Urethritis in men is an inflammation of the urethra (urinary canal) and is a common manifestation of sexually transmitted infections (STIs) in men. Most cases of infectious urethritis occur in young, sexually active men.
When the first symptoms appear—such as burning during urination or urethral discharge—patients often try to assess the severity of the problem on their own. However, even mild or atypical symptoms of urethritis require medical attention, as the condition is frequently associated with serious infections.
Urethritis is defined as inflammation of the urethra. Because it has traditionally been diagnosed using microscopy, urethritis is classified as either gonococcal or nongonococcal urethritis (NGU).
The most common pathogens associated with urethritis include:
• Neisseria gonorrhoeae (gonococcus), which is a relatively common cause in the United States and Europe
• Chlamydia trachomatis, which is the most frequently identified cause of nongonococcal urethritis (NGU)
• Mycoplasma genitalium, which is also strongly associated with urethritis and is the second most common cause of NGU
• Trichomonas vaginalis and herpes simplex virus (HSV), which are also recognized causes of urethritis
It is important to note that coinfections (simultaneous infection with multiple pathogens) are common; for example, chlamydial coinfection has been observed in approximately 20% of men infected with gonorrhea.
The primary symptom in men with urethritis is usually dysuria—discomfort or burning during urination. This symptom occurs in most men with gonococcal infection and in more than half of patients with NGU.
Other common symptoms of urethritis include:
• Itching (pruritus) and burning
• Urethral discharge, which may range from watery or mucoid to purulent
Urethritis in men is almost always caused by infections transmitted through sexual contact. Because urethral discharge and burning during urination are common but nonspecific symptoms, accurate identification of the causative pathogen is essential for effective treatment and for preventing further transmission of infection.