Gonococcal and Non-Specific Urethritis

Urethritis involves the painful inflammation of a tube that draws urine out of the bladder and out of the body called the urethra. The condition can be asymptomatic, particularly in women, but can cause painful urination amongst other symptoms. In this article we look at the differences between two types of the most common types of urethritis, gonococcal and non-gonococcal (or non-specific) urethritis.

Similarities and Differences between NSU and Gonococcal Urethritis

The main difference between the two conditions is the fact that while non-specific urethritis can be attributed to a number of different causes, including injury, chemical irritation, and infection, gonococcal urethritis is attributed to a gonorrhoeal infection.


Gonorrhoea is a sexually transmitted infection caused by a bacterium known either as gonococcus or Neisseria gonorrhoea. Like other STIs, gonorrhoea is spread by unprotected sexual contact with partners carrying the disease. While about 50% of infected females and 1% of infected males are asymptomatic, the rest experience a number of symptoms including the characteristic painful burning sensation during urination that is caused by the gonococcal infection of the urethra.

NSU can be caused by a range of different factors, including infection by sexually transmitted disease like herpes or chlamydia, as well as injury through the insertion of a foreign object into the urethra or exposure of the urethra to an irritating chemical substance.

While there are differences in causes, the two types of urethritis are often treated in a similar fashion, and cause similar symptoms. The solution to both forms of urethritis is a course of antibiotics to remove the aggravating bacteria and thereby clear up the painful and unpleasant symptoms.

Both forms of urethritis can, if left untreated, cause serious complications that can impact fertility like pelvic inflammatory disease in women and epididymo-orchitis in men. Ultimately it is important for doctors to make the distinction between the two conditions to better judge how to address the infection underlying the urethritis. If the condition is gonococcal, then treating the gonorrhoea is necessary to achieve long term health and to prevent the transmission of the condition to future sexual partners.

Distinguishing between Gonococcal and Non-Specific Urethritis

Because of the importance in distinguishing the difference between gonococcal and non-specific urethritis, a number of tests are performed to determine the exact infectious cause of the condition, and therefore how to best manage it.

Once you start experiencing the symptoms of NSU you should visit your GP or a specialist GUM (genitourinary medical) clinic/sexual health clinic. The latter will be usually be able to see you without an appointment, although in some cases it may be advisable to phone up in advance to either arrange one or look into waiting times and spare yourself a particularly long wait during a busy period. You can rely on the discretion and confidentiality of either source of care.

Your doctor will then take a history of both your symptoms and your recent sexual activity. This is important in determining the likelihood of unprotected sexual activity being the cause of your urethritis, and from there what tests you would need to determine any infection causing the urethritis. Part of this history will involve asking you about the onset of symptoms. Interestingly if you experience the symptoms of urethritis (e.g. burning sensation while emptying your bladder or a discharge from the penis for example) within a couple of days of having unprotected intercourse, it is unlikely that that sexual encounter is responsible for the condition.

If deemed necessary by your doctor, he or she will order a series of tests to determine the exact cause of your urethritis. Blood or urine tests can determine which bacteria is causing the condition, and is a great way of identifying gonorrhoeal bacteria or any other infectious agent responsible for your urethritis. In cases where there is a discharge from the genitals, a sample of this can be studied to the same end.

The test results should indicate which infectious agent is responsible for your condition will inform how your doctor will go about treating the urethritis. Whether gonococcal or non-specific, this condition is treated through antibiotic medication. Slightly different antibiotics are used in the treatment of gonococcal urethritis and NSU. For the former common medications include spectinomycin and ceftriaxone, while for the latter doxycycline and azithromycin are the go to drugs.

If gonorrhoea or another sexually transmitted illness is found to be responsible for your urethritis, you will need to inform any recent sexual partners about the infection so that they can pursue treatment.

Informing these partners may be embarrassing, but it is an extremely important step towards preventing the spread of STIs and an unpleasant condition in urethritis. Moreover some infectious causes of urethritis can be asymptomatic, like gonorrhoea and chlamydia, and these conditions can infiltrate the reproductive tract and cause more serious infections which can, in the worst of cases, lead to infertility.

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