In men urethritis usually shows itself sooner than in women. The classic combination is burning urination plus discharge from the urethra, and that discharge is often visible. Chlamydia and gonorrhoea are the best known causes, yet in a sizeable share of men the lab finds neither (Jordan, 2020).
That last part is what this article is really about.
A negative result with persistent symptoms feels like a dead end. It is not. Below you will read which symptoms fit urethritis, which causes play a role, and what a sensible next step looks like.
What does urethritis feel like in men?
Usually a burning or sharp feeling in the urethra while urinating, sometimes with itching or irritation at the opening. There can also be discharge: clear, whitish or yellowish. Some men mainly notice a tender urethra without clear pain.
One detail gets overlooked a lot.
Discharge is typically most visible just before the first urination of the day, because nothing has washed it away overnight. Anyone who only checks during the day can easily miss a drop. That is not a diagnosis, but it is a concrete thing to watch for before you sit down with your GP.
Symptoms can also be absent entirely. Chlamydia often runs silently, which we covered in STIs without symptoms.
What causes urethritis in men?
Usually a sexually transmitted bacterium. Chlamydia and gonorrhoea top the list and both sit in a standard STI panel. Alongside them, mycoplasma genitalium and, less often, trichomonas can play a role. Sometimes there is no infection and it comes down to irritation or a skin problem.
The colour of the discharge gives a direction, not an answer.
| What you see or feel | More often fits | In a standard panel |
|---|---|---|
| Clear yellowish discharge, firm pain on urination | Gonorrhoea | Yes |
| Little or clear discharge, mild symptoms | Chlamydia | Yes |
| Persistent symptoms after a negative test | Mycoplasma genitalium | No |
| Redness and itching mainly on the glans | Candida or irritation | No, not an STI |
This table helps you prepare the conversation. Telling them apart is a test's job, not a colour's.
When should you get checked?
With symptoms that fit urethritis, a targeted test for chlamydia and gonorrhoea is the usual first step. Those are the causes found most often. Both have a clear treatment route. Even without symptoms, testing can make sense after unprotected contact with a new partner.
Timing matters here.
Every test needs a window before a cause becomes detectable. Testing too early can produce a negative result while something is going on. Which window fits which infection is covered in which test you need when.
You can get checked with us through a test for chlamydia, gonorrhoea and trichomonas, without an appointment and without anything reaching your GP records.
What if the STI test is negative and symptoms persist?
Then that is a familiar scenario, not an exception. Research into non-gonococcal urethritis shows several causes are regularly involved at once, and that in a share of men no known cause is identified at all (Jordan, 2020). A clean result does not rule symptoms out.
Picture two men aged 24 getting tested after the same risk. One tests after 3 days, the other after 3 weeks. Both get a negative result, but the first one says far less.
That difference in timing is what we've found missing most often in the questions we get.
There are three explanations you can walk through with your GP.
You tested too early. Or the cause was not in the panel, where mycoplasma genitalium is the textbook example: an established STI that is not routinely tested for in the Netherlands, ours included (Jensen, 2022). Or there is no infection and the symptoms come from irritation.
For the related bacteria you meet in broad commercial panels, such as ureaplasma, routine testing is actually advised against (Horner, 2018). More on that in ureaplasma urealyticum.
What should you not do yourself?
Do not use leftover antibiotics from the cupboard. With mycoplasma that is one of the ways resistance develops, and then a second treatment gets harder than the first. That story is in mycoplasma genitalium treatment.
Also skip the extra vigorous washing.
Soap and heavy scrubbing irritate the urethra and the glans, and can restart symptoms that were just settling. The Dutch GP standard on the STI consultation describes how GPs in the Netherlands look at these complaints. Thuisarts.nl explains in plain language what to expect with pain on urination.
If it keeps going, have it reassessed rather than repeating the same step.
Further reading
For the full overview of causes and tests: urethritis. For the STI a standard panel does not measure: mycoplasma genitalium.
For the wider symptom picture in men: STI symptoms in men and chlamydia in men.
References
- Jordan SJ, et al. Aetiology and prevalence of mixed-infections and mono-infections in non-gonococcal urethritis in men: a case-control study. Sexually Transmitted Infections, 2020. PMID 31515293.
- Jensen JS, et al. 2021 European guideline on the management of Mycoplasma genitalium infections. Journal of the European Academy of Dermatology and Venereology, 2022. PMID 35182080.
- Horner P, et al. Should we be testing for urogenital Mycoplasma hominis, Ureaplasma parvum and Ureaplasma urealyticum in men and women? A position statement from the European STI Guidelines Editorial Board. Journal of the European Academy of Dermatology and Venereology, 2018. PMID 29924422.
- NHG-Standaard Het soa-consult, Dutch College of General Practitioners. Accessed July 2026.
- RIVM, Sexually transmitted infections in the Netherlands, annual report. Accessed July 2026.
- Thuisarts.nl, Pain when urinating. Accessed July 2026.
Every test result includes a professional assessment from a BIG-registered doctor. For treatment decisions, discuss your results with your GP.
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