Urethritis - Urinary Tract Disorders

URETHRITIS

Urethritis (inflammation of the urethra) is usually an ascending infection and may be classified as gonococcal or nongonococcal. Both conditions may be present in the same patient. Gonococcal urethritis and nongonococcal urethritis are the most common STDs in men in developed countries (Centers for Disease Con-trol and Prevention, 2001).

Gonococcal urethritis is caused by N. gonorrhoeae and is transmitted by sexual contact. In men, inflammation of the ure-thral meatus or orifice occurs, with burning on urination. A pu-rulent urethral discharge appears 3 to 14 days (or longer) after sexual exposure, although the disease is asymptomatic in up to 10% of men. The infection involves the tissues around the ure-thra, causing periurethritis, prostatitis, epididymitis, and ure-thral stricture. Sterility may occur as a result of vasoepididymal obstruction. Gonorrhea in women is frequently not diagnosed and reported because a urethral discharge is not always present and the disease may be asymptomatic.

Nongonococcal urethritis is usually caused by C. trachomatis or Ureaplasma urealyticum. Male patients with symptoms usu-ally complain of mild to severe dysuria and scant to moderate urethral discharge. Nongonococcal urethritis requires prompt treatment with tetracycline or doxycycline. In patients who do not respond to or who are allergic to the tetracyclines, erythro-mycin may be substituted. Follow-up care is necessary to make certain that a cure is achieved. All sexual partners of patients with nongonococcal urethritis should be examined for STDs and treated.