Non-gonococcal urethritis

Urethritis is inflammation of the urethra, the tube that carries urine from the bladder out of the body. It's usually caused by an infection.

The term non-gonococcal urethritis (NGU) is used when the condition isn't caused by the sexually transmitted infection gonorrhoea.

NGU is sometimes referred to as non-specific urethritis (NSU) when no cause can be found.

Urethritis is the most common condition diagnosed and treated among men in GUM clinics or sexual health clinics in the UK.

Symptoms of non-gonococcal urethritis

Symptoms of NGU in men include:

• a white or cloudy discharge from the tip of the penis 
• a burning or painful sensation when you pee
• the tip of your penis feeling irritated and sore

In women, NGU rarely causes any symptoms.

Read about the symptoms of NGU.

When to seek medical advice

Visit your local genitourinary medicine (GUM) clinic or sexual health clinic if you're experiencing symptoms of NGU or you may have been exposed to a sexually transmitted infection (STI).

You should still seek treatment if the symptoms of NGU disappear on their own, as there's a risk you could pass the infection on to someone else.

Find sexual health services.

Diagnosing non-gonococcal urethritis

Two tests can be used to diagnose NGU, and both may be carried out to ensure the diagnosis is correct.

The tests are:

• a swab test  – a sample of fluid is taken from your urethra using a swab, which is like a small cotton bud with a plastic loop at the end; it's not painful, but can feel a little uncomfortable for a few seconds
• a urine test  – you'll be asked not to urinate for at least one hour before providing a urine sample as this can help make the test results more reliable

You may also be offered tests for other STIs. It's up to you whether to have these or not, but a test for all infections is recommended. You can discuss this with healthcare professionals at the clinic if you wish.

Some clinics will be able to give you the results on the same day. Others may need to send the samples to a laboratory for testing, in which case the test results may not be available for a week or two.

Healthcare professionals at the clinic will tell you when you'll get your test results, and they'll also arrange your treatment.

Read more about visiting a sexual health clinic.

Causes of non-gonococcal urethritis

NGU can have a number of possible causes, including:

• irritation or damage to the urethra
• sexually transmitted infections (STIs) – such as chlamydia
• other infections – such as a urinary tract infection (UTI)

There are many cases of NGU where no infection is found. If no cause is found, you'll still be offered treatment for possible infection.

Read more about the causes of NGU.

Treating non-gonococcal urethritis

A short course of antibiotics is usually prescribed to treat NGU. You may be given them before you get your test results, and symptoms should clear up after about two weeks.

It's important that past and current sexual partners are also treated to prevent any infection spreading to others.

After treatment has been completed and the symptoms have disappeared, it should be safe to start having sex again.

Read more about treating NGU.

Preventing non-gonococcal urethritis

As NGU is usually caused by an STI, practising safer sex is the best way to reduce the chances of it developing.

Safer sex involves using barrier contraception, such as condoms, and having regular checks at sexual health clinics or GUMs.

Read a guide to contraception.

Complications of non-gonococcal urethritis

NGU can have some complications – for example, the condition can keep coming back.

You should return to the genitourinary medicine (GUM) clinic or sexual health clinic if you still have symptoms two weeks after starting a course of antibiotics.

Serious complications are rare, but may include:

• *reactive arthritis * – when the immune system starts attacking healthy tissue, which can lead to joint pain and conjunctivitis
• *epididymo-orchitis * – inflammation inside the testicles

Women often have no symptoms of NGU. However, it can lead to pelvic inflammatory disease (PID) if it's caused by chlamydia and left untreated.  

Repeated episodes of PID are associated with an increased risk of infertility.