can include a painful burning whilst passing urine, pain at the end of the penis, and the secretion of a discharge from the penis as well. The symptoms can be unpleasant, and management techniques can be key to managing the pain and discomfort of NSU.

Managing symptoms

Ultimately the best course of action to ensure that the symptoms of NSU are resolved is to pursue the correct treatment from your doctor or a GUM (genitourinary medicine) or sexual health clinic. This will usually be a course of antibiotics which should resolve symptoms within 3 weeks at most.

Unfortunately for many people as long as 3 weeks of painful and frequent urination can be extremely discomfiting, which is why management strategies that can accelerate the healing process and alleviate some of the pain of the condition have been explored and developed. These can be particularly important for patients suffering from a relatively common complication of NSU called persistent urethritis, where the infection and symptoms of the condition recur despite treatment.

It is advisable to discuss the management strategies included in this article with your doctor before pursuing them as their effectiveness has yet to be proven conclusively. Ultimately some may work for you, and others may not, and talking to your doctor gives you the benefit of making use of their experience on the subject.

Adjusting your diet can help your body combat infections, and ensuring that you get the right amount of certain nutrients can help alleviate your symptoms more quickly. Eating foods that are rich in antioxidants like certain fruits and vegetables (e.g. blueberries, squash) can provide your body with a class of compounds that combat the cellular damage caused by inflammation. Similarly avoiding food allergens and additives, as well as refined and overly fatty foods, can help your overall health, and therefore your recovery.

Despite the pain of frequent urination, it is important that you keep well hydrated if you are suffering from NSU. Hydration is absolutely vital to good health, and providing getting yourself the right amount of water is extremely important to your recovery and general health. Drinking lots of water also reduces the concentration of your urine, and this dilution can ultimately lessen the pain of urination.

Cranberry juice is often recommended for urinary tract infections, and can help alleviate the symptoms of NSU as well. Some sources suggest that acupuncture can help promote urogenital health and recovery, however the evidence in support of these claims is lacking.

As mentioned above painful and frequent urination and penile pain are some of the more unpleasant symptoms of NSU. Filling a bathtub with enough warm water to cover your genitals can very effectively relieve some of the pain, particularly where urethritis has been caused by exposure to a chemical irritant. You should not use soap or any other chemical in the bath as this can exacerbate the condition.

Your doctor may advise that you take a class of over the counter drugs called NSAIDs or non-steroidal inflammatory drugs. A common example of this is ibuprofen which is readily available across the UK. Paracetamol can also offer pain relief, but it does not alleviate the inflammation behind urethritis.

These are fairly easy and straightforward methods you can pursue to help you cope with the symptoms of urethritis, which should resolve within 2-3 weeks of treatment. During this time it is critical that you avoid sex to help you recover and avoid re-infection.

Similarities and Differences Between Gonococcal and Non-Specific Urethritis

Urethritis involves the painful inflammation of a tube that draws urine out of the bladder and out of the body called the urethra. The condition can be asymptomatic, particularly in women, but can cause painful urination amongst other symptoms. In this article we look at the differences between two types of the most common types of urethritis, gonococcal and non-gonococcal (or non-specific) urethritis.

Similarities and Differences between NSU and Gonococcal Urethritis

The main difference between the two conditions is the fact that while non-specific urethritis can be attributed to a number of different causes, including injury, chemical irritation, and infection, gonococcal urethritis is attributed to a gonorrhoeal infection.

Gonorrhoea is a sexually transmitted infection caused by a bacterium knon either s gonococcus or Neisseria gonorrhoea. Like other STIs, gonorrhoea is spread by unprotected sexual contact with partners carrying the disease. While about 50% of infected females and 1% of infected males are asymptomatic, the rest experience a number of symptoms including the characteristic painful burning sensation during urination that is caused by the gonococcal infection of the urethra.

NSU can be caused by a range of different factors, including infection by sexually transmitted disease like herpes or chlamydia, as well as injury through the insertion of a foreign object into the urethra or exposure of the urethra to an irritating chemical substance.

While there are differences in causes, the two types of urethritis are often treated in a similar fashion, and cause similar symptoms. The solution to both forms of urethritis is a course of antibiotics to remove the aggravating bacteria and thereby clear up the painful and unpleasant symptoms.

Both forms of urethritis can, if left untreated, cause serious complications that can impact fertility like pelvic inflammatory disease in women and epydidimo-orchitis in men. Ultimately it is important for doctors to make the distinction between the two conditions to better judge how to address the infection underlying the urethritis. If the condition is gonococcal, then treating the gonorrhoea is necessary to achieve long term health and to prevent the transmission of the condition to future sexual partners.

