Nongonococcal urethritis commonly presents with what symptom?

• A. Dysuria with scant urethral discharge
• B. Thick, purulent urethral discharge
• C. Severe flank pain
• D. No symptoms at all

Answer: (A)

Nongonococcal urethritis is typically due to organisms like Chlamydia trachomatis or Mycoplasma genitalium. The most common presentation is irritation of the urethra with painful or burning urination (dysuria) accompanied by a small amount of urethral discharge. The discharge tends to be scant rather than thick and purulent, which helps distinguish NGU from gonococcal urethritis, where a thick, purulent discharge is more characteristic. Severe flank pain points away from urethritis and suggests kidney or upper urinary tract involvement, which is not the usual scenario for NGU. While some infections can be asymptomatic, the classic teaching is dysuria with scant discharge as the typical presentation.