Best STD Specialist for Urethritis in Kathmandu Gonococcal vs. Non-Gonococcal — Resolved
Urethritis — inflammation of the urethra — is almost always an STI, and the bacterial cause determines the treatment. Thamel Clinic distinguishes gonococcal from non-gonococcal urethritis correctly, including the mycoplasma that routine panels miss.
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Reviewed by: STD Specialist (MBBS, MD - Medicine)
NMC Registration:
Last medical review: June 1, 2026
This content follows evidence-based medical guidelines and is regularly updated to reflect current medical practices.
Urethritis Mis-Management
- Treated as UTI — bladder antibiotics that miss urethral STIs.
- Gonorrhea assumed — chlamydial NGU never tested.
- Mycoplasma never checked — persistent NGU without the organism identified.
- Recurrent NGU unexplained — partner untreated, or non-infectious cause missed.
The Urethra's Infection Categories
Urethritis divides into two categories with different organisms and different treatment: gonococcal urethritis (gonorrhea — classically purulent discharge) and non-gonococcal urethritis (NGU) — the larger category caused by chlamydia, mycoplasma genitalium, trichomonas, ureaplasma, herpes and others. The distinction is clinical plus laboratory — and it determines which antibiotic is correct.
NGU is where diagnosis fails most often: standard urine culture misses mycoplasma entirely, urethral discharge is subtler than gonorrhea's, and persistent NGU after treatment is the classic "urethritis that will not clear." The under-tested pathogens — M. genitalium especially — are a specialist's territory.
This page covers the urethritis categories, the causative organisms, and the treatment per organism.
The Urethritis Types
Gonococcal (gonorrhea)
Purulent discharge, more symptomatic — ceftriaxone treatment, resistance-aware.
Chlamydial NGU
Commonest NGU — mucoid discharge; doxycycline first-line.
M. genitalium
Persistent NGU cause — resistance-aware macrolide or extended doxycycline; needs PCR.
Trichomonas/ureaplasma
Less common NGU causes — identified on extended panels.
Non-infectious
Irritative and inflammatory causes — diagnosed after infection excluded.
The Urethritis Workup
- First-catch urine or urethral swab PCR — GC/CT/trichomonas/mycoplasma.
- Urine culture alongside where indicated.
- Partner and symptom-site history.
- Persistent cases — extended pathogen panel, resistance consideration.
Complications to Screen
- Epididymitis — testicular pain/swelling.
- Prostatitis — perineal/rectal symptoms.
- Reactive arthritis — joint/eye symptoms after urethritis.
- Ascending infection — pelvic symptoms in women.
Urethritis Services & Costs
| Service | What It Includes | Cost (NPR) |
|---|---|---|
| Consultation + exam | Urethritis evaluation. | Rs. 450 |
| Urine PCR | GC/CT/trichomonas/mycoplasma. | Rs. 6,000 – 12,000 |
| Treatment | Organism-matched regimen. | Rs. 300 – 1,500 + medicines |
| Partner treatment | Where STI confirmed. | Rs. 450 |
| Persistent-case workup | Extended testing. | Lab rates |
Quoted at consult.
Why Urethritis Resolves Here
- Gonococcal vs. NGU distinguished — the categories separated correctly.
- Mycoplasma included — the pathogen standard workups miss.
- Organism-matched treatment — not empiric guessing.
- Complications screened — ascending infection caught.
- Persistent cases analyzed — systematic failure review.
Frequently Asked Questions
What is urethritis?
Inflammation of the urethra — usually an STI (chlamydia, gonorrhea, mycoplasma, trichomonas); presents with burning, discharge or itch.
Why did my urethritis come back?
Commonest causes: untreated partner, incomplete course, or a missed organism (mycoplasma especially). Persistent cases get systematic analysis.
Can urethritis be non-infectious?
Yes — irritative and inflammatory causes exist and are diagnosed after infection is excluded.
What is M. genitalium?
An increasingly recognized urethritis cause that standard cultures and panels miss — needs specific PCR and resistance-aware treatment.
Still have questions? Contact us or book an appointment for personalized guidance.
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Last Updated: October 19, 2026 |Clinic: Thamel Clinic |Licensed: Registered