Does Syphilis Cause Urinary Problems?

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Key Takeaways:

  • Syphilis and neurosyphilis damage the CNS, leading to dysfunctional bladder signaling.
  • Urinary urgency, frequency, dysuria, incomplete bladder emptying, and neurogenic bladder may all be caused by syphilis.

While syphilis has long been associated with symptoms like sores and rashes, the impact of this infection on the urinary system is a relatively unexplored aspect.

Syphilis can lead to dysfunctional bladder signaling, resulting in urinary issues. Learn how this can occur and which treatment options are available.


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What Is Syphilis?

Syphilis is a sexually transmitted infection (STI) that develops in different stages. You may contract syphilis from direct contact with another person who has a syphilis sore during vaginal, anal, or oral sex. It may spread from a mother to her unborn baby. Syphilis can also be contracted through sharing needles with a person who has the infection.

Symptoms of Syphilis

The first symptom of syphilis is typically a painless sore on the genitals.

A rash appears in the second stage, typically on the palms of the hands and soles of the feet. The rash is seen relatively quickly after the sore on the genitals heals, and can be accompanied by flu-like symptoms, such as:

  • Fever
  • Sore throat.
  • Enlarged lymph nodes.
  • Headache
  • Fatigue

The third and final stage occurs years later and affects multiple organ systems in the body, which can be fatal.

What Is Neurosyphilis?

When left untreated, syphilis can turn into a life-threatening infection that affects the central nervous system (CNS) known as neurosyphilis. With neurosyphilis, the bacteria that cause syphilis, called treponema pallidum, cover the brain and spinal cord. If left untreated, neurosyphilis may cause dementia, paralysis, and death. 

Symptoms of Neurosyphilis

There are 2 stages of neurosyphilis. In the first stage of neurosyphilis, you may experience symptoms, such as:

  • Headache
  • Nausea and / or vomiting.
  • Stroke and / or seizure.
  • Immobility
  • Numbness in the legs, feet, and toes.
  • Confusion
  • Depression
  • Loss of bladder control (urinary incontinence).

During the second stage of syphilis, you may experience symptoms, such as:

  • Personality changes.
  • Altered mood.
  • Nerve pain.
  • Immobility
  • Loss of bladder control (urinary incontinence).

Can Syphilis Cause Urinary Symptoms?

Syphilis and neurosyphilis affect the genitourinary system through damage to the CNS and spinal cord nerves. This damage leads to dysfunctional bladder nerve signaling and can cause urinary symptoms, such as:

  • Incomplete bladder emptying.
  • Neurogenic bladder.

The damage to the nervous system can also cause sexual health concerns with erectile dysfunction (ED), decreased arousal in women, and inhibited orgasm or anorgasmia for all genitals.

Structural damage may occur at the kidneys, leading to protein, toxins, or blood in the urine, which will make the urine appear darker. Structural changes in the CNS system will cause disruption to the nerve function to the bladder leading to long-term urinary concerns.

It is very rare, but syphilis can also cause urethritis. Urethritis occurs when the tube that drains your urine from your bladder becomes sore or swollen. A side effect of urethritis may be dysuria (painful urination).

When to See a Doctor

If you have any symptoms related to syphilis, visit your healthcare provider right away to be tested. A thorough history should be taken by your healthcare provider to investigate if you are at higher risk of contracting syphilis. 

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Any change in urinary function should be evaluated by a urology provider or reproductive care specialist. Recurrent urinary symptoms with negative urine cultures should be questioned by your healthcare provider and they should take screenings.

Treating Urinary Symptoms & Syphilis

A urinalysis, post-void residual, urine cultures, and microscopic urinalysis are great starting diagnostic tests for urinary symptoms and suspected syphilis. A blood test screening for syphilis is also important, and with the rise of syphilis cases in the United States, offering screenings more often is imperative to decreasing the number of cases.

You should aim to receive treatment as soon as possible once you’re diagnosed with urinary incontinence. The longer the delay, the more permanent the neurological urinary symptoms can become.

If treated early, syphilis may be cured by penicillin injections.

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Aleece Fosnight

Aleece Fosnight, MSPAS, PA-C, CSC-S, CSE, NCMP, IF, HAES is a Medical Advisor and Writer for Aeroflow Urology and a board-certified physician assistant specializing in sexual medicine, women’s health, and urology. In 2019, she opened up her own private practice, the Fosnight Center for Sexual Health, and implemented the sexual health grand rounds curriculum at her local hospital and residency program.

Aleece is also the founder of the Fosnight Foundation, a non-profit organization dedicated to the education and training of professionals in the sexual health field and providing funding for access to healthcare services in her local community.

About the Author

Marlee Septak is the Senior Content Specialist at Aeroflow Urology. She brings a deep understanding of incontinence and health conditions associated with it to her writing. She graduated from Columbia College Chicago and holds a Bachelor's degree in Journalism. Marlee has contributed to various magazines and blogs, including Borgen Magazine, Echo Magazine, Chicago Ideas Week, Assuaged, and Peaceful Dumpling. In her spare time, she enjoys traveling, trying new restaurants, and just sitting down with a good book.


Urethritis. (2017, October 23).

‌Sexually Transmitted Infections Surveillance, 2022. (2024, January 29).


Information provided on the Aeroflow Urology blog is not intended as a substitute for medical advice or care from a healthcare professional. Aeroflow recommends consulting your healthcare provider if you are experiencing medical issues relating to incontinence.