Distinguishing between Gonococcal and Non-Specific Urethritis

Because of the importance in distinguishing the difference between gonococcal and non-specific urethritis, a number of tests are performed to determine the exact infectious cause of the condition, and therefore how to best manage it.

Once you start experiencing the symptoms of NSU you should visit your GP or a specialist GUM (genitourinary medical) clinic/sexual health clinic. The latter will be usually be able to see you without an appointment, although in some cases it may be advisable to phone up in advance to either arrange one or look into waiting times and spare yourself a particularly long wait during a busy period. You can rely on the discretion and confidentiality of either source of care.

Your doctor will then take a history of both your symptoms and your recent sexual activity. This is important in determining the likelihood of unprotected sexual activity being the cause of your urethritis, and from there what tests you would need to determine any infection causing the urethritis. Part of this history will involve asking you about the onset of symptoms. Interestingly if you experience the symptoms of urethritis (e.g. burning sensation while emptying your bladder or a discharge from the penis for example) within a couple of days of having unprotected intercourse, it is unlikely that that sexual encounter is responsible for the condition.

If deemed necessary by your doctor, he or she will order a series of tests to determine the exact cause of your urethritis. Blood or urine tests can determine which bacteria is causing the condition, and is a great way of identifying gonorrhoeal bacteria or any other infectious agent responsible for your urethritis. In cases where there is a discharge from the genitals, a sample of this can be studied to the same end.

The test results should indicate which infectious agent is responsible for your condition will inform how your doctor will go about treating the urethritis. Whether gonococcal or non-specific, this condition is treated through antibiotic medication. Slightly different antibiotics are used in the treatment of gonococcal urethritis and NSU. For the former common medications include spectinomycin and ceftriaxone, while for the latter doxycycline and azithromycin are the go to drugs.

If gonorrhoea or another sexually transmitted illness is found to be responsible for your urethritis, you will need to inform any recent sexual partners about the infection so that they can pursue treatment.

Informing these partners may be embarrassing, but it is an extremely important step towards preventing the spread of STIs and an unpleasant condition in urethritis. Moreover some infectious causes of urethritis can be asymptomatic, like gonorrhoea and chlamydia, and these conditions can infiltrate the reproductive tract and cause more serious infections which can, in the worst of cases, lead to infertility.

Catheters and Non-Specific Urethritis

One of the potential causes of non-specific urethritis is injury to the urethra, which can induce a response from the body’s defences which ultimately results in the inflammation of the affected structure. In this article we look at a fairly common cause of the injury that can lead to non-specific urethritis or NSU, namely urinary catheterization.

Urinary catheterization

Urinary catheterization is a medical technique in which a specially designed tube made out of silicone, polyurethane, or latex is inserted into the bladder to allow for the free drainage of urine into an attached artificial bladder.

There are a huge range of different modern catheter technologies, all with their own distinctive advantages and drawbacks, but generally speaking they will all involve the same basic mechanism of inserting a tube and draining the urine into an appropriate vessel.

The catheter tube needs to be inserted through the urethra to access the bladder. The urethra itself is a biological tube which normally works as the means by which we pass urine out from our bladders. Catheters are needed in instances where a person is unable to urinate normally for a variety of different medical reasons. In some cases this could be because of urinary incontinence, a condition during which a person is sometimes unable to control their urination. In others it could be for the opposite reason, referred to as urinary retention, where a person can’t empty their bladder when they need to. Surgical procedures on the genital area or on the prostate in men can affect bladder control and function. And finally a number of neurological injuries and conditions, including dementia and paralysis, can affect a person’s ability to urinate as and when necessary. In all of these cases the use of a urinary catheter may be advised.

Inserting a catheter into the urethra can be painful, particularly for men as will be discussed in the next section. The procedure is performed by trained medical professionals who will lubricate the catheter tube to reduce the chances of injury or damage to the urethra. Unfortunately despite these safeguards, there is still a risk of urethral damage which would cause non-specific urethritis.

Differences in male and female catheters

Anatomical differences between male and female urethra means that catheter insertion, and therefore the risk of urethritis, varies according to gender. While the insertion itself can be complicated in women, it carries with it a lower risk of injury to the urethra when compared to the male procedure provided it is performed by an experienced clinician. Because the catheter tube is inserted into the penis to access the urethra, male catheterization is known to be quite painful. Moreover because of male anatomy there is also an increased risk of bladder spasms and urethral injury.

NSU caused by catheters

Because catheterization is performed carefully and at the hands of skilled experts, injury is generally avoided. A topical anaesthetic is often applied to spare patients, particularly male ones, the pain involved in catheterization. Short term catheterizations used for surgeries and the like will often have a much lower risk of urethritis associated with them.

The chances of NSU caused by catheterization increase where multiple or long term catheterization is needed. This is why catheterization is generally avoided for long term urinary incontinence. The risk of injury is also increased where a person is applying the catheter themselves.

