Medically reviewed
May 6, 2022Symptoms of sexually transmitted infections (STIs), such as pain or a burning sensation while urinating can be concerning.
Though there are several possible causes of painful or burning urination, if accompanied by itchy skin and discharge, you may have nongonococcal urethritis (NGU).
Anyone who’s sexually active can get nongonococcal urethritis.
In this article, we’ll go over the symptoms, causes, and diagnosis of NGU, as well as how it’s commonly transmitted.
We’ll also cover the possible complications that can happen if NGU is left untreated and where and how you can find treatment.
Finally, we’ll explain what you can do to prevent NGU and when you may want to reach out to a healthcare provider for care.
Nongonococcal urethritis (NGU) is an infection of the urethra, the tube that allows urine to be passed out of the body.
In people born with penises, the urethra also carries semen.
In people born with vaginas, the urethra is very short and sits just above the vagina.
Dissecting the name of NGU also helps to understand the condition it describes – “Urethritis” refers to inflammation and infection of the urethra, while “nongonococcal” refers to an infection caused by an agent other than gonorrhea.
The most common cause of NGU is chlamydia. In fact, 15-40% of NGU cases are caused by chlamydia.
However, the infection can also be caused by other agents, including:
Though cases of NGU caused by Trichomonas vaginalis, herpes simplex virus, Epstein-Barr virus, and Adenovirus are rare, M. genitalium accounts for roughly 15-20% of NGU cases.
Importantly, not all people who get NGU experience symptoms, which can make it challenging to diagnose. In fact, data from 2009 suggests that over 40% of all cases of NGU are asymptomatic.
When symptoms are present, they can take between one to five weeks to appear after infection.
These symptoms can include:
People born with penises may experience additional symptoms, such as:
Though less common, NGU can also present with:
Diagnosing NGU requires the exclusion of gonorrheal infection.
To rule out a gonorrheal infection, your provider will perform a gram stain on your discharge to look for gram-negative diplococci or test your urine.
If diplococci are present, then a gonorrheal infection is confirmed. If not, the diagnosis is classified as NGU.
Your provider may also physically examine your discharge to aid their diagnosis, as NGU discharge is usually mucus-like or clear, while a gonorrheal infection usually produces a discharge that contains pus.
However, because these generalizations aren’t reliable, testing can help to confirm the diagnosis.
NGU is almost exclusively spread through sexual contact, including that which takes place during oral, anal, and vaginal sex.
A person infected with NGU can spread the infection from the time they are infected until they are cured.
Though less common, NGU can also be spread during birth or as a result of urinary tract infections, bacterial prostatitis, urethral stricture, tightening of the foreskin of the penis, and catheterization.
