You've taken it. The first correct step in the treatment of your urinary problems is proper diagnosis. Perhaps you gradually began to realize you were urinating more frequently or you felt a sense of unusual urgency when you had to void. You might even have experienced back pains or discomfort In the lower abdomen. You may have experienced burning when you urinated (and possibly asked yourself, "Could I have a venereal disease?" If you are a man, you might have noticed some itching in the penis and a slight discharge (a "morning drip".

You did the wise thing. You reported your symptoms to the doctor, who examined you and, with the help of some laboratory tests, made the diagnosis: Non Specific Urethritis NSU. Had you let it go it could have resulted in something more serious? But as disturbing as the name sounds, it is not a serious afflic on... because now your doctor knows what he or she is dealing with and how to approach its treatment. Probably your annoying symptoms will disappear within days, perhaps never to return. However, successful therapy requires cooperation on your part, in the form of patience and strict adherence to your physician's instructions. After reading these pages you will realize just how much is involved.

Despite the similarity in symptoms, you do not have gonorrhea. In fact, the term nonspecific urethritis is derived from the fact that gonorrhea has specifically been ruled out. Often, nonspecific urethritis has nothing at all to do with sexual activity. Because certain forms of urethritis can be sexually transmitted it is possible that your doctor may recommend that you refrain from sexual Intercourse for a while. It is important to be aware that some forms NSU that both partners develop is not a venereal disease in the usual sense of the word. Please do not feel embarrassed to discuss with your doctor any concerns you may have about the sexual aspect of your condition. Rest assured, too. that nonspecific urethritis does not cause cancer. Doctors consider it an "annoying" type of affliction-never a life threatening one.

Nonspecific urethritis is an inflammation of the urethra. Inflammation is caused by irritation of the tissues, and that irritation can result from several causes: mechanical, chemical, or infectious. Although bacterial or viral infection is the most common cause of urethral Inflammation, it can also be the result ₉f mechanical or chemical Irritation. Let's see how:

Urine is formed in the kidneys and is collected in the bladder. During the act of voiding, urine flows from the bladder through a short tube (the urethra) and leaves the body through the urinary meatus. You unconsciously control urination by tightening the muscles in the urethra to flatten it and restrict flow, or by relaxing the muscles to round the urethra into a tube through which urine can flow freely. Now you can see how inflammation and swelling of the urethra can affect your ability to void. Women are much more subject to diseases of the urinary tract than men are. In fact, the chances are that one out of every four women will have had at least one such infection sometime during her lifetime. This view of the female anatomy can explain why. Contrary to popular belief, normal urine is quite clean. This means that germs must come from someplace else to cause an infection. The gastrointestinal tract is loaded with bacteria-normal inhabitants of the bowel that are needed to help digest food. Notice how close the opening to the urethra is to the anus, the opening through which you defecate. Even when you practice good hygiene, it is easy for bacteria from the feces to reach the urethra. You can see, too, how discharges from vaginal infections can infect or irritate the urethra. Also, because the urethra is so close to the vagina, during childbirth the urethra can be compressed and injured.

Urethritis has also been associated with sexual intercourse in young women-the so-called "honeymoon cystitis." (Cystitis, a disease of the bladder, is commonly associated with urethritis.) Another contributing factor can be too frequent or too strong douches. They can wash away or destroy the normal protective vaginal secretions, resulting in an Infection of either the genital or urinary tract. Although it is only about 11/2 inches long, the female urethra is not as simple a 'tube as it appears. It is lined with hundreds of tiny pockets and crevices in which bacteria can hide, walled off from normal body defenses or antibacterial drugs. With such a foothold, these bacteria can trigger future flare-ups of infection. When this happens the woman is said to have chronic urethritis and may have to undergo repeated and prolonged drug therapy, local Instrumentation or even surgery.

There are times when the doctor simply cannot locate a cause for the urethritis. In certain individuals, it may be a defect the woman was born with. Whatever the exact cause, some women seem more prone to nonspecific urethritis than others do.

Men are luckier than women are when it comes to their urinary plumbing. For example, the male urethra is much longer. That means that the meatus (opening) is comfortably out of the way of the anus, so fecal bacteria are not likely to gain entrance. Therefore, men are much less susceptible to urinary infections than women are. When men do develop nonspecific urethritis, It is often secondary 10 some other problem

For example because the prostate empties into the urethra, urethritis may be the first sign of a disease of this gland. Urethritis may also accompany Reiters syndrome, a disease that also involves arthritis and conjunctivitis (pink eye").

Men do pay a price for their longer urethra, because it is more difficult to pass an instrument through this extended, angular canal. An examination with a cystoscope, for exam pie, can irritate the tissues or push bacteria back up into the more sensitive posterior area, causing urethritis. Men can also contract nonspecific urethritis from sexual contact with a woman who has certain types of infection. (But again, these have nothing to do with gonorrhea.)

As with women, In about 20-30 percent of the cases the exact cause of the urethritis may never become known. It just seems to happen.

As you can see, it takes a little detective work on the part of the doctor to find the precise source of your problem. But now that an examination and tests have been completed, your physician has a pretty good idea of what it is and has tailored a treatment regimen just for you. The important thing is to treat the disease adequately to prevent recurrence. To help achieve that:

1. Take your medication as prescribed for as long as prescribed. One of the most common causes of recurrent flare-ups of urethritis is inadequate treatment. Sometimes medication will relieve symptoms within hours, and it is easy to conclude that you are well and can stop taking your medication. Don't be fooled! As was discussed earlier, germs have many places to hide" In the urethra, and it takes a minimum of five days and as many as fourteen days to eradicate them completely. To avoid flare-ups, follow your prescription to the letter.

2. Return for your next appointment. Your doctor may have asked to see you again in a week or so. Indeed, you may have to return for periodic follow-up examinations for several months. This is to make sure you are thoroughly cured and, if not, to institute further treatment measures. Again, because you feel well, do not be tempted to skip an appointment.
3. Do not be discouraged if you think you are not getting better. As mentioned, there are a number of cases of urethritis for which the cause is not clear, and your doctor may have to try several approaches before the right one is found. Talk to your doctor and be patient.

IF YOU ARE A MAN.

There is little extra you need to do other than follow your physician's directions. Strict attention to personal hygiene is, of course, always necessary.

Personal hygiene is especially important in helping to prevent bacteria from entering your urethra:

3. Feminine hygiene deodorants. They are unnecessary and can be harmful.

Douche only when directed to do so Under normal circumstances the vagina cleans itself very efficiently. Douching is generally unnecessary and may even cause damage. In some circumstances, however, your physician may recommend a douche. If so, be sure you use only the douche solution he or she recommends, because some commercial preparations may do more harms than good.

The chances are good that your urethritis will clear up soon. The challenges to you to adopt the simple measures that will help prevent recurrence. Drink plenty of liquids and urinate frequently. Remember the rules of personal hygiene, take your medicine regularly, and keep your doctor appointments. This will make you a good patient and better still a healthy one.