Fortunately many modern catheters don’t necessarily require the invasive insertion of a tube into the urethra, and there are a number of alternatives which can not only reduce the risk of NSU, but also improve the general comfort and usability of urinary catheters.

If you are using a catheter regularly and/or self-catheterizing, there are steps you can take to not only reduce the risks of injury and infection to the urethra, but improve the comfort and overall safety of catheter usage. These include regularly cleaning the catheter itself, keeping your hands and urethral region clean, and keeping the drainage bag or bladder clean as well. Using a thin catheterization tube will also reduce the risk of injury and NSU as it will place less stress on the urethral walls.

NSU caused by catheter insertion is also treated with antibiotics as there is often an infectious component to the condition. The symptoms should pass within 2 weeks of receiving treatment, and if they do not you should consult your doctor and seek further treatment as it is possible that there is another underlying infection. The symptoms of the condition can be painful, particularly in men, but using over the counter anti-inflammatories and pain killers like ibuprofen and immersing your genitals in a warm bath can help manage the condition.

Thanks to improvements in catheter technologies the incidences of NSU as a result of urinary catheterization have been vastly reduced. That being said, if you are making use of a catheter it is important to take care when doing to so to spare yourself the pain and discomfort that can occur as a result of NSU.

Non-Specific Urethritis and Sexually Transmitted Infections

Non-specific urethritis (NSU) is perhaps not very aptly names as there are a number of well-known causes for the condition which can be determined through testing and examination. One of the most common causes of non-specific urethritis is sexually transmitted disease, and in this article we look at which STIs (sexually transmitted infections) can cause NSU and how, as well as how these conditions can be effectively treated to alleviate the symptoms of NSU, and any potential complications of NSU caused by STIs.

STIs as causes of non-specific urethritis

Urethritis is essentially the painful inflammation of the urethra, a biological pipe through which we urinate. Urethritis is usually classed into either gonococcal or non-gonococcal (aka non-specific) urethritis. The former being cases attributable to the STI gonorrhoea, while the latter can be a consequence of any one of a wide range of different causes.

NSU can be caused by injury to the urethra or exposure to irritant chemicals like certain soaps for example, however the majority of the cases of NSU reported are actually caused by sexually transmitted infections. These infections can quite often affect the urethra because of the structure’s role in sexual intercourse, and the result is often the pain and discomfort of non-specific urethritis.

Chlamydia is a sexually transmitted disease which is thought to cause at least half of all cases of NSU in men and 40% of cases in women. Chlamydia is in fact one of the most prevalent STIs here in the UK, and is transmitted, like other STIs through unprotected sexual intercourse. Chlamydia is a bacterial infection which can be asymptomatic in 50% of male and as many as 80% of female cases. However when symptoms do present, urethritis is one of the most common, presenting with the distinctive burning during urination.

While chlamydia is perhaps the most common STI to cause NSU, it is far from the only one. A number of other sexually transmitted infections can cause urethral inflammation, and in many of the following examples the pathogen (infectious agent e.g. virus or bacterium) responsible for disease can be transmitted through oral and anal sexual contact as well as vaginal intercourse.

Mycoplasma is a class of bacteria which can potentially cause urethritis. There are many types of mycoplasma, but the type perhaps most commonly associated to NSU will be Mycoplasma genitalium, a species responsible for a sexually transmitted infection which often causes non-spcific urethritis.

Certain viruses, most notably herpes simplex and adenovirus, can cause non-specific urethritis. Herpes simplex is the virus responsible for both genital herpes and cold sores, and there are in fact a number of different types of herpes virus which can have different effects on the body and different symptoms. Genital herpes is an STI which can cause non-specific urethritis, and this particular infection is quite often transmitted during oral as well as vaginal sex.

The adenovirus exists in dozens of sub-types which most often cause respiratory tract illnesses like tonsillitis, but because of the immense diversity of this particular type of virus, there are dozens of examples of other infections which can be attributed to the adenovirus. These include conditions like gastroenteritis, and genital infections leading to urethritis. Types 2, 37, and 8 are closely linked to non-specific urethritis, and infection with these subtypes can be sexually transmitted.

Trichomonas Vaginalis is a type of microorganism called a protozoan, a creature which usually resides within the urethra and can therefore often cause NSU. Trichomonas also causes a number of other symptoms, particularly an unpleasant discharge from either the vagina or penis. Trichomonas is less common than many other STIs that can potentially cause NSU.

As you can see from the above example, there are diverse STIs which can potentially cause NSU. Because of its location within our genitals, the urethra is particularly vulnerable to infection from these agents as it is often one of the first structures to make contact with an infected person’s tissues and fluids. This is also why many STIs will present with classic symptoms of urethritis.