Non-Specific Urethritis in men

What is it? How is it transmitted? How is it treated?

A service provided by What is Non-Specific Urethritis (NSU)?

Non-Specific Urethritis (NSU) is pain, redness and/or swelling of the (the tube, in men, that both urine and semen come out of), when the cause is not known. Women can get NSU in the urethra, but it is difficult to diagnose; this leaflet is for men.

How is NSU transmitted?

There are many different causes of NSU. Sometimes it is passed on through having sex, but occasionally no cause is found. If you have pain, redness or swelling in your urethra you will probably be tested for sexually transmitted and other to try to find out the cause. Sexually transmitted infections can cause NSU. A common cause is . and are less common causes. During unprotected vaginal, anal or oral sex, organisms which cause can pass into the urethra. NSU can occur in any man who is sexually active.

Are there other causes of NSU? Other organisms that can cause NSU: • Tiny organisms can live normally in the body without causing symptoms; however, they sometimes multiply quickly, leading to inflammation of the urethra. These organisms may then be transmitted by having sex. • Some that live in the rectum and the mouth and throat can be passed on during sex and cause inflammation.

page 2 of 8 • Bacteria that cause in the urinary tract (kidneys, bladder and urethra) or the prostate gland can lead to inflammation of the urethra. • A vaginal infection in your female partner, such as thrush or bacterial vaginosis, may trigger non-specific urethritis in you through having sex. Damage to the urethra • This can be caused by friction during vigorous sex or masturbation, or inserting objects into the urethra. Overly inspecting or squeezing your urethra can also irritate it and cause swelling or pain. Antibacterial liquids • Applying liquids such as antiseptic or disinfectant or using medicated or highly perfumed shower gels or oils can cause inflammation. Sensitivity or irritation • Rarely, inflammation can occur if your skin is very sensitive to chemicals, such as those in latex (in , for example), spermicide or soap.

What are the signs and symptoms of NSU?

Not all men who have inflammation of the urethra will have signs or symptoms, or their symptoms may be so mild they do not notice them. If signs and symptoms do occur they usually show up within 2–4 weeks of contact with an infection, but they can sometimes appear within a day or two (depending on the cause). In mild cases, symptoms may not show up for several months. If you do get signs and symptoms you might notice: • A white or cloudy discharge from the tip of the penis, usually more noticeable first thing in the morning

page 3 of 8 • Difficulty or pain or a burning sensation when passing urine • The urge or feeling to pass urine frequently • Itching or irritation at the tip of the penis/end of the urethra

What is the test for NSU?

The tests may be: • giving a urine sample • examination of your penis by a clinician • using a swab to collect a sample of cells from the entrance of the urethra

What is the treatment for NSU?

NSU is treated with antibiotics. • If the test shows that inflammation is present, or if there is a high chance that you have an infection, you will be given treatment even if the cause is not yet known • There are several different antibiotics that can be used, either as a single dose or a longer course (up to two weeks) • Some men may get non-specific urethritis more than once, and for a few men it may keep coming back. If this happens, you may be given more antibiotics

What happens if NSU is not treated?

If left untreated, some causes of NSU can have long-term consequences. These include: • Painful infection in the testicles • Inflammation of the joints, known as reactive • Possible reduced fertility

page 4 of 8 Can I still have sex?

It is advised that you do not have sex, including vaginal, anal or oral sex until you and your partner(s) have both finished the treatment. This is to prevent you being reinfected or passing the infection on to someone else and to allow healing.

What about telling my partner(s)?

Because NSU is often caused by a sexually transmitted infection it is very important that your current sexual partner(s) and any other recent partners are also tested and treated. Sexual Health Sheffield can help you with this. In some men who are not responding to treatment, NSU may only clear up after their partner has been treated too.

How can I protect myself from NSU and other sexually transmitted infections?

The following measures can help to protect you from NSU and most other sexually transmitted infections, such as genital warts, chlamydia and gonorrhoea. If you have a sexually transmitted infection they will also help prevent you from passing it on to your partner(s): • Use condoms every time you have vaginal or anal sex • If you have oral sex, use a to cover the penis, or a dam to cover the anus or female genitals • Any genital to genital contact between partners could pass on STIs. Using dams or condoms before sexual contact can help prevent infection • If you are not sure how to use condoms correctly visit www.sexualhealthsheffield.nhs.uk

page 5 of 8 • Avoid sharing sex toys. If you do share them, wash or sterilise them or cover them with a new condom before anyone else uses them • Arrange regular HIV/STI check-ups, especially at change/start of relationships with new sexual partners

What happens at Sexual Health Sheffield?

When you attend for your appointment, you will be asked to provide the following: • Your name and how we can contact you - any details you provide will be treated confidentially • During your visit you will be asked personal information so we can provide the relevant and appropriate care • We have a duty of care to all our patients, so if you are 17 or under you will be asked relevant questions to assess your safety. If staff are concerned, they may talk to you about what to do about this and may contact other appropriate agencies. Sexual Health Sheffield will not tell your parents or carers that you have visited Sexual Health Sheffield This is the service you can expect when you attend Sexual Health Sheffield: • All advice, information, tests, condoms and treatments are free at Sexual Health Sheffield • No one should judge you because of your sexual behaviour or lifestyle • All our services are confidential • All Sexual Health Sheffield workers are appropriately and fully trained NHS staff • All tests are optional; no examination will take place without your permission

page 6 of 8 • Please ask questions to ensure you fully understand what services have been offered, what tests carried out and what treatments given • You can have a chaperone to help you feel more comfortable – please ask • Our friendly and professional staff are here to help you. We will give you as much support as you need (particularly if you need help on how to inform any partners)

If you feel that we have not met the above or want to give us any other feedback, please contact us via www.sth.nhs.uk/patients/tell-us-what-you-think

Further information www.sexualhealthsheffield.nhs.uk 0114 226 8888 NHS Choices website: www.nhs.uk/conditions/Sexually-transmitted-infections/Pages/Introduc tion.aspx

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PD8476-PIL3573 v4 Issue Date: May 2018. Review Date: May 2021