Urethritis: Symptoms, Treatment, and Next Steps

Urethritis issues?

Hello Doctor, I had unprotected sexual intercourse on July 17.
About two weeks later, I went to the clinic for a urine test, and the doctor said there was some inflammation in my urethra.
During the inflammation period, I experienced a burning sensation while urinating and noticed my urine was often yellow.
The appearance of my penis was normal, with no unusual discharge of white or yellow fluid.
The doctor prescribed a four-day course of antibiotics, and after completing the treatment, the burning sensation during urination has resolved.
However, I sometimes feel an itchy, prickly sensation inside my penis.
When I returned to the hospital for another urine test, the doctor said my urine was normal and there was no need for further medication.
However, the doctor mentioned that the bacteria in my urine sample were too few to culture and identify the cause of the inflammation.
Later, I asked the staff at the blood draw station, and they said I could go to the infectious disease department for a urine test, as their testing method is different.
Is my current situation normal? Would you recommend that I go to the infectious disease department for a urine test? Thank you, Doctor.

Hong Guohua, 20~29 year old female. Ask Date: 2015/08/29

Dr. Li Yilun reply Urology

Routine urinalysis in general hospitals is typically the same and does not differentiate between urology and infectious disease urine tests.
If you are undergoing treatment for an infection in urology and there is no improvement, it is advisable to consult an infectious disease specialist, as they have expertise in infections and antibiotic use.
It is important to seek medical attention for any abnormalities in your body.
A physician can provide a more accurate diagnosis based on a detailed history, thorough questioning, and physical examination.
It must be emphasized that a simple description of symptoms is insufficient for determining the condition; a comprehensive assessment including history-taking and physical examination is necessary.
Therefore, it is recommended to consult a qualified physician for evaluation and testing, as doctors often need to inquire about medical history, perform visual and tactile examinations, and conduct tests to confirm a diagnosis and determine the appropriate treatment.

Reply Date: 2015/08/29

More Info

Understanding urethritis, particularly in the context of your symptoms and treatment history, is crucial for managing your condition effectively. Urethritis, which is the inflammation of the urethra, can be caused by various factors, including infections (bacterial, viral, or fungal), irritants, or even trauma. Your experience of burning during urination and the subsequent itching sensation inside the penis are common symptoms associated with this condition.

From your description, it appears that you initially experienced symptoms consistent with urethritis following unprotected sexual intercourse. The fact that your doctor prescribed a course of antibiotics suggests that a bacterial infection was suspected. The resolution of the burning sensation after completing the antibiotic course is a positive sign, indicating that the initial infection may have been effectively treated. However, the lingering itching sensation you describe could indicate several possibilities, including:
1. Residual Inflammation: Even after the infection has cleared, inflammation can persist, leading to discomfort. This can happen if the urethra was irritated during the infection or from the antibiotics themselves.

2. Non-Infectious Causes: Sometimes, urethral irritation can be caused by non-infectious factors such as soaps, lotions, or even friction during sexual activity.
3. Recurrent or Persistent Infection: Although your urine culture did not yield any bacterial growth, it is possible that a low-level infection or a different pathogen (like a virus or fungus) could be present. This is where your consideration of seeing an infectious disease specialist comes into play.

Given that your symptoms have not completely resolved and considering the complexity of urethritis, it is indeed advisable to follow up with an infectious disease specialist. They may employ different testing methods that could provide more insight into your condition. For example, they might conduct more sensitive tests for sexually transmitted infections (STIs) or other pathogens that standard urine cultures might miss.

In the meantime, here are some general recommendations to help manage your symptoms and prevent further irritation:
- Hydration: Drink plenty of water to help flush out your urinary system. This can dilute your urine and may alleviate some discomfort.

- Avoid Irritants: Steer clear of potential irritants such as scented soaps, lotions, or other personal care products that could exacerbate your symptoms.

- Safe Sexual Practices: If you are sexually active, consider using protection to reduce the risk of future infections.

- Monitor Symptoms: Keep track of any changes in your symptoms, including the frequency and intensity of itching or any new symptoms that may arise.

In summary, while your initial treatment seems to have addressed the acute symptoms of urethritis, the persistence of discomfort warrants further investigation. Consulting with an infectious disease specialist can provide you with a more comprehensive evaluation and tailored treatment options. Your proactive approach to managing your health is commendable, and I encourage you to seek the necessary follow-up care to ensure a complete resolution of your symptoms.

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