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Information to Live By:
Nongonococcal Urethritis (NGU)
What
is NGU?
NGU (NonGonococcal Urethritis) is an infection of the urethra caused by
pathogens (germs) other than gonorrhea.
Several kinds of
pathogens can cause NGU, including:
- Chlamydia trachomatis
- Ureaplasma
urealyticum
- Trichomonas
vaginalis (rare)
- Herpes simplex
virus (rare)
- Adenovirus
- Haemophilus
vaginalis
- Mycoplasm genitalium
NGU is most often
caused by chlamydia, a common infection in men and women. The diagnosis
of NGU is more commonly made in men than women, primarily due to anatomical
differences.
How
can I get NGU?
Sexual:
Most germs that cause NGU can be passed during sex (vaginal, anal or oral)
that involves direct mucous membrane contact with an infected person.
These germs can be passed even if the penis or tongue does not go all
the way into the vagina, mouth or rectum, and even if body fluids are
not exchanged.
Nonsexual:
These causes of NGU may include:
- Urinary tract
infections.
- An inflamed prostate
gland due to bacteria (bacterial prostatitis).
- A narrowing or
closing of the tube in the penis (urethral stricture).
- A tightening of
the foreskin so that it cannot be pulled back from the head of the penis
(phimosa).
- The result of
a process such as inserting a tube into the penis (catheterization).
Perinatal:
During birth, infants maybe exposed to the germs causing NGU in passage
through the birth canal. This may cause the baby to have infections in
the:
- eyes (conjunctivitis)
- ears
- lungs (pneumonia)
What
are the signs or symptoms of NGU?
Men (urethral infection):
- Discharge from
the penis
- Burning or pain
when urinating (peeing)
- Itching, irritation,
or tenderness
- Underwear stain
Women (vaginal/urethral
infection): The germs that cause NGU in men might cause other infections
in women. These might include vaginitis or mucopurulent cervicitis (MPC).
Women may also be asymptomatic (have no symptoms). Symptoms of NGU in
women can include:
- Discharge from
the vagina
- Burning or pain
when urinating (peeing)
- Abdominal pain
or abnormal vaginal bleeding may be an indication that the infection
has progressed to Pelvic inflammatory Disease
(PID)
Anal or Oral Infections
Anal infection may result in:
- Rectal itching
- Discharge or pain on defecation
Oral infection may occur. Most (90 percent) are asymptomatic, but some
people might have a sore throat.
How
can I find out if I have NGU?
An NGU diagnosis is made when a man has urethritis (inflammation of the
urethra), but gonorrhea is ruled out because he has a negative gonorrhea
culture and/or gram stain.
Other tests include:
- Chlamydia culture
- Urinalysis (sometimes, but rarely)
Women:
- Chlamydia culture
- Gonorrhea culture to rule out gonorrhea
What
can I do to reduce my risk of getting NGU?
- Abstinence from
sex is the best form of prevention.
- Using latex condoms
from start to finish every time you have oral, vaginal or anal sex.
- Having sex with
only one uninfected partner whom only has sex with you (mutual monogamy).
- Water-based spermicides
can be used along with latex condoms for additional protection during
vaginal intercourse. Use of spermicide is not recommended nor found
to be effective for oral or anal intercourse.
- Have regular check-ups
if you are sexually active.
- If you have an
STD, don't have sex (oral, vaginal, anal) until all partners have been
treated.
- Prompt, qualified
and appropriate medical intervention, treatment and follow-up are important
steps in breaking the disease cycle.
- Know your partner(s).
Careful consideration and open communication between partners may protect
all partners involved from infection.
What
is the treatment for NGU?
The main treatments for NGU are:
· Azithromycin
· Doxycycline
Alternatives are:
· Erythromycin
· Ofloxacin
Recommended treatment for recurrent/persistent urethritis:
· Metronidazole with Erythromycin
A woman who is pregnant, or thinks she might be, should tell her doctor.
This will ensure that a medicine will be used that will not harm the baby.
Follow-up:
- Take all medications-even
if you start to feel better before you finish the bottle.
- Treat all partners.
- Inform all partners.
- Abstain from sex
until all partners are treated.
- Return for evaluation
by a health care provider if symptoms persist or if symptoms recur after
taking all the prescribed medicine.
Why
worry about NGU?
Left untreated, the germs that cause NGU-especially chlamydia-can lead
to:
Men:
- Epididymitis (inflammation
of the epididymis, the elongated, cordlike structure along the posterior
border of the testes) which can lead to infertility if left untreated.
- Reiter's syndrome
(arthritis)
- Conjunctivitis
- Skin lesions
- Discharge
Women:
- Pelvic
Inflammatory Disease (PID) which can result in ectopic (tubal) pregnancy.
- Recurrent PID
may lead to infertility.
- Chronic pelvic
pain
- Urethritis
- Vaginitis
- Mucopurulent cervicitis
(MPC)
- Spontaneous abortion
(miscarriage)
Men or Women:
Infections caused by anal sex might lead to severe proctitis (inflamed
rectum).
Infants:
Exposure to the germs causing NGU during passage through the birth canal
may result in infants having:
· Conjunctivitis (If left untreated, this may lead to blindness.)
· Pneumonia
Do
I need to talk to my partner about NGU?
Yes. If you have been told that you have NGU, talk to your partner(s),
and let them know so they can be tested and treated. The most common cause
of NGU is chlamydia, and it is easy to pass from an infected partner to
one who is not infected.
A man who is diagnosed with NGU should tell his female sex partner and
ask her to get tested. He can prevent lasting damage to her body by telling
her right away.
All sex partners of someone diagnosed with NGU should be treated because:
- They may have
an infection and not know it.
- It keeps them
from passing the infection back to you or to others.
- It prevents them
from suffering possible complications.
Remember: Do not
have sex until your partner(s) have been tested and treated.
Should
I talk to my health care provider about NGU?
If you are sexually active with more than one person and do not use latex
condoms, then you should talk to your health care provider about being
tested for STDs and NGU. Not all STDs cause symptoms, and you may have
one and not know it.
More
information
If you have additional questions about NGU, call the National STD
and AIDS Hotlines at 1-800-342-2437
or 1-800-227-8922. The hotlines are open 24 hours a day, seven days a
week. For information in Spanish call 1-800-344-7432, 8:00 a.m. to 2:00
a.m. Eastern Time, seven days a week. For the Deaf and Hard-of-Hearing
call 1-800-243-7889, 10:00 a.m. to 10:00 p.m. Eastern Time, Monday through
Friday. The hotlines provide referrals and more answers to your questions.
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information about other STDs
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