How long does urethral irritation last? (+5 facts)

In this article, we will discuss the duration of urethral irritation that might be induced by various diseases of the urethra, bladder, and kidney. We will also discuss the bacterial and viral infections that may cause urethral irritation.

How long does urethral irritation last?

Mild urethral irritation resolves within a few days. However, severe urethral irritation may persist for weeks or months. Urethral irritation duration varies from person to person and on the underlying disease condition.

Sometimes urethral syndrome makes it difficult for the doctor to identify the underlying reason. This might delay the diagnosis and prognosis of the disease. The patient might have to bear the irritation for a longer time before the proper treatment is started.

If the underlying cause is infection, the urethral irritation will go away in days. However, if cancer is causing urethral irritation, then it might take many months. Sometimes, irritation might persist forever (adverse drug reaction of Triaprofenic acid) or reoccur.

What does the research suggest?

In one of the clinical studies, 67 patients with benign prostatic hyperplasia still exhibited irritative bladder symptoms including urethral irritation, and urinary inconsistency even after treatment by transurethral resection of the prostate (TURP) (1).

In another study, nongonococcal urethritis and urethral irritation reoccurred in 6 out of 45 men due to Mycoplasma genitalium. The patients were previously given Levofloxacin for the treatment of the infection (2).

What factors cause urethral irritation?

Various underlying diseases related to kidney, bladder, and urethra may cause urethral irritation. One of the common reasons is urethritis (inflammation of the urethra). Some of the conditions and diseases that can cause urethral irritation include:

  • Urethral catheterization: Improper catheterization may cause bladder spasms (catheter’s cramp), damage to the urethra, blockage and urethral irritation. 

Urethral catheterization might also cause septicemia and urosepsis. Cathetar-related bladder discomfort (CRBD) is caused by urethral irritation generated by muscarinic receptor-mediated involuntary contraction of smooth muscles (3).

  • Kidney stones: The kidney stones may reach the area between the ureter and bladder, causing excruciating pain, burning, and urethral irritation while urinating.
  • Allergy: Chemicals found in contraceptive creams and spermicides can cause allergic reactions.

The allergic reaction can cause inflammation, burning sensation, urinary tract infection (UTI), and irritation. Spermicide-coated condoms may also cause infection induced by Staphylococcus saprophyticus (4). 

  • Ureterocele: It is a congenital disorder in which the end of the ureter does not mature properly, resulting in a blockage of urine flow and urethral irritation.

Which medicines may cause urethral irritation?

Some medicines may also cause urinary retention, difficulty in urination, and urethral irritation, including.

  • Cyclophosphamide: It is used in the treatment of ovarian cancer, retinoblastoma, and multiple myeloma.

It may increase the risk of developing chemical cystitis and bladder tumours. This can cause inflammation, or irritation and a burning sensation while urinating (5). 

  • Tiaprofenic acid: It is a nonsteroidal anti-inflammatory drug (NSAID) that is used in the treatment of arthritic pain.

In a few cases, the use of tiaprofenic acid may lead to cystitis. It is characterized by suprapubic pain, blood in urine, difficulty in urination, and irritation. These symptoms might be disabling and persist even after drug discontinuation (6).

  • Anticholinergic drugs: These drugs, such as Oxybutynin and Solifenacin, block the action of acetylcholine.

In the absence of acetylcholine, the bladder won’t be able to contract for urine expulsion. This might lead to urinary retention, difficulty in urinating, and urethral irritation.

Which infection causes urethral irritation?

Some protozoal, bacterial and viral infections might also cause urethral irritation, including:

  • Trichomoniasis: It is a sexually transmitted disease caused by Trichomoniasis vaginalis, a protozoal parasite. 

Trichomoniasis may cause urethritis, prostatitis, and epididymitis in males. In females, it is characterized by vaginal discharge and urethral irritation. 

  • Chlamydial infection: It is caused by a bacteria known as Chlamydia trachomatis. It can be transmitted during sexual intercourse. 

In males, chlamydia can cause nongonococcal urethritis, urethral tenderness and irritation. In females, chlamydial urethritis causes difficulty in urination, discharge and irritation (7).

  • Ureaplasma infection: It is caused by the bacterium Ureaplasma urealyticum.

Although it has a low level of pathogenicity, the bacterium can lead to various UTI infections. The symptoms often include urethral discharge, difficulty in urination and urethral irritation (8).

  • Herpes urethritis: It is an inflammation of the urethra caused by the Herpes Simplex virus (HSV).

HSV can cause non-gonococcal urethritis even in the absence of visible herpes lesions. This can cause difficulty in urination, urethral irritation and inflammation (9). 

What causes urethral irritation in males?

Few diseases, specifically in men, can cause urethral irritation, including:

  • Prostatic adenocarcinoma: Due to cancerous growth, the prostate presses the urethral tube carrying the urine. This causes urethral obstruction and irritation.
  • Benign prostatic hyperplasia: It is not cancer but rather makes the prostate grow larger. This makes the enlarged prostrate cause urinary obstruction, leading to urethral irritation.

