Recurrent or persistent urethritis assessment

What is a recurrent or persistent urethritis assessment?

Urethritis means inflammation of the urethra, the tube that carries urine out of the body. It often causes discharge, a burning feeling when passing urine, or irritation at the tip of the penis. When no gonorrhoea is found, it is called non-gonococcal urethritis (NGU).

Most urethritis settles with a first course of treatment. Sometimes symptoms do not go away (persistent) or come back after improving (recurrent). This assessment is for those situations. It looks again at the cause, checks whether the infection was fully treated, considers reinfection from an untreated partner, and tests for organisms such as Mycoplasma genitalium, which is a common cause of persistent and recurrent symptoms.

The assessment confirms there really is ongoing inflammation, usually by looking at a sample under a microscope, and uses urine tests and swabs to identify a cause. It does not treat the problem by itself, but it directs the right treatment and avoids giving repeated antibiotics blindly.

It is also a chance to consider non-infectious causes of similar symptoms and to make sure nothing more serious is being missed.

Types, options & approaches

There may be different ways to do this. The right approach depends on the clinical question and your circumstances.

Options at a glance

These are the main approaches described in this guide. The right option depends on the diagnosis, your goals and what your clinician thinks is safe.

Preparing for your test

• Try not to pass urine for at least 1–2 hours before the appointment, as a recent wee can affect the sample — check what the clinic prefers.
• Bring details of any previous treatment, including what you were given and whether you finished it.
• Note when symptoms started, whether they fully went away, and when they came back.
• Think about recent sexual partners, as they may need testing and treatment.
• Avoid sex, or use condoms, until you have been reassessed, to avoid passing on or catching infection.
• List any other medicines, allergies and recent antibiotics.
• Mention any symptoms such as joint pain or eye irritation, which can occasionally go with urethritis.

What happens

The clinician asks about your symptoms, previous treatment and sexual history. With your consent, they examine the area and usually take a sample — a small urethral swab or a first-pass urine sample (the first part of your wee).

A sample is often looked at under a microscope at the visit to confirm there is still inflammation. Urine and swab tests are sent to the laboratory to look for chlamydia, gonorrhoea and Mycoplasma genitalium, and a wider sexual health screen is usually offered.

The clinician explains what they think is happening and may start or change treatment based on the likely cause, then refine it when results return. They will discuss partner testing and treatment, and arrange follow-up if needed.

Is this test right for me?

A good consultation should explore whether it's the right choice for you now — including reasons to wait or consider something else.

Before you decide

Use this as a shared-decision checklist. The aim is not just “can this be done?”, but whether it is right for you, now, with the risks and alternatives clearly understood.

The main pitfall is being given course after course of antibiotics without confirming there is still inflammation or identifying the cause. Persistent symptoms are not always due to ongoing infection. Ask whether your inflammation has been confirmed, whether Mycoplasma genitalium has been tested for (with resistance testing if positive), and whether reinfection has been considered.

Published figures to discuss

How often persistent or recurrent urethritis resolves depends on the cause, whether partners were treated, and antibiotic resistance, particularly for Mycoplasma genitalium. Because figures vary widely between studies and populations, we describe causes and outcomes in qualitative terms rather than quoting precise percentages.

These are literature figures, not a personalised prediction. Your own risks and likely benefits depend on your circumstances, your health, and how your care is carried out and followed up.

What happens afterwards

There is no physical recovery from the assessment itself. "Afterwards" means starting or adjusting treatment, waiting for results, and knowing when symptoms should settle.

• Brief stinging after a urethral swab that soon settles
• Symptoms easing over days once the right treatment is given
• A wait of a week or two for some laboratory results
• Mild side effects from antibiotics, such as tummy upset

Aftercare

• Take any treatment exactly as directed and complete the full course.
• Avoid sex, including oral sex, until you and any partner have completed treatment and any advised waiting period.
• Ensure recent partners are tested and treated to prevent reinfection.
• Attend for any test of cure or follow-up advised, especially for Mycoplasma genitalium.
• Avoid alcohol if you are on an antibiotic that interacts with it — ask the clinician.
• Go back if symptoms persist, recur, or new symptoms such as joint or eye problems appear.
• Keep using condoms with new partners to reduce future infections.

• A record of previous treatments and whether you completed them
• A note of recent sexual partners who may need contacting
• Your current medicines and any allergies
• Plans to avoid passing urine for 1–2 hours before the appointment
• Questions about Mycoplasma genitalium and resistance testing
• The clinic's contact route for results and follow-up

⚠ Get urgent help if…

• Fever, or pain and swelling in the testicles or scrotum
• Severe pain passing urine, or being unable to pass urine
• Blood in the urine or heavy discharge
• Lower tummy or pelvic pain
• Joint pain, eye redness or a rash alongside urethritis
• Symptoms that keep returning despite treatment and partner treatment
• Any sore, ulcer or lump on the genitals

Who to contact: your clinician, clinic or test provider first (keep their number to hand). For urgent advice when you can't reach them, call NHS 111. In an emergency, call 999.

General guidance — it doesn't replace the specific advice your specialist gives you.

Results & realistic expectations

A useful result either confirms a treatable cause — such as Mycoplasma genitalium or reinfection with chlamydia — or shows that, despite symptoms, there is no ongoing inflammation or infection, which changes the approach. Resistance testing for Mycoplasma genitalium helps choose an antibiotic that will actually work.

