NGU can be caused by many different things. Causes can include:

• Sexually transmitted infections (STIs): Chlamydia and Mycoplasma genitalium are common causes of NGU. Genital herpes and Trichomonas vaginalis are less common causes
• Other organisms: Bacteria (tiny germs) that cause infection in the urinary tract (kidneys, bladder and urethra) or the prostate gland
• Things that make the urethra sore or irritated: NGU may sometimes be caused by friction during sex or masturbation, or by getting irritants like soap in the urethra

Sometimes a cause isn’t found. If the cause of the urethritis is unknown, it’s sometimes called non-specific urethritis.

It’s usually passed on through sex or sexual contact.

NGU can occur in anyone who has a penis. Many cases are caused by an STI, but not all cases are caused by having sex.

During vaginal/frontal, anal or oral sex without a condom, germs can pass into the urethra (tube you pee from) where they can cause an infection that leads to inflammation.

You cannot get NGU from hugging, sharing baths or towels, swimming pools, toilet seats or sharing cups, plates or cutlery.

Not everyone with NGU will have obvious signs or symptoms or they may have symptoms so mild they’re not noticed.

If you do get signs and symptoms, they can show up soon after coming into contact with an infection, many months later, or not until the infection spreads to other parts of your body.

They most usually show up after 2 to 4 weeks for an infection that causes NGU or within a few days for other causes of irritation to the urethra.

You may notice:

• An unusual discharge from the tip of the penis. It may be white/cloudy or watery
• Pain or a burning feeling when passing urine (peeing)
• Pain in the testicles (balls)
• Itching or irritation at the end of the urethra
• Occasionally, you may feel like you need to pee often
• Other symptoms, depending on the cause of the inflammation

Anyone with a penis can be diagnosed with NGU.

You can get a check-up and tests if you have any signs and symptoms. Because the inflammation can be caused by an STI, it’s recommended to be tested for STIs if:

• you or a sexual partner have, or think you might have, symptoms
• you’ve recently had sex without a condom with a new partner
• you or a partner have had sex without a condom with other partners
• a sexual partner tells you they have an STI

It’s important not to delay getting a test if you think you may have an STI. The earlier an STI is treated, the less likely you are to have any complications.

Tests for the causes of NGU can be done straight away but you may be advised to have another test 2 weeks after having sex.

You can have an STI test even if you don’t have any symptoms.

• Your penis will be examined for signs of inflammation
• You’ll usually be asked to give a urine sample
• A doctor or nurse may take a swab from the entrance of the urethra (tube you pee from) to test

A swab is like a long, thin cotton bud. It sometimes has a small plastic loop on the end rather than a cotton tip. It’s wiped over body parts that could be infected. This only takes a few seconds and isn’t painful, though it may be uncomfortable for a moment.

You’ll be tested for chlamydia and gonorrhoea.

In some clinics, if you’re found to have NGU you’ll be offered a test for Mycoplasma genitalium (an STI that can cause NGU). Routine testing isn’t available at all clinics but is becoming more widely available, particularly for people with persistent NGU. If you can’t be tested for Mycoplasma genitalium, you may be treated as though you have it.

Routine blood tests don’t detect NGU.

If you’re not sure which infections you’ve been tested for, just ask.

Your swab sample will be looked at under a microscope and you should get the result straight away.

If you have signs and symptoms but the test doesn’t confirm NGU, you may be asked not to urinate (pee) overnight and come back to be tested again.

You may have to wait up to 2 weeks for the results of some tests for sexually transmitted infections or urinary tract infections.

The accuracy of a test depends on the kind of test used, the type of sample that’s collected, and which part of your body the sample is collected from.

Recommended tests done by trained healthcare professionals are usually highly accurate. If there are any doubts about your test results you may be offered a second test.

There are different services you can go to. Choose the one you feel most comfortable with.

Free tests for possible causes of NGU can be done at:

• a sexual health clinic or genitourinary medicine (GUM) clinic
• some GP surgeries
• some contraception and young people’s clinics

If tests for chlamydia and gonorrhoea are negative but you have symptoms, you’ll need to go to a GUM or specialist sexual health clinic who may recommend other tests.

