What Causes Urethritis Explained in Detail

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What Is Urethritis?

Urethritis is an inflammation of the urethra, which is a urinary tube that carries the urine from the bladder for excretion. Symptoms in men include burning, painful urination, pain with ejaculation, frequent urination and penile discharge. Women have symptoms such as burning pain and frequent urination, abdominal or pelvic pain and vaginal discharge. Discuss any of these symptoms with your health care provider to get the appropriate diagnosis and treatment.


A bacteria or virus can be what causes urethritis. A common bacterium that causes urinary tract infections, E. coli, can also lead to urethritis. E. coli is usually found in the colon and can easily spread to the urethra in women, causing urethritis.

Sexually transmitted microorganisms, Chlamydia trachomatis and Neisseria gonorrhea, can cause urethritis in both men and women. In men, the urethritis can include the testicles and the epididymis. In sexually transmitted diseases, both partners must be treated.

Treatment of urethritis depends on the cause. For E. coli infections, antibiotics such as trimethoprim, sulfamethoxazole, amoxicillin, ampicillin and ofloxacin are used. For bacterial sexually transmitted diseases, the most common treatment options include tetracycline, doxycycline or trimethoprim/sulfamethoxazole medications, according to the National Kidney and Urologic Diseases Information Clearinghouse.

Other Infectious Causes

Rare causes of urethritis, according to eMedicine, include the following:

  • Streptococcal bacteria, which can be either group A or group B, with group B strep the more likely of the two to be the cause of urinary tract infections. Treatment consists of antibiotics, such as penicillin.
  • Meningococcal, the bacteria that can cause meningitis, can also lead to urethritis.
  • Anaerobic bacteria, which grows in the absence of oxygen, such as in the gastrointestinal tract, can be introduced into the urethra.
  • Herpes genitalis, one of the herpes simplex viruses, is highly contagious even when there are no obvious lesions or symptoms present. An antiviral drug may lessen the outbreaks, but there is no cure.
  • Syphilis, which is caused by Treponema pallidum bacteria, may cause urethritis from the sores that occur in the vagina, rectum or external genitals. Early treatment with penicillin cures most cases of syphilis. Re-infection is possible.

Infectious syndromes that may be related to urethritis include:

  • Prostatitis, which is an inflammation of the prostate gland
  • Epididymitis, inflammation of the epididymis, located at the back of the testicle
  • Orchitis, which is swelling of either or both testicles
  • Proctitis, in which the rectum becomes inflamed, leading to rectal discharge or pus

Non-infectious Causes

Injury to the urethra can cause urethritis. Some of the common sources for injury include biking, insufficient lubrication for intercourse, diaphragm contraceptive devices and horseback riding. For repetitive urethritis from injury, you need to make adjustments in the type of activity causing the irritation.

Chemical irritation, which includes sensitivity to soaps, spermicides or contraceptives such as creams, foams or jellies, is another cause of urethritis. Once the offending agent is removed, the irritation usually goes away. Phenazopyridine may be prescribed to ease the pain and burning with urination caused by chemical irritation or injury.


National Kidney and Urologic Diseases Information Clearinghouse: Urinary Tract Infections in Adults https://kidney.niddk.nih.gov/kudiseases/pubs/utiadult/

eMedicine: Urethritis https://emedicine.medscape.com/article/438091-overview