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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 is it transmitted?
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:
- 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)
Symptoms
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.
Testing/Diagnosis
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
Treatment
The main treatments for NGU are:
Alternatives are:
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.
What does it mean for my health?
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
Reduce your risk
- 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.
Talk to your partner
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.
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