Urethritis
Encyclopedia
Urethritis is inflammation of the urethra
. The most common symptom is painful or difficult urination
.
, caused by Neisseria gonorrhoeae
, or non-gonococcal urethritis
(NGU), most commonly caused by Chlamydia trachomatis
. NGU, sometimes called non-specific urethritis (NSU), has both infectious and non-infectious causes.
Other causes include:
discharge usually indicates a urethritis of gonococcal nature, while clear discharge indicates urethritis of non-gonococcal nature. Urethritis is difficult to diagnose in women because discharge may not be present, however, the symptoms of dysuria
and frequency may be present.
s per HPF
, but this definition has recently been called into doubt. The physician sometimes performs a digital rectal examination
to inspect the prostate gland for swelling or infection.
, clotrimazole
, fluconazole
, metronidazole
, nitrofurantoin
, nystatin
, and trimethoprim/sulfamethoxazole.
Proper perineal
hygiene should be stressed. This includes avoiding use of vaginal deodorant sprays and proper wiping after urination and bowel movements. Intercourse should be avoided until symptoms subside.
Urethra
In anatomy, the urethra is a tube that connects the urinary bladder to the genitals for the removal of fluids out of the body. In males, the urethra travels through the penis, and carries semen as well as urine...
. The most common symptom is painful or difficult urination
Dysuria
In medicine, specifically urology, dysuria refers to painful urination.Difficult urination is also sometimes described as dysuria.It is one of a constellation of irritative bladder symptoms, which includes urinary frequency and haematuria....
.
Causes
The disease is classified as either gonococcal urethritisGonorrhea
Gonorrhea is a common sexually transmitted infection caused by the bacterium Neisseria gonorrhoeae. The usual symptoms in men are burning with urination and penile discharge. Women, on the other hand, are asymptomatic half the time or have vaginal discharge and pelvic pain...
, caused by Neisseria gonorrhoeae
Neisseria gonorrhoeae
Neisseria gonorrhoeae, also known as gonococci , or gonococcus , is a species of Gram-negative coffee bean-shaped diplococci bacteria responsible for the sexually transmitted infection gonorrhea.N...
, or non-gonococcal urethritis
Non-gonococcal urethritis
Nongonococcal urethritis is an inflammation of the urethra that is not caused by gonorrheal infection.For treatment purposes, doctors usually classify infectious urethritis in two categories: gonococcal urethritis, caused by gonorrhea, and nongonococcal urethritis .-Causes:There are many causes of...
(NGU), most commonly caused by Chlamydia trachomatis
Chlamydia trachomatis
Chlamydia trachomatis, an obligate intracellular human pathogen, is one of three bacterial species in the genus Chlamydia. C. trachomatis is a Gram-negative bacteria, therefore its cell wall components retain the counter-stain safranin and appear pink under a light microscope.The inclusion bodies...
. NGU, sometimes called non-specific urethritis (NSU), has both infectious and non-infectious causes.
Other causes include:
- AdenoviridaeAdenoviridaeAdenoviruses are medium-sized , nonenveloped icosahedral viruses composed of a nucleocapsid and a double-stranded linear DNA genome...
- Uropathogenic Escherichia coliEscherichia coliEscherichia coli is a Gram-negative, rod-shaped bacterium that is commonly found in the lower intestine of warm-blooded organisms . Most E. coli strains are harmless, but some serotypes can cause serious food poisoning in humans, and are occasionally responsible for product recalls...
(UPEC) - Herpes simplexHerpes simplexHerpes simplex is a viral disease caused by both Herpes simplex virus type 1 and type 2 . Infection with the herpes virus is categorized into one of several distinct disorders based on the site of infection. Oral herpes, the visible symptoms of which are colloquially called cold sores or fever...
- Mycoplasma genitaliumMycoplasma genitaliumMycoplasma genitalium is a small parasitic bacterium that lives on the ciliated epithelial cells of the primate genital and respiratory tracts. M. genitalium is the smallest known genome that can constitute a cell, and the second-smallest bacterium after the recently-discovered endosymbiont...
- Reiter's syndromeReactive arthritisReactive arthritis , is classified as an autoimmune condition that develops in response to an infection in another part of the body. Coming into contact with bacteria and developing an infection can trigger the disease. Reiter's syndrome has symptoms similar to various other conditions collectively...
