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Urethritis, Proctitis, Chlamydia & “NSU”

sexual health pages

What is urethritis?

Urethritis means inflammation of the urethra (“water passage”). It can be caused by a number of different germs, including gonorrhoea, chlamydia, ureaplasma and a number of other bacteria, including those found naturally in the throat and anal areas. Although chlamydia is a very common cause of NGU (non-gonococcal urethritis) in men who have sex with women, it is less common in exclusively gay men. For more information on chlamydia, see below.

What is proctitis?

Proctitis means inflammation of the rectum. It is caused by the same germs which cause urethritis (see above) - with the addition of herpes simplex and various intestinal parasites such as amoebae. Also, any substances including chemicals can be irritating to the anal lining.

How are the germs transmitted?

Because the germs which cause urethritis and proctitis live in the body’s cells and surrounding fluids, they need close contact for transmission to occur. This includes oral, anal and genital contact; the risk may extend to fingering and sharing of sex toys. You can’t catch infections from towels, toilet seats or ordinary social contact - no matter how friendly!

What are the symptoms?

Non-gonococcal Urethritis - about a third of men with NGU have no symptoms. If you do have symptoms, you’re likely to notice minor stinging or burning on passing urine and / or a clear or yellowish discharge from the urethra.
Proctitis - again, symptoms can be very mild or totally absent, especially if you have had the problem for a long time. Symptoms to look out for are diarrhoea, mucus streaking of stools, anal pain and a sensation of needing to go the the toilet again shortly after your last visit.

How do I know if I have urethritis or proctitis?

The test for urethritis involves wiping a very fine cotton-tipped swab over the lining of the urethra - the test has a higher “pick-up” rate if you have not passed urine in the preceding four hours. The doctor can diagnose urethritis immediately by looking at the specimen under the microscope and additional tests are carried out in the laboratory.

The test for proctitis involves the doctor gently looking at the appearance of the anal lining through a small instrument called a proctoscope. This is the best way to diagnose proctitis, but if you prefer you may simply have some swabs taken from the entrance to the anus - these can screen for gonorrhoea and chlamydia.

What is the treatment?

This very much depends on the cause - and it’s usually best if both you and your partner have treatment together. Usually this means a short course of antibiotics - take the complete course, even after the symptoms disappear. Until you and your partner have been back for check-ups to confirm that the problem has cleared, be sure you’re having the right kind of low risk sex.

Chlamydia & “NSU”

Chlamydia is a bacterium which affects the genitals and sometimes the eyes. It causes “NSU” (Non Specific Urethritis) in men. Chlamydia is passed on through vaginal, anal and oral sex.

Symptoms

Women often show no signs until the chlamydia has spread elsewhere but may notice extra discharge and pain when passing urine.

Men may get symptoms of NSU if infected: a white cloudy discharge from the penis and a burning sensation when passing urine.

Treatment

Infections are easily treated with a short course of antibiotics. If untreated, chlamydia can lead to serious problems in women such as pelvic inflammatory disease which can cause infertility, tubal pregnancy and pelvic pain. In men, untreated chlamydia can lead to serious problems with the prostate gland (which helps makes semen) and sometimes the testicles, causing a painful swelling. As the symptoms are so easily missed and the consequences so serious, it is worth asking to be tested at your local GUM Clinic or GP.

Prevention

Using a condom for vaginal sex and strong condom and lubricant for anal sex will help to prevent transmission.

For further information on this and a range of other important sexual health issues, contact the GUM Clinic or Gay Men’s Health.

GUM (Genito Urinary Medicine) Clinic
http://www.nhslothian.scot.nhs.uk/health_services/access/genito.html

Royal Infirmary of Edinburgh
Level 4, Lauriston Building
39 Lauriston Place
Edinburgh
EH3 9YW
Tel : 0131 536 2103 (appointments – men)
Tel : 0131 536 2104 (appointments – women)

You may have to arrange an appointment up to 4 weeks in advance but there is a walk-in clinic, where no appointment is necessary, from 9.00am until 10.00am, Monday to Friday. Currently there are no evening clinics. Same day HIV tests are available Monday – Thursday between 8.30am and 10.30am with results available from 3.30pm the same day.

As well as HIV tests, GUM provides sexual health check-ups and treatments. All results are totally confidential. A full check-up normally involves a swab from the penis, a urine sample and a blood test. You may also have a rectal and throat swab taken. A complete sexual health screening would test for :

Images courtesy of the Steve Retson Project

If you live outside Edinburgh and the Lothians a full list of GUM clinics in the UK, Ireland and the US is available at http://www.bashh.org/directory.htm

Last updated 20th May 2004

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