What are the signs and symptoms of urethritis?

Updated: Dec 12, 2018
  • Author: Martha K Terris, MD, FACS; Chief Editor: Edward David Kim, MD, FACS  more...
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Answer

The clinician should specifically address the following manifestations:

  • Timing: Symptoms generally begin 4 days to 2 weeks after contact with an infected partner, or the patient may be asymptomatic.

  • Urethral discharge: Fluid may be yellow, green, brown, or tinged with blood, and production is unrelated to sexual activity.

  • Dysuria: Dysuria is usually localized to the meatus or distal penis, worst during the first morning void, and made worse by alcohol consumption. Urinary frequency and urgency are typically absent. If present, either should suggest prostatitis or cystitis.

  • Itching: A sensation of urethral itching or irritation may persist between voids, and some patients have itching instead of pain or burning.

  • Orchalgia: Men sometimes complain of heaviness in the genitals. Associated pain in the testicles should suggest epididymitis, orchitis, or both.

  • Menstrual cycle: Women occasionally complain of worsening symptoms during menses.

  • Foreign body or instrumentation: The patient should be questioned about recent urethral catheterization or instrumentation, either medical or self-induced (eg, foreign body). These procedures may cause traumatic urethritis.

Systemic symptoms

Systemic symptoms (eg, fever, chills, sweats, nausea) are typically absent but, if present, may suggest disseminated gonococcemia, pyelonephritis, arthritis, conjunctivitis, proctitis, prostatitis, epididymitis or orchitis, pneumonia, otitis media, or reactive arthritis (eg, low back pain, iritis, or rash [characteristically involving the palms of hands and soles of feet]).


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