Nongonococcal Urethritis: Treatment, Procedure, Cost and Side Effects

Urethritis is the inflammation of the urethra (the tube which runs from the bladder to the penis in males and the labia in females through which the urine discharges) due to bacterial conditions. On the other hand, nongonococcal urethritis is known as the infection of the urethra that is not caused by gonorrhea. This infection is caused due to multiple different organisms. Frequently, a germ called Chlamydia, which is a sexually transmitted disease (STD) is the source. It is mostly found in men, the reason being that this infection is caused due to sexual transmission and females during intercourse are seldom infected.

If nongonococcal urethritis is suspected a person need to take a few tests. Even if the symptoms go away after a point, he needs to reassure whether there is anything still wrong or not. A local genitourinary clinic (GUM) will carry out all the tests needed. A urine specimen must be provided to identify the cause. There may also be a requirement of a tiny swab (sample) from the blood tests. Medications like antibiotics usually clear the infection. The antibiotics prescribed are usually dependent on germs (bacteria) like Chlamydia or conditions when other infections are also present. Even if there are no bacteria found after tests, the individual may still be suggested to take antibiotics if he has shown the symptoms. Antibiotic treatment will more likely make a person better if taken in a continuous course and completed properly.

Firstly, men with urethral symptoms must be examined for urethral discharge, ulcers, or inguinal lymphadenopathy. Serial palpation should be used to gently ‘’milk’’ the urethra down the penis shaft towards the urethra. Currently, urethritis is tested by a positive leukocyte esterase test result in first-void urine. In case there is no discharge present, first-void urine should be examined to document pyuria. A DNA test for Chlamydia is also recommended. The doctor does a digital rectal examination of the prostate.

Patients with confirmed nongonococcal urethritis receive the primary treatment of a combination of 100 mg of oral doxycycline (for chlamydia) or a single 1-g dose of oral azitrhomycin (Zithromax) twice per day for a week. Both of these medications have similar cure rate. It is a possibility that doxycline has a higher clearance rate than azithromycin. There has been a caution expressed by doctors about single-doze azithromycin 1g involving macrolide resistance in genitalium, despite compliance and successful treatment cases of nongonococcal urethritis in which the test results are mostly negative for Chlamydia, ureaplasma and mycoplasma species. Because of the concern for induced macrolide resistance of genitalium after the intake of single-dose azithromycin 1g, some doctors recommend treatment of doxycycline 100 mg orally a couple of times, per day for a week.

Patients who haven’t used antibiotics in the past month are eligible for the treatment. Also, patients with chlamydial infections (detected by urine assay) are included.

Patients who have taken antibiotics in the previous month are ineligible for treatment. Also, patients with gonococcal infections (detected by urine assay) are precluded from receiving the treatment.

The side effects of the antibiotics include nausea, diarrhea, vomiting, stomach ache and many more.

A healthcare professional or a doctor will need to know regularly if the treatment has worked or not. It is normal to be reviewed two or three weeks after the treatment has been started on a patient, to keep a check on the symptoms. Once in a while, re-testing and a second anti-toxin medication are needed if the symptoms or side effects persist. A patient must wear a condom during anal or oral sex as it prevents the spreading of STIs (sexually transmitted infection). The risk associated with STIs increase with multiple changes of sexual partner. After ruling out all the infections, the doctors suggest the patients to use lubricants, fragrance-free soaps, and other products. Carbonated beverages should be avoided and water intake should be increased. Discontinuation of spermicide use is necessary.

It takes about 2 weeks to recover from nongonococcal urethritis. In case a patient doesn’t get better by then, he should return to the sexual health clinic and be given a new drug prescription.

The price of treatment ranges between Rs. 2,828 to Rs. 5,000.

The results of the treatment are not permanent as a person with untreated nongonococcal urethritis can pass the infection to the previously infected person again.

It is necessary for a patient to include garlic in his meals as garlic cloves are rich in anti-microbial agents like allacin. In order for the body to fight infection a garlic tonic must be prepared and had every day. Chopping and mashing two or three pods of garlic, putting it in a glass of boiling water and having it daily will help rule out the infection.