Please enable JavaScript.
Coggle requires JavaScript to display documents.
Urethritis (Aetiology (Infection NG, CT, TV, mycoplasma E Coli etc.,…
Urethritis
Aetiology
Infection
NG, CT, TV, mycoplasma
E Coli etc.
Trauma
Catheterisation
Irritation (soaps, lotions, spermicide)
Degenerative
Stricture
Metabolic
Calculus
Clinical
presentation
Discharge
Dysuria
Penile irritation/pain
Asymptomatic
25%
Pathophysiology
Agents
Chlamydia (commonest)
Gonnorrhoea
Mycoplasma genitalium
TV
Non STI (E Coli, proteus)
Classification
Gonococcal urethritis
Non-gonococcal urethritis (NGU)
Persistant/recurrent (1-3m after NGU tx)
Transmission
Sexual (UPSI or oro-genital)
Diagnosis
Examination
Male genital examination
Erythema, swelling, discharge,
ulcers, blistering, masses
Investigations
Swabs
Urethral swab (NG/CT NAAT, TV MCS, mycoplasma)
Urethral smear (gram stain and microscopy)
Urine
FPU (NG/CT NAAT)
MSU (dipstick, MCS)
Bedside
Obs (fever)
Bloods
BBV (HIV, HCV, HBV, syphilis)
History
DH
Current meds, allergies
SxH
Partners (casual/regular, gender, age)
Type of sex (vaginal, anal, oral, receptive/passive)
Contraception (UPSI/barrier)
Partners (last 3m and 12m)
BBV risk (IVDU, abroad, blood products, paid for sex)
PMH
Previous STIs, chronic medical conditions
SH
Occupation, living arrangements,
smoking, alcohol, drugs (IVDU)
PC/HPC
Discharge, discomfort, dysuria
Epidemiology
Commonly due to STI
CT>NG
Management
Conservative
Information, advice, support
Referral to GUM for testing/treatment
Advie abstinence SI until self and partner tx
Contact tracing (last 3m)
FU 1-2weeks (symptoms, tx, contact tracing)
Medical
Abx
Indication: 1L suspected STI
E.g. azithromycin 1g STAT/doxy 100mg BD 7d/ofloxacin 200mg BD 7d (if suspect CT); otherwise tx per NG/TV etc
Complications
NGU
Epididymoorchitis
Reactive arthritis
Balanitis
Gonococcal urethritis
Epididymoorchitis
Penile lymphangitis
Peri-urethral abscess
Acute prostatitis
Seminal vesiculitis
Gand infection
Definition
Inflammation of the urethra,
usually caused by an STI