Family doctor

Overview

• NSU is a sexually transmitted disease which causes inflammation of the urethra
• It may not cause any symptoms and men may not realise they have it
• Common symptoms include a burning sensation while urinating and a discharge from the penis
• Antibiotics usually cure the condition
• Sexual partners also need treatment
• Sex should be avoided during treatment
• Condoms provide protection

What is NSU?

NSU stands for non-specific urethritis and causes inflammation of the urethra which is the tube inside the penis which passes urine and semen.

NSU is basically any infection in the urethra except those caused by gonorrhoea and chlamydia. It is believed to be one of the most common STDs in men and is three times more prevalent than gonorrhoea.

Women who have sex with men with NSU are at risk of chlamydia and this can lead to pelvic inflammatory disease which can cause infertility.

The condition is caused by a number of organisms, some of which have not been identified.

What are the symptoms?

Often there are no symptoms, but when there are, they appear about two to four weeks after sexual intercourse. However, the incubation period can be as long as 12 weeks in some cases.

The main symptoms in men are a burning sensation while urinating or a clear, white or yellow discharge from the penis, and itching, tingling, or irritation inside the penis.

The first noticeable symptom in men is a tingling or burning at the tip of the penis, often in the morning. The pain can become severe and is usually followed by a discharge which is clear at first but can turn yellowish without treatment.

The only symptoms in some people are spots on the underpants or dampness under the foreskin.

The infection can spread to the prostate gland and testicles.

In women, contact with NSU usually causes no symptoms, but some develop a vaginal discharge or burning with urination.

What treatment is needed?

NSU responds well to antibiotic treatment. However, the condition may take longer to cure in some people and recur in others.

A 10-21 day course of antibiotics such as tetracycline or doxycycline is the recommended treatment. About one in five patients may need more than one course of medication.

People taking doxycycline should use sunblock outside because the medication causes increased sensitivity to sunlight.

Men are usually the first to seek treatment. However, it is important their sex partners are also treated with antibiotics, and tested for chlamydia and gonorrhoea.

Sexual intercourse must be avoided until the condition is cured. The uncomfortable symptoms of the STD will settle faster by not having sex and not masturbating.

Do not squeeze the penis to look for discharge because this will only irritate the condition. The symptoms are likely to disappear within two weeks after treatment. Some men continue to experience mild discomfort after successful treatment.

Men with persistent or recurrent urethritis should be retreated with antibiotics if they failed to complete the first course or had sex with an untreated partner during the treatment period.

Untreated men may develop epididymitis which causes inflammation of a small organ (the epididimis) just next to the scrotum, chronic urethral irritation or chronic testicular discomfort.

How can it be prevented?

Condoms provide some protection from NSU, and these should be used with any new partner.

Sexual intercourse during treatment should be avoided to help the condition to heal.

Future trends

Azithromycin is a drug which has been suggested as a new treatment for NSU because it is equivalent to doxycycline. However, this study has not yet been published in a medical journal.

The bacteria causing the condition my be more exactly found in future.

Getting help

Don't delay seeking treatment if you have symptoms.

Sexual Health and STD clinics can provide treatment and advice.

Your doctor, gynaecologist, urologist or Family Planning Clinic can also help.