Complications of Non-Specific Urethritis

Many different infections can cause complications in certain cases, particularly if left untreated. Because of the nature of the site affected by non-specific urethritis, namely the urethra which is found near the genitals, complications of the condition can have serious consequences to men and women who suffer from the disease and develop complications.

The complications of NSU are a particular concern amongst women as many female sufferers of the condition do not experience any symptoms. This means that the condition can be difficult to pick up and therefore treat, increasing the chances of the infection progressing to cause a more serious disease which will be discussed later in this article.


General complications of NSU

Both men and women can develop recurring NSU, which is potentially the most common complication of the condition. In most cases NSU will clear up after a course of antibiotic treatment however, in some instances symptoms will return, indicating a repeated infection. This condition is also called persistent urethritis, and is thought to affect about 2 in every 10 male sufferers of NSU and a smaller number of women.

Persistent urethritis often requires further testing and another round of treatment. Recurring infections usually indicate that there might be another underlying condition, like a sexually transmitted infection, which requires attention before the urethritis itself can be completely cleared up.

Reiter’s syndrome is another potential consequence of NSU, albeit a much rarer one. The condition is also referred to as a type of reactive arthritis, and belongs to a class of conditions known as autoimmune diseases. These conditions are typified by a faulty reaction from our body’s natural immunity which results in an attack on the body’s own tissues and cells rather than an infectious agent. In this case, the autoimmune response is triggered by the presence of the infectious agents causing NSU.

Reiter’s syndrome will typically present with an inflammation and swelling of the joints which is quite painful, as well as conjunctivitis and potentially other symptoms. Reiter’s is quite rare, but can affect sufferers of urethritis. The best way to address the reactive arthritis is to properly treat the infectious cause of urethritis, and potentially providing treatments to alleviate the symptoms of Reiter’s. The former treatments will usually be a course of antibiotics which, upon clearing the NSU, will remove the stimulus causing the body’s autoimmune response. The latter will be pain killing medications and anti-inflammatories which will am to make the painful symptoms of Reiter’s manageable.

Complications of NSU in Male Patients

Because of the distinct differences in the anatomy of male and female genitals and urethras, men and women experience can potentially experience different complications of the condition as well as the more general complications discussed above (persistent urethritis and Reiter’s syndrome).

Male patients can develop a condition called epididymo-orchitis, which is in fact a combination of two inflammatory complications. This occurs when the infection spreads from the urethra into the male reproductive tract to cause an inflammation of the testes (orchitis) and epididymis (a tube which stores and transports sperm cells). Less than 1% of male sufferers of NSU can develop the condition, and will experience a very painful enlargement of the scrotum. This will also be tender to the touch, and will often be experienced alongside the usual painful urination and other symptoms of NSU.

The treatment for this complication is antibiotic treatment which can reduce the pain experienced within a few days, although it can take longer for the swelling and tenderness to completely subside. The same antibiotics used for the treatment of NSU can be used.

While in most cases quick treatment can clear up epididymo-orchitis, there are potential complications of this condition as well. In some instances an abscess (concentration of puss) can form and may need to be removed surgically. This operation is a small one and no major cause for concern.

Testes affected by epididymo-orchitis can also demonstrate reduced fertility in some cases, this is most often where the condition is caused by a mumps virus as opposed to NSU, however there is still a risk of this happening.

In extremely rare causes the infection can cause dead tissue and a condition called gangrene. Gangrene is extremely serious and spreads quickly, and the only treatment available is to surgically remove the affected tissues.

Complications of NSU in women

Women suffering from NSU can potentially develop a serious condition called pelvic inflammatory disease, which is often shortened to PID. PID is a major concern because of its potential effects on female fertility and pregnancies.

PID occurs where the infectious agent causing NSU works its way up the urethra and into the female reproductive tract, a system rich in sensitive organs like the womb (uterus) and ovaries. Unfortunately because the symptoms of NSU are often not present in women suffering from the illness, it can be all too easy for the condition to progress to PID, which is why safe sex is such an important practice. In cases where there are symptoms of PID, these will often include distinctive symptoms like fever, a yellow/green discharge from the vagina, unusual bleeding following sexual intercourse or periods, discomfort or pain in the abdomen or pelvis, and pain during intercourse.

If you experience any of these symptoms you should always contact your GP straightaway for the necessary treatment. It is very important that you receive a diagnosis and treatment for this condition as soon as possible as it can have severe consequences.

PID itself will involve, as the name suggests, the inflammation of reproductive structures within the pelvis. PID is, in a sense, an umbrella term which encompasses the infection of any of the organs within the pelvis and female reproductive tract. The structures most often affected by the condition can include:

  • The endometrium: Is the lining of the womb or uterus which is essential to its good health. The inflammation of this structure during PID is called endometriosis.
  • Fallopian tubes: Structures linking the ovaries to the womb and through which a fertilised egg will travel to implant into the womb wall. The inflammation of this part of the reproductive tract during PID is called salpingitis.
  • Ovaries: The ovaries are the structures housing the female reproductive cells, the eggs. The inflammation of these is called oophoritis.
  • Womb: The womb is where a pregnancy takes place, and is responsible for protecting and nurturing an embryo as it progresses to form a fully developed unborn child. Inflammation of the womb more specifically affects cells around it and is called parametritis.
  • Peritoneum: This is the lining of the abdomen which is inflamed during pelvic peritonitis as a consequence of PID.

Salpingitis in particular can have lasting consequences as the swelling of the fallopian tubes makes the passage through which fertilised egg pass to access the womb much smaller. This can result in the implantation of said eggs into the fallopian tubes rather than the uterus to cause a condition called an ectopic pregnancy. Ectopic pregnancies pose a number of risks to both the unborn child and the mother, and can be one of the more severe consequences of PID.

Testing for PID will often involve a blood test ultrasound, and swab test, and in some instances a laparoscopy is necessary. If the condition is diagnosed then treatment can be administered, and at its early stages the condition is very treatable. A 14 day course of antibiotics can effectively cure the condition, provided you follow your doctor’s instructions to the letter. During this time you must not have sex as this can disrupt your body’s attempts to repair itself. In about 20% of cases a second episode can occur within 2 years of treatment, and should this occur you must seek treatment as soon as possible.

PID is a major concern because about 20% of sufferers will become infertile as a consequence of the condition. In most cases, this will follow a second episode of the condition.

The complications of NSU can be serious, which is why it is so important to practice preventative measures like safe sex to avoid the condition, and any associated STIs, in the first place. As always, prevention is better than cure, and considering the gravity of some of the more severe consequences of NSU’s complications, these measures are extremely important.

« Non-Specific Urethritis in Women Managing the Symptoms of Non-Specific Urethritis »