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Nongonococcal Urethritis
Reproductive Tract Infections
Type of Infection: Urethritis, or inflammation of the urethra, can be caused by gonorrhea (gonococcal urethritis) or other types of infections (nongonococcal urethritis or NGU). Nongonococcal urethritis is caused by Chlamydia trachomatis about 30% of the time. Other sexually transmitted agents, which cause 10% to 45% of NGU, include Trichomonas vaginalis, Mycoplasma genitalium, and herpes simplex virus. The cause of the remaining cases is unknown.
Prevalence of Nongonococcal Urethritis: NGU occurs more frequently than gonorrhea in both public STD clinics and private practices. More than 1 million cases annually are estimated to occur in men.
Symptoms of Nongonococcal Urethritis: Men usually have painful or difficult urination, urinary frequency, and discharge of mucus and pus. Many men have infections with no symptoms.
Diagnosis of Nongonococcal Urethritis: Men with typical symptoms are presumed to have NGU if a gonorrhea test is negative and they have either white blood cells in their urethral discharge or sexual exposure to an agent known to cause NGU. Chlamydia testing is strongly recommended for a specific diagnosis. Gonococcal and nongonococcal urethritis may coexist in the same person.
Treatment of NGU: When NGU is caused by chlamydia, antibiotics are typically prescribed. For herpes-based infections this will not be effective.
Possible Consequences of NGU for the Infected Person: Narrowing of the urethra or inflammation of the testicles may occur. If chlamydia is transmitted to female sex partners, the condition may result in mucopurulent cervicitis and pelvic inflammatory disease.
Possible Consequences of NGU for the Fetus and Newborn: If chlamydia is transmitted to a pregnant woman, the infant can experience problems such as eye infection or pneumonia.
Prevention of Nongonococcal Urethritis: Abstaining from sexual contact with an infected person is the most effective means of prevention. Latex or polyurethane condoms can reduce but not eliminate the risk of contracting NGU.
Source of Information: JM Marrazzo, F Guest, W Cates, "Reproductive Tract Infections," In Hatcher et al, Contraceptive Technology, Ardent Media, 2007.
Photo Source: Public Health Agency of Canada, Division of STD Prevention, STD Self Directed Learning Module, Slide Gallery, "Other STIs and Genital Conditions," www.phac-aspc.gc.ca/slm-maa/slides/index-eng.php.