Understanding Non-Gonococcal Urethritis (NGU)

A Patient's Guide to Diagnosis, Treatment, and Prevention

Family Medicine

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Last updated: Mar 24, 2025

What is NGU?

Non-gonococcal urethritis (NGU) is inflammation of the urethra caused by infections other than gonorrhea. It's one of the most common sexually transmitted infections in men.

Common Causes

  • Chlamydia trachomatis (responsible for 15-40% of cases)
  • Mycoplasma genitalium
  • Trichomonas vaginalis
  • Ureaplasma urealyticum
  • Viral infections (HSV, adenovirus)

Symptoms

Common signs include:

  • Discharge from the penis (usually clear or white)
  • Burning or pain during urination
  • Itching or irritation at the urethral opening
  • Redness around the urethral opening

Note: Some people may have no symptoms at all

Diagnosis

  1. Physical examination
  2. Urethral swab testing
  3. Urine tests
  4. STI screening

Treatment

Primary Treatment

  • Antibiotics (typically azithromycin or doxycycline)
  • Complete full course of prescribed medication
  • Abstain from sexual activity during treatment

Follow-up Care

  • Return for evaluation if symptoms persist
  • Partner notification and treatment
  • Repeat testing after treatment completion

Prevention

  • Use condoms consistently and correctly
  • Regular STI screening
  • Limit sexual partners
  • Open communication with sexual partners

When to Seek Medical Care

  • New urethral discharge
  • Burning during urination
  • After potential exposure to STIs
  • If symptoms return after treatment

Complications if Untreated

  • Epididymitis
  • Reactive arthritis
  • Chronic urethral problems
  • Fertility issues

Important Notes

  • NGU can recur even after successful treatment
  • All sexual partners should be tested and treated
  • Regular follow-up is important for complete cure

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