What is non-gonococcal urethritis? Urethritis is an inflammation of the urinary tract (urethra), through which urine passes from the bladder as it exits the body. Urethritis is usually caused by an infection. Non-gonococcal urethritis is defined as any form of urethritis that is not caused by gonorrhea (a bacterial infection caused by the microorganism Neisseria gonorrhoeae that is transmitted during unprotected intercourse). Approximately 15 to 40% of cases of nongonococcal urethritis are caused by chlamydia. Another 15 to 25% of cases are caused by mycoplasma. However, non-gonococcal urethritis can be caused by other sexually transmitted infections, such as trichomoniasis (Trichomonas vaginalis infection). Herpes simplex virus can also cause non-gonococcal urethritis. Non-gonococcal urethritis is a diagnosis that is made when other causes of urethritis are excluded, that is, when the causative agent of the infection is not determined. In most cases, when a person is diagnosed with non-gonococcal urethritis, additional tests will be performed to try to identify the cause of the infection. However, with the exception of chlamydia, the bacteria that cause nongonococcal urethritis can be difficult to identify. Therefore, the doctor may simply decide to prescribe treatment with broad-spectrum antibiotics. It is especially important to know that there is no widely available test for mycoplasma. Because it is one of the most common causes of nongonococcal urethritis, it makes it difficult for many people to be diagnosed. Therefore, they can be treated according to mycoplasma treatment guidelines, especially if previous treatment of nongonococcal urethritis has failed. Who is at increased risk for nongonococcal urethritis? Non-gonococcal urethritis is diagnosed most often in men. Although women can develop urethral infections, these infections are usually not caused by sexually transmitted diseases. Infections of the urethra (urethritis) are not the main reason for the diagnosis of sexually transmitted infections in women. Instead, the equivalent diagnosis in women would likely be either cervicitis or bacterial vaginosis. Both diseases can involve infection with the same types of bacteria that are sometimes responsible for non-gonococcal urethritis. How is non-gonococcal urethritis diagnosed? The overall diagnosis of non-gonococcal urethritis can be based on a urine test or a swab. Usually, the initial diagnosis is based on visible symptoms of urethritis. Then the specialist must rule out gonorrhea and chlamydia. If none of these infections is the cause of the urethritis, it is often defined as non-gonococcal urethritis. However, some doctors order additional tests to try to identify the pathogen responsible. Additional tests are often indicated,if the initial course of treatment does not cure non-gonococcal urethritis. What is the treatment for non-gonococcal urethritis? For the treatment of non-gonococcal urethritis, a course of antibiotics is usually prescribed, which may be given to the patient even before the test results are received. It is important that the patient’s past and present sexual partners are also treated to prevent the spread of infection to others. The patient should avoid sexual contact, including anal and oral sex, until the course of antibiotic treatment has been completed and the symptoms of urethritis have disappeared. Urethritis symptoms should improve within a week. The patient may be asked to go for a follow-up examination to check if the treatment has been successful. References: 1. Centers for Disease Control and Prevention. Sexually Transmitted Diseases Treatment Guidelines 2. Verywell Health. Overview of Nongonococcal Urethritis 3. National Health Service (NHS). Non-gonococcal urethritis