Presentation
METHODS: The present study comprised 424 men with symptoms and signs compatible with acute urethritis. Their urethral swabs and first-voided urine underwent detection of the microorganisms. [ncbi.nlm.nih.gov]
Men with Gonococcal urethritis may present with any combination of symptoms [ 12 ]. [omicsonline.org]
Entire Body System
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Unsafe Sexual Practices
The predisposing factors for urethritis are multiple sexual partners, unsafe sexual practices, a current sexually transmitted infection (STI), and recent urethral instrumentation. [infectiousdiseaseadvisor.com]
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Pathologist
Histology for Pathologists, 2nd edn, pp. 1046–1047. Philadelphia: Lippincott-Raven. Thomas, E., Jiang, C., Chi, D. S., Li, C. & Ferguson, D. A., Jr ( 1997 ; ). The role of the oral cavity in Helicobacter pylori infection. [mic.microbiologyresearch.org]
Cardiovascular
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Heart Failure
These effects include the following: congestive heart failure, a condition in which a weakened heart cannot pump blood effectively death from overwhelming sepsis or bloodstream infection endocarditis, which is an infection involving the heart infertility [medicineonline.com]
Eyes
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Eye Pain
Those who have symptoms may notice the following: discharge of pus from the penis eye pain and discharge frequent or painful urination pus-filled discharge from the penis rectal discomfort sore throat Gonorrhea that has spread to other parts of the body [medicineonline.com]
Neurologic
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Tingling
[…] highly transmissible (re-infection common) significant asymptomatic reservoir 50% asymptomatic incubation period ranges from 5-10 days in symptomatic infection, 7-21 in asymptomatic Most common sign/symptom of Chlamydia pain on urination and itch or tingling [quizlet.com]
However, if you have urethritis, you may experience: Pain during urination (Dysuria) Urethral Discharge Pain during intercourse Blood in semen Penile Itching or tingling An increased urge to urinate Increased frequency of micturition. [condom-sizes.org]
Symptoms of urethritis in men typically include urethral discharge, penile itching or tingling, and dysuria. [aafp.org]
Urogenital
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Urethral Discharge
Incubation period: 1 to 10 days or more Clinical findings: (1) dysuria, often described as burning (2) urethral discharge that may be mucoid and/or purulent A small percent of men may be asymptomatic and may go unrecognized. [meducator3.net]
Physical exam of the male may reveal a urethral discharge. Women rarely exhibit any urethral discharge. Tests : A thin urogenital swab is inserted into the urethra to obtain a specimen. [nmihi.com]
In male patients with urethritis, the diagnosis can be made by direct microscopy of stained smears of urethral discharge [ 15 ]. [omicsonline.org]
In males the symptoms are usually obvious with purulent urethral discharge, frequent and painful urination. [chp.gov.hk]
Gonococcal urethritis (GCU) usually presents with severe dysuria and profuse mucopurulent urethral discharge. The external meatus is often erythematous and oedematous. [ijdvl.com]
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Dysuria
Men complain of glassy or purulent discharge from the urethra, Dysuria and burning in the urethra. Women complain of vaginal discharge, dysuria or abdominal pain (sign of progression to pelvic inflammatory disease). [urology-textbook.com]
Patients with gonococcal urethritis usually had symptoms of both dysuria and discharge of short duration; patients with nongonococcal urethritis had variable symptoms of longer duration (P 0.0005). [annals.org]
Incubation period: 1 to 10 days or more Clinical findings: (1) dysuria, often described as burning (2) urethral discharge that may be mucoid and/or purulent A small percent of men may be asymptomatic and may go unrecognized. [meducator3.net]
In another such study discharge was present in 82 percent of cases and dysuria in 53 percent [ 13 ]. [omicsonline.org]
[…] trachomatis and occurring mostly among males as an early symptom of chlamydia. nongonococcal urethritis (NGU) [-gon′əkok′əl] Etymology: L, non Gk, gone, seed, kokkos, berry an infectious condition of the urethra in males that is characterized by mild dysuria [medical-dictionary.thefreedictionary.com]
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Urinary Urgency
If men have prostatic involvement, they may also complain of nocturia and urinary urgency. Common to both sexes is urethral tenderness, erythema, and pruritis. [infectiousdiseaseadvisor.com]
The patient will have dysuria without increases in urinary urgency or frequency helping to differentiate these infections from cystitis. Asymptomatic infections are common. [atsu.edu]
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Painful Ejaculation
- Painful ejaculation. 32. Proctitis – repetitive anal intercourse or by lymphatic spread from posterior urethra. - Rectal pain - Discharge - mucopurrulent - Bleeding 33. Reiter’s syndrome – urethritis - conjuctivitis - arthritis - characteristic [slideshare.net]
Workup
[…] followers Placement of suprapubic tube: In severe cases of urethral trauma that prevent placement of urethral catheters or in the absence of adequate facilities for emergent cystoscopy; temporizing measure to divert urine and relieve patient discomfort See Workup [emedicine.medscape.com]
Urine
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Pyuria
