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]
Underlying anxiety may be present and if present should be discussed. Disclaimer The content of these treatment guidelines is for information purposes only. [mshc.org.au]
Men with Gonococcal urethritis may present with any combination of symptoms [ 12 ]. [omicsonline.org]
Immune System
- Inguinal Lymphadenopathy
Urethritis caused by HSV or adenovirus is associated with insertive oral sex among men who have sex with men. 15 Diagnosis Men presenting with urethral symptoms should be examined for inguinal lymphadenopathy, ulcers, or urethral discharge. [aafp.org]
Entire Body System
- Swelling
Untreated men may develop swelling of the testicles and an infected prostate gland. [medical-dictionary.thefreedictionary.com]
If the infection is not treated, it may move up around the testicles, causing pain, swelling, and sterility. The infection also may spread to other parts of the body, causing severe illness. [my.clevelandclinic.org]
Some symptoms are: Burning or pain when urinating Irritation in the penis Pus discharge from the penis Pain and possible swelling in one or both testicles Infections in the urethra are usually caused by sexually transmitted diseases, or STDs. [fairview.org]
Urethritis is inflammation (swelling and irritation) of the urethra. The urethra is the tube that carries urine from the body. Both bacteria and viruses may cause urethritis. [medlineplus.gov]
- Chills
[…] burning sensation during urination (dysuria) Dark, cloudy, bloody or abnormal-smelling urine Signs and symptoms that may indicate the infection is worsening, or has moved to the kidneys, include: Pain in the abdomen, pelvic area or lower back Fever and/or chills [nmihi.com]
[…] dysuria ) Discharge from penis Fever (rare) Frequent or urgent urination Itching, tenderness, or swelling in penis Enlarged lymph nodes in the groin area Pain with intercourse or ejaculation In women: Abdominal pain Burning pain while urinating Fever and chills [medlineplus.gov]
Both men and women should call a doctor if they start urinating more frequently, or if urination causes pain or a burning discomfort, especially if fever or chills occur. [drugs.com]
Systemic symptoms (eg, fever, chills, sweats, nausea): Typically absent See Presentation for more detail. Diagnosis Most patients with urethritis do not appear ill and do not present with signs of sepsis. [emedicine.medscape.com]
Fever, chills. Frequency, nocturia, urgency. Perineal pain, scrotal masses. Difficulties initiating and maintaining stream. [canada.ca]
- Sepsis
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]
These untreated infections can also spread to the blood and result in sepsis, which can be deadly. In addition, the STIs that frequently cause urethritis can damage the reproductive system. [healthline.com]
Diagnosis Most patients with urethritis do not appear ill and do not present with signs of sepsis. The primary focus of the examination is on the genitalia. [emedicine.medscape.com]
The most severe manifestations of N gonorrhoeae infection in newborns are ophthalmia neonatorum and sepsis, including arthritis and meningitis. [atsu.edu]
- Lymphadenopathy
Urethritis caused by HSV or adenovirus is associated with insertive oral sex among men who have sex with men. 15 Diagnosis Men presenting with urethral symptoms should be examined for inguinal lymphadenopathy, ulcers, or urethral discharge. [aafp.org]
Examination may be normal or may reveal haematuria and/or lymphadenopathy. There is currently a national screening programme for chlamydia. [ 7 ] Identify high-risk patients [ 2, 8 ] Sexually active. Male. Unprotected vaginal sex. [patient.info]
Lymphadenopathy Management and Treatment (see Figure 1 ) Gonococcal urethritis Cefixime 400 mg PO in a single dose PLUS EITHER doxycycline 100 mg PO bid for 7 days Footnote 15 [A-l] OR azithromycin 1 g PO in a single dose if poor compliance is expected [canada.ca]
- Burning Pain
pain while urinating ( dysuria ) Discharge from penis Fever (rare) Frequent or urgent urination Itching, tenderness, or swelling in penis Enlarged lymph nodes in the groin area Pain with intercourse or ejaculation In women: Abdominal pain Burning pain [medlineplus.gov]
The urethra swells and narrows and the flow of urine is impeded; both urination and the urgency to urinate increase and there is burning pain, sometimes with a purulent discharge, on urination. [medical-dictionary.thefreedictionary.com]
Respiratoric
- Sore Throat
Most (90%) are asymptomatic, but some people might have a sore throat. [std-gov.org]
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]
Oral infections are usually asymptomatic (express no symptoms), but they may occasionally result in a sore throat. 2,3 How Is It Treated? If you a urethral infection becomes a concern, please see a health care provider. [soc.ucsb.edu]
Skin
- Ulcer
Ten patients (0.89%) did not respond to the proposed treatment. 133 patients presented healed ulcers after 3 days of treatment, 976 patients healed chancres on the seventh day after the treatment, and 39 patients… CONTINUE READING [semanticscholar.org]
