Urethritis and Prostatitis in Men after Oral Sex: Pain and Burning in Penis and Urethra

Urethritis, Prostatitis from Oral Sex

by Alex Shteynshlyuger MD

If you have any questions, to schedule a consultation or if you need a second opinion, please contact us or call: 646-663-4080

What is Urethritis in Men?

Urethritis refers to inflammation, pain and burning in the urethra before, during or after urination.  In men, this is commonly felt as pain in the penis, as urethra runs on the underside of the penis. Urethritis is most often caused by an infection. Bacterial infections are most common but viral urethritis can also occur. Non-infectious urethritis can also occur but is believed to be fairly rare.

What is the Difference Between Urethritis and Prostatitis?

Urethritis and prostatitis are related and commonly occur together.  Urethritis and prostatitis are different types of UTIs (urinary tract infection).  Often, it is difficult to distinguish urethritis from prostatitis as symptoms are very similar.  Urethritis refers to inflammation often caused by infection of the urethra, and prostatitis refers to inflammation often caused by an infection of the prostate. Because urethra and prostate are next to each other, inflammation of either one can cause similar symptoms.  Typically, prostatitis causes more severe symptoms and suggests a more severe infection.  With severe infection, the prostate is often tender when examined.

Oral Sex and Urinary Problems

Oral Sex UTI and UrethritisUrinary problems are not uncommon after oral sex.  Most commonly men experience mild urethritis that often disappears spontaneously within a few hours to a day. The symptoms include mild urethral discomfort and burning in the penis.

Urethritis may be caused by a sexually transmitted infection that clears after urination.  Urethritis may also be caused by an allergic reaction to saliva for example.

In some cases, urethral irritation, pain, and discomfort do not disappear after one day and symptoms become more severe.  Men may experience difficulty urinating, frequent urination, severe pain and burning during urination and may also experience pain in the lower abdomen, bladder area as well as near the rectum and the prostate.  These symptoms are caused by a type of urinary tract infection (UTI) affecting the urethra (urethritis), urinary bladder (cystitis) and the prostate (prostatitis).

Bacterial organisms in the mouth are often not easy to identify and culture in a lab.  They are also not the usual type of bacteria that is typically associated with urethritis and UTI in men.   As a result, occasionally men may develop severe symptoms of urethritis and prostatitis after oral sex (blowjob), which do not respond to typical therapy for UTI and prostatitis.

What is the Cause of Urethritis and Prostatitis after Oral Sex?

At New York Urology Specialists, we commonly see men with urethritis that failed initial treatment, especially when the route of the acquisition was associated with oral sex.

Mouth is a Beehive of Bacterial Infections

More than 500 species of bacteria can be found in a human mouth.  Close to 100 species can be identified in each individual.   Because of differences in anatomy and tissues, antibiotics used by dentists for treatment of oral infections may not be effective when these bacteria infect the urinary tract (urethra, bladder, prostate, and epididymis)

Based on DNA studies, more than half of the bacterial species found in the mouth are not yet identified or commonly grown when the tissue (urine, saliva) is cultured in a lab.    It is not surprising then that urine culture may not grow anything even when there is a severe infection.

In addition to typical antimicrobial antibiotics, broad-spectrum antibiotics with coverage for oral bacteria which often include anaerobic organisms should be used.

What You Should Know

Despite the fact that many bacteria live in the mouth, severe infections after oral sex are fairly uncommon.  In general oral sex is considered to be fairly safe, in general at least as safe as vaginal sex.

Effective treatment for UTIs caused by oral sex including urethritis and prostatitis are available.

If you have any questions, to schedule a consultation or if you need a second opinion, please contact us or call: 646-663-4080

Dr. Alex Shteynshlyuger is a board-certified urologist in NYC who specializes in treating men and women with frequent urinary tract infections (UTI). He specializes in all aspects of care for frequent urinary tract infections in men and women involving the bladder, urethra, and kidneys. 

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