Among patients in whom N. gonorrhoeae was eradicated, pyuria and clinical symptoms, respectively, disappeared in 92.6% (162/175) and 98.9% (173/175) of patients without concomitant C. trachomatis and in 78.6% (22/28) and 71.4% (20/28) with C. trachomatis [ncbi.nlm.nih.gov]
In women – - Cevicitis – mucopurulent cervical discharge - cervical erythema & edema with an area of ectopy - spontaneous or easily induced cervical bleeding - Urethritis – dysuria - frequency - pyuria 36. - Bartholoinitis - Endometritis – abnormal [slideshare.net]
Children with urethritis Sexual abuse must be considered if there are symptoms of unexplained pyuria in prepubertal boys or young males who are not sexually active (see Sexual Abuse in Peripubertal and Prepubertal Children chapter). [canada.ca]
[…] presence of urethral discharge, a positive leukocyte esterase test result in first-void urine, or at least 10 white blood cells per high-power field in first-void urine sediment. 16 If no discharge is present, first-void urine should be tested to document pyuria [aafp.org]
Microbiology
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Gram-Positive Bacteria
Gram-positive bacteria: Enterococci in 15%, Streptococci in 12%, Staphylococcus aureus in 5%. Trichomonas vaginalis: an anaerobic, parasitic flagellated protozoan, rare cause of urethritis ( Uncertain etiology: in 20–30%. [urology-textbook.com]
Treatment
Twenty-eight patients (2.3%) did not respond to treatment; treatment was successful in 1,140 patients (92.7%) after only one dose, and in 62 (5.0%) after two doses. The overall rate of treatment success was 97.7%. [ncbi.nlm.nih.gov]
The Social Hygiene Clinic of Department of Health offers check up, treatment and counseling. A referral is not required, and all information are kept confidential. You should follow medical advice on treatment. [chp.gov.hk]
Prognosis
Prognosis NGU is completely curable with proper antibiotic treatment. Untreated, NGU can lead to sterility in both men and women, inflammation of the mouth of the uterus, and infections of the woman's internal sexual organs. [medical-dictionary.thefreedictionary.com]
Prognosis is typically very good if the diagnosis is made early and treated properly. [infectiousdiseaseadvisor.com]
What Is the Prognosis for Urethritis? When treated early, simple urethritis has few complications. If allowed to progress, you may develop a bladder infection, kidney infection, or infection involving your testicles or prostate. [emedicinehealth.com]
Prognosis If gonococcal urethritis is diagnosed and treated quickly and correctly, there usually is complete recovery. [drugs.com]
Prognosis All patients with uncomplicated urethritis spontaneously recover with or without treatment. [emedicine.medscape.com]
Etiology
Navy, and the University of Washington; and a review of case-control studies of the etiology of NGU, conducted in London and Seattle. [link.springer.com]
Thus, the notion that NGU of chlamydial or mycoplasmal etiology can be dealt with by a single antibiotic, namely azithromycin, has had considerable clinical appeal. [academic.oup.com]
Trichomonas vaginalis: an anaerobic, parasitic flagellated protozoan, rare cause of urethritis ( Uncertain etiology: in 20–30%. Signs and Symptoms Urethritis: Incubation period 1–5 weeks. [urology-textbook.com]
Etiology The etiology of most cases of NGU is not known however, Chlamydia trachomatis serovars D-K is a frequent cause (15%--55% of cases). The prevalence differs by age group, with fewer infections associated with this organism among older men. [atsu.edu]
Causes of Urethritis It is most commonly of bacterial etiology. Although classified as STD, urethritis is not always caused by sexual activity. On basis of etiology, urethritis can be classified as Gonococcal and Non-Gonococcal urethritis. [condom-sizes.org]
Epidemiology
This paper presents a preliminary analysis of a cohort study of the epidemiology of NGU, conducted by the U.S. Public Health Service, the U.S. [link.springer.com]
Epidemiology Increasing incidence, nowadays more frequent than gonorrheal urethritis. Causes (Pathogens) of Non-Gonococcal Urethritis Chlamydia trachomatis: Most often cause of NGU. [urology-textbook.com]
Epidemiology of Helicobacter pylori : acquisition, transmission, population prevalence and disease-to-infection ratio. Br Med Bull 54, 39 –53. [CrossRef] [Google Scholar] Fisk, P. & Riley, V. ( 1995 ; ). [mic.microbiologyresearch.org]
Sex partner of the patient is always given the same treatment even if there is no clinical or laboratory evidence of urethritis (epidemiological treatment). [ijdvl.com]
Epidemiology Humans are the only known host and infection is almost always via sexual contact. There are about 300,000-500,000 reported cases/year in the U.S. [atsu.edu]
Pathophysiology
Pathophysiology Urethritis is an inflammatory condition that can be infectious or posttraumatic in nature. [emedicine.medscape.com]
Prevention
Prevention & Expectations What can be done to prevent the infection? Many cases of gonorrhea can be prevented by following safer sex guidelines. Prompt treatment of the infected person and any sexual partners will prevent further spread. [medicineonline.com]
How is NGU prevented? NGU is best prevented by consistent and correct latex male condoms. [stdclinic.ie]
Rein, Public Health Image Library, Center for Disease Control and Prevention, USA, www.cdc.gov. [urology-textbook.com]
What can be done to prevent the spread of NGU? There are a number of ways to prevent the spread of NGU: Limit your number of sex partners. Use a condom. Carefully wash genitals after sexual relations. [health.ny.gov]
This is to prevent re-infection. This factsheet is due for review in December 2021 [aidsmap.com]