SP 3 : NON-

GONOCOCCAL
URETHRITIS
M A D E D I C K Y P R A N ATA P A N D E
1670121045 / SGD 4
CONTENT

• Definition
• Epidemiology
• Clinical Presentation
• Diagnosis
• Treatment
• Prevention
DEFINITION

• Urethritis is urethral inflammation and historically, the term urethritis was reserved for
patients with urethral discharge.
EPIDEMIOLOGY

• Mycoplasma genitalium
• Trichomonas vaginalis
• Other bacterials (M. genitalium, Ureaplasma urealyticum)
• HSV and adenoviruses
• Noninfectious causes of urethritis
CLINICAL PRESENTATION

• Painful urination,
• Urethral stinging or itching,
• Penile tip irritation or as a urethral
discharge, which may be scant or
profuse, watery, mucoid or purulent
• Urethritis due to HSV or adenovirus is
more likely to present with severe
dysuria or meatitis
DIAGNOSIS

• Male presenting with dysuria, urethral pruritus or discharge

• Genital examination should be performed at least 2 hours after last micturition
• Placing the gloved thumb
• Gram stain of urethral discharge demonstrating Z2 WBC per oil immersion field or positive
leukocyte esterase test
• (NAAT) testing for C. Trachomatis
• Culture and PCR
TREATMENT

• Ceftriaxone 250 mg IM in a single dose plus azithromycin 1 g orally in a single dose (gonorrhea
and chlamydia)
• Antiviral therapy for HSV 1 or 2
PREVENTION

• Use of condoms
• Effective diagnosis, treatment, counseling and follow-up
REFERENCES

• Perkins, J. (2016). Non-Gonococcal urethritis. European Handbook of Dermatological Treatments, Third

Edition, 983–990. http://dx.doi.org/10.1016/j.disamonth.2016.03.011
• Le, P. T., Hamasuna, R., Matsumoto, M., Furubayashi, K., Hatanaka, M., Kawai, S., … Matsumoto, T.
(2017). The detection of microorganisms related to urethritis from the oral cavity of male patients
with urethritis. Journal of Infection and Chemotherapy, 23(10), 668–673.
https://doi.org/10.1016/j.jiac.2017.06.011
• Hakenberg, O. W., Harke, N., & Wagenlehner, F. (2017). Urethritis in Men and Women. European
Urology, Supplements, 16(4), 144–148. https://doi.org/10.1016/j.eursup.2017.01.002
• Bartoletti, R., Wagenlehner, F. M. E., Bjerklund Johansen, T. E., Köves, B., Cai, T., Tandogdu, Z., & Bonkat,
G. (2019). Management of Urethritis: Is It Still the Time for Empirical Antibiotic Treatments?
European Urology Focus, 5(1), 29–35. https://doi.org/10.1016/j.euf.2018.10.006