Gleet is a medical term describing a persistent discharge originating from the urethra, the tube that carries urine out of the body. This symptom is not a diagnosis but a physical manifestation of an underlying, often chronic, inflammatory process. Although the word “gleet” is somewhat archaic, the condition—a chronic, low-grade urethral discharge—signals the need for medical investigation. This lingering symptom suggests an initial infection or inflammatory condition has not been fully resolved.
Defining Gleet: Characteristics and Historical Context
Gleet is characterized by a thin, clear, or whitish discharge that is non-purulent, meaning it lacks the thick, yellow-green appearance of acute infection. The volume is usually scanty, often noticed as slight moisture or sticky residue on the urethral opening. Patients frequently observe this mild discharge first thing in the morning before the first urination, as the overnight accumulation becomes visible.
The term dates back to the 14th century and was historically associated with chronic gonorrhea, often called “the running gleet.” It represented a late stage where the acute, heavy discharge subsided, but inflammation and the infectious agent persisted. This lingering discharge signaled that the infection had not been completely cleared. Modern medicine maintains this concept: gleet is a persistent discharge caused by chronic inflammation (urethritis).
Identifying the Underlying Causes
Gleet is a symptom of chronic urethritis, which is inflammation of the urethra that has failed to resolve. The most common causes are infectious, specifically Non-Gonococcal Urethritis (NGU), meaning the infection is not caused by Neisseria gonorrhoeae. Pathogens such as Chlamydia trachomatis are frequent culprits, especially if the initial infection was not fully treated.
Other microorganisms, including Mycoplasma genitalium and Ureaplasma urealyticum, contribute to persistent urethritis. These organisms can be difficult to eradicate with standard antibiotics, leading to chronic, low-level inflammation. Symptom persistence often indicates an incomplete treatment regimen or the presence of an antibiotic-resistant strain.
Non-infectious factors can also cause the chronic irritation resulting in gleet. Mechanical irritation from repeated trauma, such as aggressive sexual activity or long-term use of indwelling catheters, causes inflammation. Anatomical issues like urethral strictures (narrowings of the urethra) impede urine flow, leading to chronic irritation or stagnant residue. Chemical irritants, such as certain spermicides or soaps, may also cause localized inflammation.
Medical Evaluation and Treatment Protocols
A medical evaluation begins with a physical examination and a detailed history. To identify the specific cause, providers rely on laboratory testing, typically using a first-catch urine sample. This sample, collected before the main stream of urine, contains urethral cells and discharge material used for molecular testing.
Nucleic Acid Amplification Tests (NAATs) are the preferred method for detecting infectious agents like Chlamydia trachomatis, Neisseria gonorrhoeae, Mycoplasma genitalium, and Trichomonas vaginalis. Identifying the exact pathogen is necessary because treatment must be tailored to the organism, especially due to antibiotic-resistant strains. For non-infectious causes, diagnostic procedures may include a cystoscopy, where a small camera visualizes strictures or structural abnormalities.
If an infectious cause is confirmed, treatment involves specific antibiotics, such as Doxycycline or Azithromycin, or a combination of agents. For urethral strictures, surgical intervention like dilation or urethroplasty may be required to resolve mechanical irritation. Follow-up testing, known as a “test of cure,” is a crucial step to ensure the infection is fully cleared and the chronic inflammatory process has ceased.