Which medications reduce urethral irritation?

  • Antimuscarinic and antiepileptic drugs: These are prescribed for the management of CRBD. 

Solifenacin and Oxybutynin are antimuscarinic drugs that block the M3 muscarinic receptor and inhibit bladder detrusor contraction. Solifenacin may also increase the bladder capacity. 

Gabapentin and Pregabalin, antiepileptic drugs, inhibit peripheral sensitization and control detrusor overactivity (3).

  • Chemotherapy: When urethral irritation is caused by prostate cancer, chemotherapeutic agents like Docitexal can be administered to the patient.
  • Shockwave lithotripsy: This is done for the removal of kidney stones that might obstruct the urethra. Other techniques might include ureteroscopy and nephrolithotripsy.

Which medications reduce urethral irritation caused by infection?

According to the underlying cause, medication can be given to treat the infection, including:

  • Metronidazole: When urethral irritation is caused by trichomoniasis, then metronidazole can be administered to the patient.

For males, the usual dose is 2 grams in a single dose. For females, 500 mf of metronidazole is given twice daily for seven days.

  • Doxycycline and azithromycin: Systemic antibiotics can be given for the treatment of chlamydia infection that can cause urethral infection and irritation.

Doxycyclin, 100 mg, should be given twice daily for ten days. Alternatively, 1 gram of azithromycin can be given every 1 week depending on the severity of infection. However, ampicillin is not recommended for the treatment of chlamydia.

  • Azithromycin and sitafloxacin: These medications are reported to alleviate urethral irritation caused by HSV. However, they do not treat HSV lesions (9). 

During one episode of protozoal infection, I experienced back pain, burning sensation, frequent urge to urinate, irritation and itchiness at the uretheral area. I was prescribed seven days course of metronidazole. I felt improvement within three days of therapy.

However, along with the antibiotic therapy, it is important for you to maintain and practice good perseonal hygiene. Keep your genital area clean and dry. Always wash your private parts after peeing and intercourse to prevent urethral infection.

If you think that urtheral irritation is due to medication’s side effect, consult your doctor immediately. Your doctor will discontinue the drug or work with you to identify the actual cause. Additionally, men should get regular prostate examination.

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References

1.-

Im Kim T, Song JM, Chung HC. Analysis of the factors causing bladder irritation after transurethral resection of the prostate. Korean journal of urology. 2010 Oct 1;51(10):700-3. https://synapse.koreamed.org/articles/1005548

2.-

Maeda SI, Tamaki M, Kojima K, Yoshida T, Ishiko H, Yasuda M, Deguchi T. Association of Mycoplasma genitalium persistence in the urethra with recurrence of nongonococcal urethritis. Sexually transmitted diseases. 2001 Aug 1:472-6. https://www.jstor.org/stable/44965535

3.-

Jang EB, Hong SH, Kim KS, Park SY, Kim YT, Yoon YE, Moon HS. Catheter-related bladder discomfort: how can we manage it?. International neurourology journal. 2020 Dec;24(4):324. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7788325

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Lech MM. Spermicides 2002: an overview. The European Journal of Contraception & Reproductive Health Care. 2002 Jan 1;7(3):173-7. https://www.tandfonline.com/doi/abs/10.1080/ejc.7.3.173.177

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Knight A, Askling J, Granath F, Sparen P, Ekbom A. Urinary bladder cancer in Wegener’s granulomatosis: risks and relation to cyclophosphamide. Annals of the rheumatic diseases. 2004 Oct 1;63(10):1307-11. https://ard.bmj.com/content/63/10/1307.short

6.-

Crawford ML, Waller PC, Wood SM. Severe cystitis associated with tiaprofenic acid. British journal of urology. 1997 Apr;79(4):578-84. https://bjui-journals.onlinelibrary.wiley.com/doi/abs/10.1046/j.1464-410X.1997.00094.x

7.-

Gollow MM, Bucens MR, Sesnan K. Chlamydial infections of the urethra in women. Genitourinary Medicine. 1986 Aug;62(4):283. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1011862/

8.-

Couldwell DL, Gidding HF, Freedman EV, McKechnie ML, Biggs K, Sintchenko V, Gilbert GL. Ureaplasma urealyticum is significantly associated with non-gonococcal urethritis in heterosexual Sydney men. International journal of STD & AIDS. 2010 May;21(5):337-41. https://journals.sagepub.com/doi/abs/10.1258/ijsa.2009.009499

9.-

Ito S, Yasuda M, Kondo H, Yamada Y, Nakane K, Mizutani K, Tsuchiya T, Yokoi S, Nakano M, Deguchi T. Clinical courses of herpes simplex virus-induced urethritis in men. Journal of infection and chemotherapy. 2017 Oct 1;23(10):717-9. https://pubmed.ncbi.nlm.nih.gov/28412134/