Urethritis

From Wikipedia, the free encyclopedia

Urethritis Classification and external resources
ICD-10	N34.
ICD-9	597 099.4
DiseasesDB	27902
eMedicine	med/2342
MeSH	D014526

Urethritis is inflammation of the urethra. The main symptom is dysuria, which is painful or difficult urination.

Contents 1 Diagnosis 2 Causes 3 Symptoms 4 Treatment 5 References

[edit] Diagnosis

A cotton swab is inserted 1–4 cm into the urethra and rotated once. 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 polymorphs per high power field, but this definition has recently been called into doubt.^[1]

Tests of gonorrhoea and chlamydia are sent on the swab.

[edit] Causes

In the diagnostic approach to urethritis, physicians classify the disease as gonococcal urethritis or non-gonococcal urethritis (NGU), based on its causation. Non-gonococcal urethritis, sometimes called non-specific urethritis (NSU), has both infectious and non-infectious causes. In men, purulent 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.

Causes include:

• Adenovirus
• Chlamydia trachomatis
• Escherichia coli
• Herpes simplex
• Mycoplasma genitalium
• Neisseria gonorrhoeae
• Reiter's syndrome
• Trichomonas spp.

[edit] Symptoms

Discharge (milky or pus-like) from the penis, stinging or burning during urination, itching, tingling, burning or irritation inside the penis.

[edit] 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:

• Clotrimazole (Mycelex) - Trichomonas
• Doxycycline (Vibramycin) - Chlamydia
• Fluconazole (Diflucan) - Monilial
• Metronidazole (Flagyl) - Trichomonas
• Nitrofurantoin - Bacterial Infection
• Nystatin (Mycostatin) - Monilial
• Co-trimoxazole, which is a combination of Sulfamethoxazole and Trimethoprim in a ratio of 5 to 1 (Septrin, Bactrim) - Bacterial Infection

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.

[edit] References

1. ^ Bradshaw CS et al.. "Etiologies of Nongonococcal Urethritis: Bacteria, Viruses, and the Association with Orogenital Exposure". J Infect Dis 193 (3): 333–5. 

v • d • e Sexually transmitted diseases and infections (STD/STI) (primarily A50-A64, 090-099) Bacterial Chancroid • (Haemophilus ducreyi) • Chlamydia (Chlamydia trachomatis) • Donovanosis (Granuloma Inguinale) • Lymphogranuloma venereum (LGV) • Gonorrhea (Neisseria gonorrhoeae) • Syphilis (Treponema pallidum) • Ureaplasma urealyticum Protozoal Trichomoniasis (Trichomonas vaginalis) Parasitic Crab louse/crabs • Scabies Viral AIDS (HIV-1/HIV-2) • Cervical cancer & Genital warts (condyloma) (Human papillomavirus (HPV)) • Hepatitis B • Herpes simplex virus (HSV1/HSV2) • Molluscum contagiosum (MCV) Other conditions Cervicitis • Epididymitis • Ectopic pregnancy • Infertility • Non-gonococcal urethritis (NGU) • Pelvic inflammatory disease (PID) • Premature birth • Proctitis • Prostatitis • Reactive arthritis • Urethritis

v • d • e Urinary system - Pathology - Nephrology, including nephritis and nephropathy (N00-N39, 580-599) Diseases of the glomerulus Glomerulonephritis - Focal segmental glomerulosclerosis - Membranoproliferative glomerulonephritis - Membranous glomerulonephritis - Nephritic syndrome - Post-streptococcal glomerulonephritis - Nephrotic syndrome (Minimal change disease) - IgA nephropathy - Lupus nephritis - Diabetic nephropathy - Rapidly progressive glomerulonephritis Tubulointerstitial diseases of the kidney Interstitial nephritis - Pyelonephritis - Hydronephrosis - Pyonephrosis - Balkan nephropathy - Reflux nephropathy Renal failure Acute renal failure (Acute tubular necrosis) - Chronic renal failure Urolithiasis Kidney stone - Renal colic Diseases of the renal tubule and other disorders of kidney and ureter Renal osteodystrophy - Nephrogenic diabetes insipidus - Nephroptosis - Ureterocele - Abderhalden-Kaufmann-Lignac syndrome - Inborn errors of renal tubular transport (Renal tubular acidosis, Gitelman syndrome) Other diseases and disorders of urinary system urinary bladder: Cystitis (Interstitial cystitis, Trigonitis) - Neurogenic bladder - Vesicointestinal fistula urethra: Urethritis (Non-gonococcal urethritis) - Urethral syndrome - Urethral stricture Urinary tract infection Tumors of the kidney Renal cell carcinoma - Wilms' tumor (children) See also congenital conditions (Q60-Q64, 753)