All tests for the causes of NGU are free through NHS services.

All treatment for sexually transmitted infections is also free through NHS services.

If you go to a GP surgery you may have to pay a prescription charge for some treatment.

NGU is treated with antibiotics.

• You’ll usually be given antibiotic tablets. There are several different antibiotics that can be used. You may be given more than 1 type. You usually need to take the antibiotics for 1 week, but sometimes it may be up to 2 weeks
• You may get NGU more than once. For a few people, it may become recurrent (keep coming back) or persistent (not get better with antibiotics)
• You may need other treatment if complications occur or if the cause of the inflammation becomes known
• Complementary therapies (treatments outside of mainstream healthcare) can’t cure NGU

Most people notice an improvement quite quickly after having treatment. It’s important to finish all your treatment, even if symptoms go away.

Discharge or pain when you urinate (pee) should improve within about a week.

This depends on the causes of the NGU and whether symptoms have gone.

Some services may ask you to go back and see them for a check- up 3 to 5 weeks later, and some may do a follow-up on the phone. This is to:

• check that signs and symptoms have gone
• check you took the treatment correctly
• check you haven’t been exposed to an infection again
• give you the results of any other tests that were done and advice on how to get further treatment if necessary
• answer any questions you have and give you any advice you need

If you still have signs or symptoms, you may need to be tested again and have more treatment.

If the symptoms have all gone, you usually won’t need any more tests.

You may need a repeat test or more treatment if:

• you think you’ve come into contact with another STI
• you had sex with a partner before the treatment for both of you was finished
• you didn’t complete the treatment or didn’t take it according to the instructions
• the signs and symptoms don’t go away
• your test was negative but you develop signs or symptoms

How quickly a repeat NGU test can be done will depend on which test is being used. Your clinic or GP surgery can advise you.

If NGU is treated early, there won’t be any complications.

If left untreated, some causes of NGU, like chlamydia, can cause long-term complications, although this is uncommon.

Complications can include:

• Painful infection in the testicles. If this isn’t treated, it can cause long-term pain and, very rarely, there’s a possibility it could affect your fertility.
• Inflammation (pain and swelling) of the joints and tendons, known as Sexually Acquired Reactive Arthritis (SARA). SARA may sometimes cause inflammation of the urethra (tube you pee from) or the eyes. This is not common.

For many causes of NGU, prompt treatment is needed to avoid complications.

If you delay seeking treatment, even if signs and symptoms go away, an infection could cause long-term damage and you may pass an infection on to someone else.

Don’t have any vaginal/frontal, anal or oral sex (even with condoms), or share sex toys, until 14 days after you and your partner(s) have started the treatment and any symptoms have gone.

This helps to stop you being reinfected or passing the infection on to someone else.

The tests can’t tell you how long any inflammation or infection has been there.

If you feel upset or angry about having NGU and find it difficult to talk to a partner or friends, don’t be afraid to discuss how you feel with the staff at the clinic or GP surgery.

If you have NGU it’s very important that your current sexual partner(s) and any other recent partners are tested and treated as they may have an STI without knowing it.

This will help to stop them reinfecting you or passing the infection on to anyone else.

Sometimes NGU may only clear up after a current sexual partner has been treated too.

You may be given a contact slip to send or give to your partner(s) or, with your permission, the clinic can do this for you. This is called partner notification. It can sometimes be done by text message. The message or contact slip will say that they may have been exposed to a sexually transmitted infection and suggest they go for a check-up. It may or may not say what the infection is. It won’t have your name on it, so your confidentiality is protected.

You’re strongly advised to tell your partner(s), but it isn’t compulsory. The staff at the clinic, GP surgery or online service can discuss this with you.

STIs are just one of many factors that can affect your fertility.

Most people who’ve had NGU won’t become infertile.

If you’ve had NGU, you won’t normally be offered any routine tests to see if you’re fertile unless a partner is having difficulty getting pregnant. If you’re concerned, talk to your doctor or practice nurse.

The following measures will help protect you from getting and passing on NGU and most other sexually transmitted infections including HIV, gonorrhoea and chlamydia.