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Urethritis

Introduction:

Urethritis is an infection and inflammation of the lining of the urethra, the narrow tube that carries urine out of the body. In men, the urethra also carries semen. Urethritis is caused by bacteria and may affect the bladder, prostate, and reproductive organs. It occurs in males and females of all ages. Females, however, are at higher risk.

Signs and Symptoms:

There may be no symptoms of urethritis, particularly in women. 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 syndrome
  • Sexually transmitted diseases (STDs), such as chlamydia, syphilis, gonorrhea, or HIV and AIDS

What to Expect at Your Provider's Office:

Your health care provider will examine your genitals, perform laboratory tests on a urine sample, and take a specimen of mucus from inside the urethra and, in women, the vagina.

Treatment Options:

  • Your health care provider may prescribe antibiotics to eliminate the organisms causing the infection.
  • All sex partners should be treated.
  • Sexual abstinence is recommended until treatment 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 four times a day, for 7 days.
  • Erythromycin, 500 mg four times a day, for 7 days (preferred in pregnancy).
  • Ceftriaxone, 250 mg 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 (not to be used during pregnancy).
  • Clindamycin, 300 mg orally twice a day, for 7 days.
  • Acyclovir, 400 mg orally three times a day, for 10 days.
  • Famciclovir, 250 - 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 strengthening the urinary system. Always tell your health care provider about the herbs and supplements you are using.

Nutrition and Supplements

Following these nutritional tips may help reduce symptoms:

  • Try to eliminate potential food allergens, including dairy, wheat (gluten), corn, preservatives, and food additives. Your health care provider may want to test for food sensitivities.
  • Eat antioxidant-rich foods, including fruits (such as blueberries, cherries, and tomatoes), and vegetables (such as squash and bell peppers).
  • Avoid refined foods such as white breads, pastas, and sugar.
  • Eat fewer red meats and more lean meats, cold-water fish, tofu (soy, if no allergy is present) or beans for protein.
  • Use healthy cooking oils, such as olive oil or vegetable oil.
  • Reduce or eliminate trans-fatty acids, found in commercially baked goods such as cookies, crackers, cakes, French fries, onion rings, donuts, processed foods, and margarine.
  • Avoid coffee and other stimulants, alcohol, and tobacco.
  • Drink 6 - 8 glasses of filtered water daily.
  • Exercise at least 30 minutes daily, 5 days a week.

You may address nutritional deficiencies with the following supplements:

  • A multivitamin daily, containing the antioxidant vitamins A, C, D, E, the B-vitamins and trace minerals, such as magnesium, calcium, zinc, and selenium.
  • Probiotic supplement (containing Lactobacillus acidophilus), 5 - 10 billion CFUs (colony forming units) a day, for maintenance of gastrointestinal and immune health. Refrigerate probiotic supplements for best results.
  • Omega-3 fatty acids, such as fish oil, 1 - 2 capsules or 1 tablespoonful oil one to two times daily, to help decrease inflammation and improve immunity. Cold-water fish, such as salmon or halibut, are good sources. Fish oil supplements can increase the effects of certain blood-thinning medications.
  • L-theanine, 200 mg one to three times daily, for nervous system support.
  • Acetyl-L-carnitine, 500 mg daily, for antioxidant and muscle protective activity.
  • Grapefruit seed extract (Citrus paradisi), 100 mg capsule or 5 - 10 drops (in favorite beverage) three times daily, for antibacterial or antifungal activity and immunity.
  • Methylsulfonylmethane (MSM), 3,000 mg twice a day, to help decrease inflammation.

You may use natural hormone replacement therapy for chronic urethritis. Check with your health care provider.

Herbs

Herbs are generally a safe way to strengthen and tone the body's systems. As with any therapy, you should work with your health care provider to diagnose your problem before starting treatment. You may use herbs as dried extracts (capsules, powders, teas), glycerites (glycerine extracts), or tinctures (alcohol extracts). Unless otherwise indicated, make teas with 1 tsp. herb per cup of hot water. Steep covered 5 - 10 minutes for leaf or flowers, and 10 - 20 minutes for roots. Drink 2 - 4 cups per day. You may use tinctures alone or in combination as noted.

