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  6. Non-Gonococcal Urethritis (NGU) (955)

Non-Gonococcal Urethritis (NGU) (955)

We try to get an objective diagnosis of NGU using Gram-stain microscopy of urethral sample combined with NAAT testing for gonorrhoea, chlamydia and Mycoplasma genitalium

Many people presenting with proven urethritis will not have a clear microbiological cause found. At present the specialty does not support further testing for organisms that are not clearly known to be pathogens.

Testing for M. genitalium will be requested after microscopy on all laboratory-proven cases of NGU and is done at the West of Scotland Specialist Virology Centre. We adopt ‘resistance-guided therapy’ if M. genitalium detected: see separate guideline

It is reasonable to defer treatment while awaiting results in selected situations.

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Editorial Information

Last reviewed: 30/10/2025

Next review date: 30/09/2026

Author(s): Kay McAllister.

Version: 4

Author email(s): kay.mcallister2@nhs.scot.

Approved By: Sandyford Governance Group

Document Id: 955

References

2015:  BASHH Clinical Effectiveness Group. 

UK National Guideline on the Management of Non-gonoccocal urethritis

Horner PJ, Blee K, Falk L, van der Meijden W, Moi H.  

Available at:

https://www.bashhguidelines.org/current-guidelines/urethritis-and-cervicitis/ngu-2015/  [accessed 15/09/2025] 

Please ensure the published guideline is read with the Nov 2018 update here:

https://www.bashhguidelines.org/media/1199/ngu-bashh-update-2018.pdf [accessed 15/09/2025]

Horner PJ et al should we be testing for urogenital Mycoplasma hominis, Ureaplasma parvum and U. urealyticum in men and women? – a Position Statement from the European STI Guidelines Editorial Board

Available at https://iusti.org/wp-content/uploads/2019/12/UrogenitalMycoplasmas.pdf [accessed 18 Sep 2023]