Epidemiology

Urethritis is a common condition, accounting for several million clinic visits annually in the US. Chlamydia and gonorrhea are the first and second most common reportable diseases to the Centers for Disease Control and Prevention (CDC). Worldwide, in 2020, there were an estimated 82 million cases of gonorrhea infection and 129 million cases of chlamydia infection, commonly presenting as urethritis in men and cervicitis in women.​[4]​​ 

Chlamydia trachomatis

The most common reportable disease in the US.[5] In 2023, a total of 1,648,568 cases of Chlamydia trachomatis infection were reported.[5] Reported rates of chlamydia were 368.3 per 100,000 and 610.7 per 100,000 for men and women, respectively, in 2023.[5]​ Prevalence rates for both men and women were highest in young adults (ages 15 to 24 years).[5]

An increased incidence of chlamydia in developed countries may be a result of improved screening and/or more sensitive tests.

Gonorrhea

Second most common reportable disease in the US.[5]​ In 2023, a total of 601,319 cases of gonorrhea were reported.[5]​ Higher rates of Neisseria gonorrhoeae infection in men than in women may relate to increased transmission in men who have sex with men.[6][7]

Mycoplasma species and Ureaplasma ​

Implicated in NGU but are also frequent commensals in the urogenital tract. Consequently, their prevalence as disease-causing agents is much more difficult to measure. One study showed that the presence of Mycoplasma genitalium was associated with a 6.5-fold increased risk of urethritis.[8]M genitalium has also been associated with negative pregnancy outcomes and infertility in women.[1]​​​​

Primary herpes simplex virus, Trichomonas, and adenovirus

Generally considered uncommon causes of urethritis in the US. However, in other countries, adenovirus (Australia) and Trichomonas vaginalis (Russia, India, Africa, and South America) may be a more significant cause of urethritis.[9][10][11]

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