  • Cranberry (Vaccinium macrocarpon) standardized extract, 300 - 400 mg daily, for kidney health. You may also drink 8 - 16 ounces of unsweetened cranberry juice daily.
  • Green tea (Camellia sinensis) standardized extract, 250 - 500 mg daily, for antioxidant, anticancer, and immune effects. Use caffeine-free products. You may also prepare teas from the leaf of this herb.
  • Cat's claw (Uncaria tomentosa) standardized extract, 20 mg three times a day, for anticancer, immune, and antibacterial or antifungal activity.
  • Uva-ursi (Arctostaphylos uva-ursi ) standardized extract, 250 - 500 mg three times daily for no more than 4 days. You may also prepare teas from the leaf of this herb.
  • Bromelain (Ananus comosus) standardized, 40 mg three times daily, for pain and inflammation.

Homeopathy

Some of the most common remedies used for urethritis are listed below. Usually, the dose is three to five pellets of a 12X to 30C remedy every 1 - 4 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, overall urogenital health, and for the pain of urethritis.

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. 

Alternative Names:

Urethral inflammation

  • Reviewed last on: 6/11/2008
  • Steven D. Ehrlich, NMD, private practice specializing in complementary and alternative medicine, Phoenix, AZ. Review provided by VeriMed Healthcare Network.

Supporting Research

Bally F, Troillet N. Diagnosis and treatment of urethritis. Rev Med Suisse. 2006;2(82):2282-4, 2286.

Cabrera C, Artacho R, Gimenez R. Beneficial effects of green tea -- a review. J Am Coll Nutr. 2006;25(2):79-99.

Cvetnic Z, Vladimir-Knezevic S. Antimicrobial activity of grapefruit seed and pulp ethanolic extract. Acta Pharm. 2004;54(3):243-50.

Doron S, Gorbach SL. Probiotics: their role in the treatment and prevention of disease. Expert Rev Anti Infect Ther. 2006;4(2):261-75.

Dryden GW Jr, Deaciuc I, Arteel G, McClain CJ. Clinical implications of oxidative stress and antioxidant therapy. Curr Gastroenterol Rep. 2005;7(4):308-16.

Gonclaves C, Dinis T, Batista MT. Antioxidant properties of proanthocyanidins of Uncaria tomentosa bark decoction: a mechanism for anti-inflammatory activity. Phytochemistry. 2005;66(1):89-98.

Hale LP, Greer PK, Trinh CT, James CL. Proteinase activity and stability of natural bromelain preparations. Int Immunopharmacol. 2005;5(4):783-93.

Heitzman ME, Neto CC, Winiarz E, Vaisberg AJ, Hammond GB. Ethnobotany, phytochemistry and pharmacology of Uncaria (Rubiaceae). Phytochemistry. 2005;66(1):5-29.

Lieske JC, Goldfarb DS, De Simone C, Regnier C. Use of a probiotic to decrease enteric hyperoxaluria. Kidney Int. 2005;68(3):1244-9.

Lichtenstein AH, Russell RM. Essential nutrients: food or supplements? Where should the emphasis be? JAMA. 2005;294(3):351-8.

Maeda S, Tamaki M, Kubota Y, Nguyen PB, Yasuda M, Deguchi T. Treatment of men with urethritis negative for Neisseria gonorrhoeae, chlamydia trachomatis, Mycoplasma genitalium, Mycoplasma hominis, Ureaplasma parvum, and Ureaplasma Urealyticum. Int J Urol. 2007;14(5):422-5.

Nanda N, Michel RG, Kurdgelashvili G, Wendel KA. Trichomoniasis and its treatment. Expert Rev Anti Infect Ther. 2006;4(1):125-35.

Schindler G, Patzak U, Brinkhaus B. et al. Urinary excretion and metabolism of arbutin after oral administration of Arctostaphylos uvae ursi extract as film-coated tablets and aqueous solution in healthy humans. J Clin Pharmacol. 2002;42(8):920-7.

Simopoulos AP. Omega-3 fatty acids in inflammation and autoimmune diseases. J Am Coll Nutr. 2002;21(6):495-505.

Takahashi S, Takeyama K, Kunishima Y, Takeda K, Suzuki N, Nishimura M, Furuya R, Tsukamoto T. Analysis of clinical manifestations of male patients with urethritis. J Infect Chemother. 2006;12(5):283-6.

Yoon JH, Baek SJ. Molecular targets of dietary polyphenols with anti-inflammatory properties. Yonsei Med J. 2005;46(5):585-96.

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