Male Genital Mycoplasma Infection: Symptoms, Diagnosis, and Treatment

Genital mycoplasma infection in men, commonly referred to as non-gonococcal urethritis (NGU), is one of the most prevalent sexually transmitted infections (STIs) worldwide. In fact, it surpasses gonorrhea in incidence rates and ranks as the leading cause of urethral inflammation among STIs. This condition primarily spreads through unprotected sexual contact and typically develops 1 to 5 weeks after exposure.

Common Signs and Symptoms

Men infected with genital mycoplasma often experience a range of urinary and genital discomforts. The most frequently reported symptoms include itching or burning sensations in the urethra, painful urination (dysuria), and the presence of a small amount of clear or whitish discharge. In some cases, the discharge may be so minimal that it only appears as slight crusting at the tip of the penis or minor staining on underwear—often noticed upon waking in the morning.

Complications and Associated Conditions

If left untreated, mycoplasma can spread beyond the urethra and affect other parts of the male reproductive system. A notable complication is acute epididymitis—an inflammation of the epididymis—which can lead to swelling, tenderness, and pain in the scrotum. Chronic or recurrent infections may impair sperm function and contribute to male infertility, making early detection and treatment crucial.

In addition to localized symptoms, patients may also report increased urinary frequency, urgency, and persistent discomfort during urination. These signs are often mistaken for a simple bladder infection, which can delay accurate diagnosis.

Diagnosis Through Laboratory Testing

Accurate diagnosis of mycoplasma infection relies heavily on laboratory analysis. Routine urine tests may reveal elevated levels of white blood cells, indicating an active infection. More specifically, a urethral swab examined under a microscope typically shows 10–15 polymorphonuclear leukocytes per high-power field—a key diagnostic clue.

While direct visualization of mycoplasma inclusion bodies is rare, advanced testing methods such as nucleic acid amplification tests (NAATs) or culture techniques are increasingly used to confirm the presence of Mycoplasma genitalium or related species with greater accuracy.

Effective Treatment Options

Antibiotic therapy remains the cornerstone of treatment for genital mycoplasma infections. Macrolide antibiotics—such as azithromycin and erythromycin—are commonly prescribed due to their effectiveness against intracellular pathogens. In cases of resistance or persistent symptoms, alternative options like minocycline (a tetracycline-class antibiotic) may be recommended.

Treatment duration and dosage depend on the severity of the infection and individual patient factors. It's essential to complete the full course of medication even if symptoms improve quickly, to prevent recurrence and the development of antibiotic-resistant strains.

Preventing Reinfection and Protecting Partners

One critical aspect of managing this infection is ensuring that all sexual partners are evaluated and treated simultaneously. This approach minimizes the risk of reinfection and helps break the cycle of transmission. During treatment, abstaining from sexual activity or using barrier protection (e.g., condoms) is strongly advised.

Regular screening for STIs, practicing safe sex, and maintaining open communication with partners are vital preventive strategies. Men experiencing any urinary or genital symptoms should seek medical evaluation promptly to avoid long-term complications.