A negative set of results does not always mean nothing is wrong; it may point to a non-infectious cause or to reinfection that has since cleared. Results are always interpreted alongside your symptoms and the microscopy, not in isolation.

An assessment reflects your situation at the time. Urethritis can return, particularly with reinfection from an untreated partner or a new partner. Using condoms and ensuring partners are treated reduces the chance of recurrence. If symptoms come back, the cause may need confirming again rather than assuming it is the same.

Related tests, treatments or support

This assessment is usually combined with a full sexual health screen, including chlamydia, gonorrhoea, HIV and syphilis testing, because infections often occur together. Partner notification is part of the same pathway.

Follow-up & long-term care

Follow-up depends on the cause. For Mycoplasma genitalium, a test of cure is usually advised a few weeks after treatment. For persistent symptoms with no infection found, review focuses on other causes and avoiding unnecessary antibiotics. You should return if symptoms persist or recur.

• Use condoms with new or casual partners to lower the risk of reinfection.
• Make sure partners are tested and treated before resuming sex.
• Attend any test of cure advised, particularly for Mycoplasma genitalium.
• Seek early review if symptoms return rather than self-treating repeatedly.

Repeat, follow-on and what comes next

• Treatment may need changing if Mycoplasma genitalium resistance is found or symptoms persist.
• A test of cure is often needed for certain infections to confirm clearance.
• If no infection is found, the focus shifts to other causes rather than further antibiotics.
• Reinfection from an untreated partner may mean repeating tests and treatment.

Ask what happens if the result is unclear or needs repeating, and what is included if further tests or follow-up are needed.

What good aftercare looks like

• Microscopy to confirm inflammation before further antibiotics, and clear results communication.
• Targeted treatment with a test of cure where appropriate, especially for Mycoplasma genitalium.
• Confidential partner notification and treatment.
• A named contact route and a plan for what to do if symptoms persist or recur.

What affects the cost

Costs vary a great deal between people and providers, and we don't publish prices. What matters is understanding what drives the cost and making sure your quote is complete. The main things that affect it:

• The length and complexity of the appointment
• Microscopy at the visit to confirm inflammation
• Tests for chlamydia, gonorrhoea and Mycoplasma genitalium, plus resistance testing
• A wider sexual health screen if offered
• Any test of cure and follow-up appointments
• Antibiotics, if prescribed
• The clinician's fee and clinic facility fee

• The consultation and examination fee
• Which tests are included, including Mycoplasma genitalium and resistance testing
• Whether microscopy is done on site
• Whether medicines are included or prescribed separately
• The cost of a test of cure and follow-up appointments
• What happens, and what it costs, if results are inconclusive or symptoms persist

On the NHS? Assessment and treatment are available free on the NHS through sexual health (GUM) clinics, which can also test partners; private care may be used for speed or privacy.

You're entitled to your total cost in writing — including reports, follow-up and what happens if the result is inconclusive — before you decide.

Consent traps and marketing red flags

These are not small details. They are often where patients lose choice, time to reflect, or realistic expectations.

Choosing a specialist safely

• Check the specialist is on the GMC Specialist Register for this area.
• Make sure they work at a CQC-registered service, and look for membership of the relevant Royal College or professional body.
• You're entitled to time to consider and to have your questions answered before you agree — the specialist who looks after you should explain it, not a salesperson.
• Be wary of pressure: time-limited offers or deposits taken before you've had time to think are red flags, not bargains.
• You're entitled to your total cost in writing — including any follow-up — before you decide.

How Vuemedics verifies every consultant →

Take this to your consultation. A good specialist will welcome every one of these.

• Has my ongoing inflammation actually been confirmed, for example under the microscope?
• Have I been tested for Mycoplasma genitalium, and if positive, for antibiotic resistance?
• Could this be reinfection, and have my partners been treated?
• Should I have a test of cure, and when?
• If no infection is found, what else could be causing my symptoms?
• What should I do if symptoms keep coming back?
• Are you on the GMC Specialist Register for this area, and which Royal College or professional body are you a member of?
• Will you be the specialist who carries out my test, and who looks after me afterwards?
• What are the risks for someone like me, and how often do your own patients have a problem or need it repeated or redone?
• What does a realistic result look like — and what can this test not achieve?
• What are my options, including waiting, doing nothing for now, or choosing a different approach?
• Can I have written information, results and aftercare instructions in a format I can use, including any accessibility or communication support I need?
• What is the total cost in writing, including any follow-ups, and how much time do I have to decide?

Find a verified specialist for recurrent or persistent urethritis assessment

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How we made this page

Medically reviewed by a GMC-registered consultant. Written in plain English, checked against NHS, NICE, GMC and relevant Royal College / specialist-society guidance, and kept under review. No clinic paid to appear on this page, and we publish no pricing. This is general information to help you prepare — it is not a substitute for advice from your own clinician. How we review our guides →

Source hierarchy: UK regulator and NHS/NICE guidance first, then relevant Royal College or specialist-society guidance, then peer-reviewed evidence for procedure-specific figures where available.

Sources & standards: BASHH — National Guideline on the Management of Non-gonococcal Urethritis (2026) BASHH — National guideline for the management of Mycoplasma genitalium (2025) NHS — Non-gonococcal urethritis (NGU) NICE CKS — Chlamydia (uncomplicated genital)

Reviews reflect patients' experience of care, not clinical outcomes. For procedure volumes and outcome data see PHIN.

Last medically reviewed 2026-09-21. Spotted something wrong or out of date? Report an error in this guide.