/1/2017) : No change 2019 (effective 10/1/2018) : No change Urethritis (anterior) (posterior) N34.2 ICD-10-CM Diagnosis Code N34.2 Other urethritis 2016 2017 2018 2019 Billable/Specific Code Applicable To Meatitis, urethral Postmenopausal urethritis Ulcer [icd10data.com]
If you have chronic liver or kidney disease or have ever had a stomach ulcer or GI bleeding, or are taking blood thinners, talk with your healthcare provider before using these medicines. [fairview.org]
Urethritis caused by HSV or adenovirus is associated with insertive oral sex among men who have sex with men. 15 Diagnosis Men presenting with urethral symptoms should be examined for inguinal lymphadenopathy, ulcers, or urethral discharge. [aafp.org]
Herpes may be present in the absence of ulceration. Trichomonas is uncommon in Australian cities but should be suspected if there has been sex overseas or if NGU persists despite initial antibiotic treatment. [mshc.org.au]
- Flushing
In addition to taking the prescribed medication, patients may be advised to increase daily fluid intake to help flush any remaining bacteria from the urinary tract. [nmihi.com]
Urogenital
- Urethral Discharge
Gonococcal urethritis (GCU) usually presents with severe dysuria and profuse mucopurulent urethral discharge. The external meatus is often erythematous and oedematous. [ijdvl.com]
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]
Manifestations Urethral discharge. Dysuria. Urethral itching or meatal erythema. Often asymptomatic. [canada.ca]
Clinical presentation Symptoms Considerations Urethral discharge Gonorrhoea - usually copious and purulent. More common in MSM and Indigenous populations. Non-gonococcal urethritis - usually less discharge. [sti.guidelines.org.au]
- Dysuria
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]
Discharge +/- dysuria or may be asymptomatic. 6. [slideshare.net]
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]
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]
- Hematuria
Children who have urethritis may present with irritative voiding symptoms, such as dysuria, urgency, or frequency; possible urethral discharge; initial hematuria; or blood spotting on the underwear. [pedsinreview.aappublications.org]
Symptoms in women are often indistinguishable from a mild bladder infection (cystitis), including painful urination, but without blood in the urine (hematuria). However, asymptomatic infections are possible in men and women. [nmihi.com]
Although urinary frequency, hematuria and urgency can, on rare occasions, occur with urethritis, the presence of any of these symptoms requires more extensive evaluation. [canada.ca]
[…] considerations Age older than 35 years Urethritis or UTIs 16 caused by increased rates of gram-negative organisms Consider 100 mg oral doxycycline twice a day for seven days, instead of azithromycin (Zithromax) Age older than 35 years, severe dysuria, hematuria [aafp.org]
Hematuria or blood in the ejaculate are uncommon in urethritis. Fem ales Dysuria and urgency are frequent symptoms of cystitis in women. A similar syndrome occurs in women who do not have evidence of urinary tract infections. [antimicrobe.org]
- 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]
Urgency and increases in urinary frequency are less common in patients with urethritis/urethral syndrome or “external dysuria”. [atsu.edu]
- Painful Ejaculation
suprapubic region or back. - 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 [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
- 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]
Acute urethral syndrome Dysuria, frequency Pyuria syndrome > 7 days No bacteria of symptom PID Lower abdominal pain, adenexal tenderness on pelvic examination evidence of MPC often present Cervical gramstaining positive for gonococcus, endometritis on [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]
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]
This is a potentially serious matter because of the possibility that extensive use of single-dose azithromycin for treatment of C. trachomatis or for presumptive treatment of NGU might lead to the development of widespread resistance in M. genitalium [academic.oup.com]
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]
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]
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]
Ongoing controversies regarding etiology, diagnosis, treatment N/A Copyright © 2017, 2013 Decision Support in Medicine, LLC. All rights reserved. [clinicaladvisor.com]
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]
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 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]
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]
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]
Rein, Public Health Image Library, Center for Disease Control and Prevention, USA, www.cdc.gov. [urology-textbook.com]
This is to prevent re-infection. This factsheet is due for review in December 2021 [aidsmap.com]