Pain Near the Urethra After Urination: Causes and Treatments

Pain near the urethral opening after urination?

I would like to ask about a situation where I had safe sexual intercourse with someone else, including oral and vaginal sex, using condoms throughout.
It has been about three weeks, and I have not experienced any physical symptoms during this time (although I also had unprotected sex with my girlfriend, who has not been with anyone else).
After this period, I started experiencing pain while urinating, specifically at the urethral opening.
I do not have a fever or discharge.
I would like to know if this could be gonorrhea, non-gonococcal urethritis, or just a regular urinary tract infection (I have not been holding my urine).

I subsequently visited a urology clinic for a urine test, and the doctor suspected it might be Chlamydia (non-gonococcal).
They asked if I wanted to pay out of pocket for Chlamydia medication or if I wanted to start treatment for urethritis.
The medications prescribed were: 1.
Tetracycline HCL capsules, to be taken orally three times a day; 2.
Panadol (Acetaminophen); 3.
Urodine F.C.
Tablets 100 (Phenazopyridine HCL).
Today is the third day of taking the medication, and while the pain during urination is not as severe as before the consultation, there is still some discomfort.
Are the medications prescribed effective? Could this be a form of non-gonococcal urethritis or just a regular infection? Since I have not had any discharge since the first day of pain, could this be related to using an unclean towel to wipe the glans? What are the possible symptoms of this condition?
Additionally, I have long noticed some cotton-like floating particles in my urine when I urinate.
The amount of these particles varies with my fluid intake; drinking more water results in fewer particles, while drinking less leads to more.
What could these floating particles be?

Ayou, 30~39 year old female. Ask Date: 2019/11/13

Dr. Xu Wencang reply Urology

It is likely not gonorrhea; follow-up after treatment is necessary.
Increase fluid intake, and if there are no abnormalities in urination, continue to drink plenty of water.

Reply Date: 2019/11/13

More Info

Understanding pain near the urethra after urination can be concerning, especially when it follows a period of sexual activity. The symptoms you describe—pain localized just below the urethral opening without fever or discharge—could indicate several potential causes, including non-gonococcal urethritis, which is often caused by Chlamydia trachomatis or Mycoplasma genitalium, or a urinary tract infection (UTI).
Given your history of safe sexual practices, including condom use, the likelihood of a sexually transmitted infection (STI) such as gonorrhea is reduced, but not entirely eliminated, especially considering the unprotected encounter with your girlfriend. The absence of discharge and fever does lean more towards a non-specific urethritis or a mild UTI rather than a classic presentation of gonorrhea.

The treatment prescribed by your urologist, which includes Tetracycline (an antibiotic effective against a variety of bacteria), Acetaminophen (for pain relief), and Phenazopyridine (which helps relieve urinary pain), is appropriate for your symptoms. Tetracycline is effective against Chlamydia, and the combination of these medications should help alleviate your symptoms. It’s important to complete the full course of antibiotics as prescribed, even if symptoms improve before finishing the medication.

Regarding your concern about the potential link between the pain and using an unclean towel, while poor hygiene can contribute to urinary tract infections, it is less likely to be the sole cause of urethral pain. However, maintaining good hygiene practices is crucial in preventing infections.
The "cotton-like" floating particles you notice in your urine could be mucus or cellular debris, which can be normal in small amounts. However, if these particles are persistent or accompanied by other symptoms, it would be advisable to discuss this with your healthcare provider. Increased fluid intake can dilute urine and may reduce the visibility of such particles, but if they continue to concern you, further investigation may be warranted.

In summary, your symptoms are likely due to a non-specific urethritis or mild UTI, and the treatment you are receiving should help. If symptoms persist beyond the course of antibiotics, or if you develop new symptoms such as fever, chills, or significant changes in urination, it would be prudent to follow up with your healthcare provider for further evaluation. Regular check-ups and open communication with your healthcare provider are essential in managing and understanding your symptoms effectively.

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