Urethritis, or the inflammation of the lower urinary tract, is a common condition in young and old (but not middle aged) men. Most of the time this stinging, burning, extremely uncomfortable condition is the result of an infection that causes any or all of the following symptoms:
- Mostly commonly yellow, but sometimes green, brown, or bloody discharge not related to sexual activity.
- Signs of discharge in the underwear.
- Difficulty urinating, especially the first time in the morning, but no "need to go" right away.
- Itching sensation between trips to the bathroom to urinate.
- Orchalgia, a feeling of heaviness in the penis and testicles.
Up to 25 percent of men who catch one of the infections that cause urethritis don't have any symptoms at all. Up to 75 percent of women who catch one of those infections are symptom-free.
Infections of the urethra in younger men are most often caused by gonorrhea, but they can also be due to infection with chlamydia, trichomonas, or several other kinds of bacteria. Infections of the urethra in older men are more likely to be due to E. coli that has found its way into the penis from traces of fecal matter in underwear that rub against the tip of the penis. Men of any age, however, can get infections with any of these microorganisms, and sometimes the infection isn't due to an infection at all.
Urethritis can also be post-traumatic, caused by an injury to the urethra. Some shower and hot tub jets are so strong that a stream of water can hit the tip of the penis at just the right moment to force itself into the urethra. Some men stimulate themselves by placing objects up the urethra, and, of course, some men have to use catheters to urinate because of stricture, or narrowing, or the urine passage or prostate problems.
Most men don't suffer long-term problems as a result of urethritis, but 1 to 2 percent may have to deal with:
- Permanent narrowing of the urethra, sometimes requiring surgery or placement of a catheter, or both.
- Prostate infections
- Epididymitis, swelling on the testicles due to infection or inflammation.
- Abscesses where bacteria accumulate inside the penis.
- Reactive arthritis.
- Rashes, usually on the palms of the hands or the soles of the feet.
- Sepsis, spreading of the infection to the rest of the body through the bloodstream, causing fever, sweats, chills, nausea, and even pneumonia as it progresses. This rare complication is usually fatal if not treated. The first sign that this seemingly simple infection has progressed to sepsis is usually racing heart and shortness of breath.
Homosexual men are at greater risk of urethritis than heterosexual men. The most common age at which the infection occurs is 20 to 24, followed by 60 to 64. The more sexual partners a man has, the more likely he is to get urethritis. Once a man has had any STD, he is at greater risk for getting the kinds of infections that cause urethral inflammation.
The good news about urethritis in men is that symptoms usually go away over time with or with treatment. The bad news about urethritis in men is that the underlying infection doesn't go away without antibiotic treatment, and the symptoms can come back over and over again, and the man can spread the infection to his sex partners, indefinitely without antibiotics. However, as little as a single dose of the right antibiotic can stop the infection for good. It is necessary to get the appropriate antibiotic from a doctor, who will be aware of what works and what does not for the particular strain of bacteria causing the infection. Only one trip to the ER or a doctor, however, is usually enough to stop the problem.
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