- TrichomonasTrichomonasTrichomonas is a genus of anaerobic protists that are parasites of vertebrates. They are included with the parabasalids.Species of Trichomonas include:*Trichomonas vaginalis, an organism generally living inside the vagina of humans...
spp. - Ureaplasma urealyticumUreaplasma urealyticumUreaplasma urealyticum is a bacterium belonging to the family Mycoplasmataceae. Its type strain is T960.-Clinical significance:U. urealyticum is part of the normal genital flora of both men and women...
Symptoms
In men, purulentPus
Pus is a viscous exudate, typically whitish-yellow, yellow, or yellow-brown, formed at the site of inflammatory during infection. An accumulation of pus in an enclosed tissue space is known as an abscess, whereas a visible collection of pus within or beneath the epidermis is known as a pustule or...
discharge usually indicates a urethritis of gonococcal nature, while clear discharge indicates urethritis of non-gonococcal nature. Urethritis is difficult to diagnose in women because discharge may not be present, however, the symptoms of dysuria
Dysuria
In medicine, specifically urology, dysuria refers to painful urination.Difficult urination is also sometimes described as dysuria.It is one of a constellation of irritative bladder symptoms, which includes urinary frequency and haematuria....
and frequency may be present.
Diagnosis
With male patients, the physician examines the penis and testicles for soreness or any swelling. The urethra is visually examined by spreading the urinary meatus apart with two gloved fingers, and examining the opening for redness, discharge and other abnormalities. Next, a cotton swab is inserted 1–4 cm into the urethra and rotated once. To prevent contamination, no lubricant is applied to the swab, which can result in pain or discomfort. The swab is then smeared onto a glass slide and examined under a microscope. A commonly used cut-off for the diagnosis of urethritis is 5 or more granulocyteGranulocyte
Granulocytes are a category of white blood cells characterized by the presence of granules in their cytoplasm. They are also called polymorphonuclear leukocytes because of the varying shapes of the nucleus, which is usually lobed into three segments...
s per HPF
High Power Field
High Power Field when used in relation to microscopy references the area visible under the maximum magnification power of the objective being used. Often, this represents a 400x magnification level when referenced in scientific papers....
, but this definition has recently been called into doubt. The physician sometimes performs a digital rectal examination
Rectal examination
A rectal examination or rectal exam is an internal examination of the rectum such as by a physician or other healthcare professional.-Procedure:...
to inspect the prostate gland for swelling or infection.
Treatment
A variety of drugs may be prescribed based on the cause of the patient's urethritis. Some examples of medications based on causes include ceftriaxoneCeftriaxone
Ceftriaxone is a third-generation cephalosporin antibiotic. Like other third-generation cephalosporins, it has broad spectrum activity against Gram-positive and Gram-negative bacteria. In most cases, it is considered to be equivalent to cefotaxime in terms of safety and efficacy...
, clotrimazole
Clotrimazole
Clotrimazole is an antifungal medication commonly used in the treatment of fungal infections such as vaginal yeast infections, oral thrush, and ringworm...
, fluconazole
Fluconazole
Fluconazole is a triazole antifungal drug used in the treatment and prevention of superficial and systemic fungal infections. In a bulk powder form, it appears as a white crystalline powder, and it is very slightly soluble in water and soluble in alcohol. It is commonly marketed under the trade...
, metronidazole
Metronidazole
Metronidazole is a nitroimidazole antibiotic medication used particularly for anaerobic bacteria and protozoa. Metronidazole is an antibiotic, amebicide, and antiprotozoal....
, nitrofurantoin
Nitrofurantoin
Nitrofurantoin is an antibiotic which is marketed under the following brand names; Furadantin, Macrobid, Macrodantin, Nitrofur Mac, Nitro Macro, Nifty-SR, Martifur-MR, Martifur-100 , Urantoin, and Uvamin . It is usually used in treating urinary tract infection...
, nystatin
Nystatin
Nystatin is a polyene antifungal medication to which many molds and yeast infections are sensitive, including Candida. Due to its toxicity profile, there are currently no injectable formulations of this drug on the US market...
, and trimethoprim/sulfamethoxazole.
Proper perineal
Perineum
In human anatomy, the perineum is a region of the body including the perineal body and surrounding structures...
hygiene should be stressed. This includes avoiding use of vaginal deodorant sprays and proper wiping after urination and bowel movements. Intercourse should be avoided until symptoms subside.