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

This article may require cleanup to meet Wikipedia's quality standards. Please improve this article if you can. (October 2009)

This article requires authentication or verification by an expert. Please assist in recruiting an expert or improve this article yourself. See the talk page for details. (October 2009)

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 See also 6 References

[edit] Diagnosis

Usually, the patient undresses and puts on a gown. 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, causing the procedure to be extremely painful. 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 polymorphonuclear leukocytes per high power field, but this definition has recently been called into doubt.^[1]

The physician sometimes performs a digital rectal exam (DRE) to inspect the prostate gland for swelling or infection.

[edit] Causes

In the diagnostic approach to urethritis, physicians classify the disease as 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
• Uropathogenic Escherichia coli (UPEC)
• Herpes simplex
• Mycoplasma genitalium
• Reiter's syndrome
• Trichomonas spp.
• Isotretinoin therapy

Doses of isotretinoin greater than 60 milligrams/square meter induced URETHRITIS (Reuter, 1984). Urethritis was reported in 2 male patients who were being treated with isotretinoin for acne vulgaris. After discontinuation and treatment with antibiotics, urethritis resolved. (Edwards & Sonnex, 1997).

[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
• 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.

Prevent

(A) To avoid sex before without cure; prohibition, do not eat spicy food, more water. (B) make the necessary isolation in family, towels, bath, washbasin, toilet, etc. used separately, or sterilized after use. (C) tell the patient what is safe sex, what is risky sexual behaviors, how to avoid risky sexual behaviors. (D) encourage the use of condoms.

[edit] See also

• Urinary tract infection

[edit] References

1. ^ Bradshaw CS, Tabrizi SN, Read TR, et al (February 2006). "Etiologies of nongonococcal urethritis: bacteria, viruses, and the association with orogenital exposure". J Infect Dis. 193 (3): 336–45. doi:10.1086/499434. PMID 16388480. 

v • d • e Urinary system · Pathology · Urologic disease / Uropathy (N00–N39, 580–599) Abdominal Nephropathy/ (nephritis+ nephrosis) Glomerulopathy/ glomerulitis/ (glomerulonephritis+ glomerulonephrosis) Primarily nephrotic Non-proliferative .0 Minimal change · .1 Focal segmental · .2 Membranous Proliferative .3 Mesangial proliferative · .4 Endocapillary proliferative .5/.6 Membranoproliferative/mesangiocapillary By condition Diabetic · Amyloidosis Primarily nephritic, .7 RPG Type I RPG/Type II hypersensitivity Goodpasture's syndrome Type II RPG/Type III hypersensitivity Post-streptococcal · Lupus (DPN) · IgA/Berger's Type III RPG/Pauci-immune Wegener's granulomatosis · Microscopic polyangiitis Tubulopathy/ tubulitis Proximal RTA (RTA 2) Thick ascending Bartter syndrome Distal convoluted Gitelman syndrome Collecting duct Liddle's syndrome · RTA (RTA 1) · Diabetes insipidus (Nephrogenic) Renal papilla Renal papillary necrosis Major calyx/pelvis Hydronephrosis · Pyonephrosis · Reflux nephropathy Any/all Acute tubular necrosis Interstitium Interstitial nephritis (Pyelonephritis, Danubian endemic familial nephropathy) Any/all General syndromes Renal failure (Acute renal failure, Chronic renal failure) · Uremic pericarditis · Uremia Vascular Renal artery stenosis · Hypertensive nephropathy · Renovascular hypertension Other Analgesic nephropathy · Renal osteodystrophy · Nephroptosis · Abderhalden-Kaufmann-Lignac syndrome Ureter Ureteritis · Ureterocele · Megaureter Pelvic Bladder Cystitis (Interstitial cystitis/painful bladder syndrome, Hunner's ulcer, Trigonitis, Hemorrhagic cystitis) · Neurogenic bladder · Vesicointestinal fistula · Vesicoureteral reflux Urethra Urethritis (Non-gonococcal urethritis) · Urethral syndrome · Urethral stricture/Meatal stenosis Any/all Obstructive uropathy · Urinary tract infection · Retroperitoneal fibrosis · Urolithiasis (Kidney stone, Renal colic) · Malacoplakia urinary system navs: anat/physio/dev, noncongen/acid+base/congen/neoplasia, symptoms+signs/eponymous, proc

v • d • e Inflammation Acute Plasma derived mediators Bradykinin · complement (C3, C5a, MAC) · coagulation (Factor XII, Plasmin, Thrombin) Cell derived mediators preformed: Lysosome granules · vasoactive amines (Histamine, Serotonin) synthesized on demand: cytokines (IFN-γ, IL-8, TNF-α, IL-1) · eicosanoids (Leukotriene B4, Prostaglandins) · Nitric oxide · Kinins Chronic Macrophage · Epithelioid cell · Giant cell · Granuloma Processes Traditional: Rubor · Calor · Tumor · Dolor (pain) · Functio laesa Modern: Acute-phase reaction/Fever · Vasodilation · Increased vascular permeability · Exudate · Leukocyte extravasation · Chemotaxis Specific types Nervous CNS (Encephalitis, Myelitis) · Meningitis (Arachnoiditis) · PNS (Neuritis) · eye (Dacryoadenitis, Scleritis, Keratitis, Choroiditis, Retinitis, Chorioretinitis, Blepharitis, Conjunctivitis, Iritis, Uveitis) · ear (Otitis, Labyrinthitis, Mastoiditis) Cardiovascular Carditis (Endocarditis, Myocarditis, Pericarditis) · Vasculitis (Arteritis, Phlebitis, Capillaritis) Respiratory upper (Sinusitis, Rhinitis, Pharyngitis, Laryngitis) · lower (Tracheitis, Bronchitis, Bronchiolitis, Pneumonitis, Pleuritis) · Mediastinitis Digestive mouth (Stomatitis, Gingivitis, Gingivostomatitis, Glossitis, Tonsillitis, Sialadenitis/Parotitis, Cheilitis, Pulpitis, Gnathitis) · tract (Esophagitis, Gastritis, Gastroenteritis, Enteritis, Colitis, Enterocolitis, Duodenitis, Ileitis, Caecitis, Appendicitis, Proctitis) · accessory (Hepatitis, Cholangitis, Cholecystitis, Pancreatitis) · Peritonitis Integumentary Dermatitis (Folliculitis) · Cellulitis · Hidradenitis Musculoskeletal Arthritis · Dermatomyositis · soft tissue (Myositis, Synovitis/Tenosynovitis, Bursitis, Enthesitis, Fasciitis, Capsulitis, Epicondylitis, Tendinitis, Panniculitis) Osteochondritis: Osteitis (Spondylitis, Periostitis) · Chondritis Urinary Nephritis (Glomerulonephritis, Pyelonephritis) · Ureteritis · Cystitis · Urethritis Reproductive female: Oophoritis · Salpingitis · Endometritis · Parametritis · Cervicitis · Vaginitis · Vulvitis · Mastitis male: Orchitis · Epididymitis · Prostatitis · Balanitis · Balanoposthitis pregnancy/newborn: Chorioamnionitis · Omphalitis Endocrine Insulitis · Hypophysitis · Thyroiditis · Parathyroiditis · Adrenalitis Lymphatic Lymphangitis · Lymphadenitis

This medical article is a stub. You can help Wikipedia by expanding it. v • d • e