Urethritis is infection and inflammation of the lining of the urethra, the
narrow tube that carries urine out of the body and which, in men, also carries
semen. Urethritis is caused by bacteria and may involve the bladder, prostate,
and reproductive organs. It can affect males and females of all ages; females,
however, are at higher risk.
Signs and Symptoms
In both sexes, and particularly in women, there may be no symptoms of
urethritis. When there are, symptoms include the following.
In men:
Burning during urination
Pus or whitish mucus discharge from the penis
Burning or itching around the penile opening
In women:
Painful urination
Unusual vaginal discharge
What Causes It?
Bacteria and other organisms entering the urethra
Bruising during sexual intercourse (in women)
Infection reaching the urethra from the prostate gland or through the
penis opening (in men)
Bacterial infection after you have taken a course of
antibiotics
Reiter's syndrome
Sexually transmitted diseases (STDs), such as chlamydia, syphilis, or
HIV/AIDS
What to Expect at Your Provider's Office
A physical examination of your genitals will be necessary, and laboratory
tests will be done on a urine sample and a specimen of mucus taken from inside
the urethra and, in women, the vagina.
Treatment Options
Antibiotics may be prescribed to eliminate the organisms causing the
infection.
All sex partners should be treated.
Sexual abstinence recommended until treatment regimen is completed,
as disease can remain active even after symptoms have
disappeared.
Prevention
Limit the number of sexual partners
Always use condoms
If you experience symptoms or suspect infections, seek treatment
immediately and notify all sexual
partners
Drug Therapies
Depending on the cause of the infection, a physician may prescribe one of the
following treatments:
Tetracycline (500 mg 4 times a day for seven days)
Erythromycin (500 mg 4 times a day for seven days; preferred in
pregnancy)
Ceftriaxone (250 mg IM once a day)
Ofloxacin (400 mg once a day)
Ciprofloxacin (500 mg once a day)
Doxycycline (100 mg twice a day for 10 days)
Metronidazole (2 g orally once a day; don't use during in
pregnancy)
Clindamycin (300 mg orally twice a day for seven days)
Acyclovir (400 mg orally 3 time a day for 10 days)
Famciclovir (250 to 500 mg orally twice a day for 10 days)
Valacyclovir (1,000 mg orally twice a day for 10
days)
Complementary and Alternative Therapies
Nutrition, herbs, and homeopathic remedies are useful in fighting infection,
relieving pain, and stengthening the urinary system.
Nutrition
You can make the following changes in your diet to help treat
urethritis.
Eliminate any known food allergens.
Eliminate refined foods, sweetened fruit juices, caffeine, alcohol,
and sugar, which may compromise immunity and irritate the urinary
tract.
Cranberries and blueberries are helpful because they contain
substances that stop bacteria from adhering to the urinary tract.
Vitamin C (250 to 500 mg twice a day) makes your urine more acidic,
which keeps bacteria from growing.
Beta-carotene (25,000 to 50,000 IU per day) is necessary for immune
function and healthy mucous membranes.
Zinc (30 to 50 mg per day) helps your immune
system .
Herbs
Herbs may be used as dried extracts (capsules, powders, teas), glycerites
(glycerine extracts), or tinctures (alcohol extracts). Teas should be made with
1 tsp. herb per cup of hot water. Steep covered 5 to 10 minutes for leaf or
flowers, and 10 to 20 minutes for roots.
Herbal therapy should begin at the first sign of symptoms and continue for
three days after the symptoms go away. Teas provide the best treatment for
infectious urethritis because the additional fluid intake helps the
"flushing action." Combine two herbs from each of the following categories and
drink 4 to 6 cups per day.
Urinary antiseptics fight bacteria and include the
following.
Uva ursi (Arctostaphylos uva ursi)
Buchu (Agathosma betulina)
Thyme leaf (Thymus vulgaris)
Pipissewa (Chimaphila umbellata)
Urinary astringents tone and heal the urinary tract and include the
following.
Horsetail (Equisetum arvense)
Plantain (Plantago major)
Cleavers (Galium aparine)
Urinary demulcents soothe the urinary tract and include the
following.
