Infection of the urethra, with inflammation and possible discharge.

 

Causes of Urethritis and NSU

Infection of the urethra, the narrow outlet tube through which urine leaves the bladder, leads to inflammation and often a thin clear discharge. Women may mistake the discharge for their usual vaginal secretions, whereas in men a discharge from the penis is obvious and always abnormal.

NSU means non-specific urethritis. It is considered a sexually transmitted condition but, by definition, no organism can actually be identified as responsible. The most common identifiable infective causes of urethritis are gonorrhoea and chlamydia, which may also cause pelvic inflammatory disease and affect a woman’s fertility.

As with cystitis, women are affected more often than men as it is easier for bacteria to ascend the urethra. In women, urethritis is often due to infection from the perineum or irritation from bubble baths, vaginal deodorants or sexual intercourse. In a particularly troubling type of post-menopausal urethritis the walls of the urethra become thin and dry.

Strictly speaking, the term cystitis means inflammation of the bladder wall but it is often used to include both urethritis, where no definite infection can be found, and a true urinary tract infection with an identifiable bacterium. The terms are thus used interchangeably.

In about one-third of cases of chronic urethritis no cause is found and it is possible that psychological factors play a part.

Symptoms of Urethritis and NSU

A burning of the walls of the urethra causes stinging on passing urine plus the urgency to pass small amounts of urine repeatedly. Often in NSU there is also a clear or cloudy discharge. Urine analysis fails to find an infection in the urine itself, which differentiates the condition from urinary infection. Many cases of NSU are asymptomatic and can be detected only by tracing the sexual contacts of people with known NSU.

Treatment of Urethritis and NSU

The first step is to take swabs from the urethra to try and identify the germ responsible. It is particularly important to detect gonorrhoea, which causes a heavy discharge in men but may cause no early symptoms at all in a female partner, yet lives on within her reproductive system to cause problems of chronic infection later. It is usual to test for other sexually
transmitted diseases with appropriate blood tests and swabs. If an organism is identified the appropriate antibiotic is given. Where none is identified – truly non-specific urethritis – it is usual to give a ‘best-guess’ antibiotic such as oxytetracycline or doxycycline. Again, it is important to trace sexual contacts who may be infected but symptom-free themselves.

It is difficult to cure chronic urethritis in women. One method is to dilate the urethra under anaesthetic, a procedure performed during cystoscopy. Post-menopausal urethritis responds well to hormone replacement therapy (HRT) or to oestrogen cream rubbed into the urethra. Careful hygiene is sensible and passing urine before and after intercourse.

Complementary Treatment of Urethritis and NSU

Chinese and Western herbalism, nutritional therapy and shiatsu-do. Ayurveda – a therapist will recommend panchakarma detoxification and specific oral preparations to prevent recurring attacks. In reflexology the heels reflect zones on the urinary system. Homeopathy – many remedies are available, depending on specific symptoms. Aromatherapy – try sitz baths with tea tree oil (six drops). Hypnotherapy – cell command therapy could have a beneficial effect. Other therapies to try: acupuncture; chakra balancing.