Non-Specific Urethritis

NSU is a kind of inflammation of the urethra. You may also have heard about non-gonococcal urethritis (NGU), which refers to inflammation that is not caused by gonorrhoea.

NSU is the term used when there is no obvious cause of the inflammation.

Facts and statistics in Australia

In Australia the majority of NSU diagnoses are made in men, however, NSU can be transferred to female partners in some cases.

NSU can cause symptoms in both men and women, although in some cases there will be no symptoms at all.

Symptoms in men may include:

• White, cloudy discharge from penis
• Burning sensation when passing urine
• Irritation of the tip of the penis

These symptoms may be experienced weeks or months after infection, or within a few days if there is a non-infectious cause.

Most of the time NSU doesn't cause symptoms in women. However, there is a risk that the infections that cause NSU could spread to other parts of the body. If they spread to the womb or the fallopian tubes, there is a risk of developing pelvic inflammatory disease (PID). This is a serious condition that can lead to infertility.

PID may not cause symptoms in every woman, but if there are symptoms they can be painful.

There are a number of causes of NSU, including STIs such as chlamydia.

Other infections can also cause NSU, including certain types of bacteria that usually live in the throat, rectum, or mouth. If they enter the urethra these infections can lead to NSU.

Infections that can lead to NSU include:

• Trichomonas vaginalis, which is an STI caused by a small parasite
• Mycoplasma genitalium
• Ureaplasma urealyticum
• Urinary tract infection (UTI)
• Herpes simplex virus, which can also cause cold sores and genital herpes
• Adenovirus, which usually leads to an eye infection or a sore throat

Alongside these infections it is also possible to contract NSU due to non-infectious causes. This refers to when inflammation of the urethra is caused by something other than an infection.

Non-infectious causes can include:

• Irritation from soap, deodorant, spermicide, or other product used in the genital area
• Damage to the urethra due to energetic sex or masturbation
• Damage due to frequent squeezing of the urethra, which is common in men who suspect that they may have an infection
• Damage due to the insertion of an object into the urethra, such as a catheter

If you suspect that you have NSU or an STI it is important to get a sexual health check-up. You can do so with your doctor or at a sexual health clinic.

There are two tests available for NSU. You may be given both tests to ensure an accurate diagnosis.

• First off is a swab test, in which a fluid sample is taken from your urethra using a swab.
• The second is a urine test, in which you will be asked to urinate into a small pot.

If you are being tested for NSU you will also be offered tests for other STIs. It is a good idea to get these tests.

NSU test results may be available on the same day, or you might have to wait a week or so.

It is best to get regular STI tests, whether you have symptoms or not. Some infections can lead to serious health complications if they are left untreated.

The doctor or nurse that carries out your tests will reassure you that your results will remain confidential.

If you test positive for NSU your doctor or staff at a sexual health clinic will arrange your treatment. If your NSU is caused by an infection you will be given antibiotics.

The two most common treatments contain the active ingredients azithromycin or doxycycline. The former is administered as a single tablet, while the latter is taken twice per day for seven days.

It can take two to three weeks for symptoms to clear up. During this time you should refrain from sex and tell any sexual partners that you have been diagnosed.

You should wait until you have no symptoms and any sexual partners have also been treated before having sex again. As long as you have completed the course of treatment correctly, told your partners, and not had sex until a week after you and your partner(s) have been treated, you shouldn't have to go back to the clinic for another test.

In some cases your symptoms may not improve. If two weeks have passed without any positive effect, you are advised to return to the sexual health clinic or make another appointment with your doctor.

Lastly, it is important to contact your previous sexual partner(s) to inform them about getting tested to avoid further spread of STIs.

NSU is usually caused by an STI, so the best way to prevent infection is to practise safe sex. This means using a condom or another barrier protection method to prevent the transfer of bodily fluids.

• Condoms, female condoms, and dental dams are all good options. Dams are used during oral sex to prevent infection.
• Take care to protect yourself during sex. You can also reduce your risk of exposure by keeping your number of sexual partners to a minimum. Infection rates are higher among those who have multiple sexual partners, or partners that have multiple sexual partners.

It is important to get tested for all STIs if you have contracted NSU to make sure it hasn't developed from chlamydia, for example.

Sexual health is incredibly important and infections such as NSU can cause long-term complications. Always use protection, get regular tests, and tell your partners if you are diagnosed with an infection.