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Non-Gonococcal Urethritis (NGU)

What is NGU?
Non-gonococcal urethritis (NGU) is an inflammation of the urethra, the tube that carries urine from the bladder and/or semen from the prostate gland to the outside of the body. NGU is a common sexually transmitted infection (STI) among young adults; approximately two million people are diagnosed each year.

In many cases, it isn’t possible to identify the exact cause of these infections through laboratory tests; when the causes of an infection are unknown, it’s called “non-specific.” There are a variety of suspected or known bacteria, viruses, yeasts, parasites, protozoans and/or fungi that cause urethritis. These infections are shared in almost all instances by vaginal, anal or oral intercourse with an infected partner. It’s not unusual for NGU to be associated with one or more other sexually transmitted infections.

NGU may be made worse by things not directly related to sexual activity. Poor hygiene or consuming citrus, spicy foods, caffeine, carbonated beverages, high doses of vitamin C or large amounts of alcohol may further irritate an already inflamed urethra.

How do I know if I have NGU?
In most instances NGU has no symptoms. If symptoms are present, they include painful or frequent urination or an itchy sensation inside the urethra. Sometimes there’s a discharge from the urethra; it can be thin and watery or thick and sticky, but is usually cloudy, white or yellow and contains pus. The discharge shouldn’t be confused with clear secretions that occur normally with sexual arousal.

How is NGU diagnosed?
Your clinician will rule out other diseases with similar symptoms (or a lack of symptoms) such as urinary tract infections, chlamydia and gonorrhea. Laboratory tests, including urethral smears and cultures or urine tests, are done.

How is NGU treated?
Your clinician will prescribe specific antibiotics; you must take the full course of medication, even if your symptoms disappear. You may be advised to abstain from vaginal, oral or anal intercourse until your treatment ends. If you’re sexually active with someone else, you must use condoms and dental dams.

It’s important for your partner(s) to be evaluated and treated for NGU to avoid passing infections back and forth; it’s best if this happens simultaneously. Even if your sexual partners have no symptoms, they must be evaluated by a clinician. To avoid further irritation, you may also be advised to avoid citrus, spicy foods, alcohol, carbonated beverages or caffeine.

NGU can be a recurring disease. Treatment fails in an estimated 10 – 40% of cases, usually because the patient doesn’t comply with instructions or is re-infected by an untreated partner. Occasionally, more than one course of treatment is necessary.

Can NGU be prevented?
The most effective method of preventing NGU is abstinence. If you’re sexually active, it’s essential to use condoms and dental dams correctly and consistently for all sexual contact with other people. Urinating before and after any type of sexual intercourse may also be helpful.