Corn silk (Zea mays)
Couch grass (Agropyron repens)
Marshmallow root (Althaea officinalis) is best used alone in a
cold infusion. Soak 1 heaping tbsp. of marshmallow root in 1 qt. of cold water
overnight. Strain and drink during the day in addition to any other urinary
tea.
For advanced or recurrent infections, prepare a tincture of equal parts
goldenseal (Hydrastis canadensis) and coneflower (Echinacea purpurea).
Take 30 drops four to six times per day in addition to the urinary tea. For
noninfectious urethritis or for urethritis with severe pain and spasm, add kava
kava (Piper methysticum) to any of the above formulas. A periwash may be
helpful in reducing pain with urination. Place 1 tsp. of the
coneflower/goldenseal tincture in an 8-oz. peri bottle. Fill with water. Rinse
off after each time you urinate.
Homeopathy
Some of the most common remedies used for urethritis are listed below.
Usually, the dose is 3 to 5 pellets of a 12X to 30C remedy every one to four
hours until your symptoms get better.
Staphysagria for urinary infections associated with sexual
intercourse
Apis mellifica for stinging pains that are made worse by
warmth
Cantharis for intolerable urging with "scalding"
urine
Sarsaparilla for burning after
urination
Acupuncture
Acupuncture may be helpful in enhancing your body's immune
function.
Following Up
If your urethritis was caused by a sexually transmitted disease, your sexual
partners may need to be treated as well.
Special Considerations
STDs can cause permanent damage to reproductive organs and infertility in
both sexes. They also can cause difficulties during pregnancy, premature
delivery, low birth weight, and infections in newborns.
Supporting Research
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Publishers; 1995:436-437.
Berkow R, Beers MH. The Merck Manual of Diagnosis and Therapy. Rahway,
NJ: Merck and Company; 1992.
Blumenthal M, ed. The Complete German Commission E Monographs: Therapeutic
Guide to Herbal Medicines. Boston, Mass: Integrative Medicine
Communications; 1998:432.
Bowie WR. Approach to men with urethritis and urologic complications of
sexually transmitted diseases. Med Clin North Am. 1990;74:1543-1557.
Accessed at www.thriveonline.com.
Carr AC, Frei B. Toward a new recommended dietary allowance for vitamin C
based on antioxidant and health effects in humans. Am J Clin Nutr.
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Hoffman D. The New Holistic Herbal. New York, NY: Barnes & Noble
Books; 1995:109-110.
JAMA Patient Page. How much vitamin C do you need? JAMA.
1999;281(15):1460.
Johnston CS. Recommendations for vitamin C intake. JAMA.
1999;282(22):2118-2119.
Kruzel T. The Homeopathic Emergency Guide. Berkeley, Calif: North
Atlantic Books; 1992:98-102.
Levine M, Rumsey SC, Daruwala R, Park JB, Wang Y. Criteria and
recommendations for vitamin C intake. JAMA. 1999;281(15):1415-1453.
Shealy CN. The Illustrated Encyclopedia of Healing Remedies. Boston,
Mass: Element Books Limited; 1998.
Tierney LM Jr, et al., ed. Current Medical Diagnosis & Treatment 1999.
38th ed. Stamford, Conn: Appleton & Lange; 1999.
Virtual Hospital: University of Iowa Family Practice Handbook. 3rd ed.
Available at www.vh.org.
Review Date: August 1999
Reviewed By: Participants in the review process include: Dahlia Hirsch, MD, Center for
Holistic Healing, BelAir, MD; William Manahan, MD, University of Minnesota
Medical School, Family Practice and Community Health, Mankato,
MN.
The publisher does not accept any responsibility for the accuracy of
the information or the consequences arising from the application, use, or misuse
of any of the information contained herein, including any injury and/or damage
to any person or property as a matter of product liability, negligence, or
otherwise. No warranty, expressed or implied, is made in regard to the contents
of this material. No claims or endorsements are made for any drugs or compounds
currently marketed or in investigative use. This material is not intended as a
guide to self-medication. The reader is advised to discuss the information
provided here with a doctor, pharmacist, nurse, or other authorized healthcare
practitioner and to check product information (including package inserts)
regarding dosage, precautions, warnings, interactions, and contraindications
before administering any drug, herb, or supplement discussed
herein.