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This article needs additional citations for verification. Please help improve this article by adding citations to reliable sources. Unsourced material may be challenged and removed. (November 2012) |
| Urethritis |
| Classification and external resources |
| ICD-10 |
N34 |
| ICD-9 |
597 099.4 |
| DiseasesDB |
27902 |
| MedlinePlus |
000439 |
| eMedicine |
med/2342 |
| MeSH |
D014526 |
Urethritis is inflammation of the urethra. The most common symptom is painful or difficult urination.[1][2]
Contents
- 1 Signs and symptoms
- 2 Causes
- 3 Diagnosis
- 4 Prevention
- 5 Treatment
- 6 References
§Signs and symptoms
In men, purulent discharge usually indicates a urethritis of gonococcal nature, while clear discharge indicates urethritis of non-gonococcal nature.[citation needed] Urethritis is difficult to diagnose in women because discharge may not be present, however, the symptoms of dysuria and frequency may be present.
§Causes
The disease is classified as either gonococcal urethritis, caused by Neisseria gonorrhoeae, or non-gonococcal urethritis (NGU), most commonly caused by Chlamydia trachomatis. NGU, sometimes called non-specific urethritis (NSU), has both infectious and non-infectious causes.
Other causes include:[1][2]
- Adenoviridae
- Uropathogenic Escherichia coli (UPEC)
- Herpes simplex
- Cytomegalovirus
- Mycoplasma genitalium
- Reiter's syndrome
- Trichomonas vaginalis
- Ureaplasma urealyticum
- Methicillin-resistant Staphylococcus aureus[3]
- Group B streptococcus[4]
§Diagnosis
With male patients, 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, which can result in pain or discomfort. 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 granulocytes per High Power Field, but this definition has recently been called into doubt.[5] The physician sometimes performs a digital rectal examination to inspect the prostate gland for swelling or infection.
A urinary tract infection may cause similar symptoms.
§Prevention
Risk of some causes of urethritis can be lessened by avoiding unprotected sexual activity, chemicals that could irritate the urethra; this could include detergents or lotions as well as spermicides or contraceptives, and irritation caused by manual manipulation of the urethra.
§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:[2] azithromycin, doxycycline, erythromycin, levofloxacin, metronidazole, ofloxacin, or tinidazole.
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.
§References
- ^ a b PubMed Health (2012). "Urethritis". U.S. National Library of Medicine. Retrieved 24 November 2012.
- ^ a b c "Disease characterized by urethritis and cervicitis". Centers for Disease Control and Prevention. 2010. Retrieved 24 November 2012.
- ^ http://www.medicaljournals.se/acta/content/download.php?doi=10.1080/000155599750010599
- ^ http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1046272/
- ^ Bradshaw CS, Tabrizi SN, Read TR, et al (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.
- Urinary system
- Pathology
- Urologic disease / Uropathy (N00–N39, 580–599)
|
|
| Abdominal |
Nephropathy/
(nephritis+
nephrosis) |
Glomerulopathy/
glomerulitis/
(glomerulonephritis+
glomerulonephrosis) |
Primarily
nephrotic |
| Non-proliferative |
- Minimal change
- Focal segmental
- Membranous
|
|
| Proliferative |
- Mesangial proliferative
- Endocapillary proliferative
- Membranoproliferative/mesangiocapillary
|
|
| By condition |
|
|
|
Primarily
nephritic,
RPG |
| Type I RPG/Type II hypersensitivity |
|
|
| Type II RPG/Type III hypersensitivity |
- Post-streptococcal
- Lupus
- IgA/Berger's
|
|
| Type III RPG/Pauci-immune |
- Granulomatosis with polyangiitis
- Microscopic polyangiitis
- Churg–Strauss syndrome
|
|
|
|
Tubulopathy/
tubulitis |
| Proximal |
|
|
| Thick ascending |
|
|
| Distal convoluted |
|
|
| Collecting duct |
- Liddle's syndrome
- RTA
- Diabetes insipidus
|
|
| Renal papilla |
|
|
| Major calyx/pelvis |
- Hydronephrosis
- Pyonephrosis
- Reflux nephropathy
|
|
| Any/all |
|
|
|
| Interstitium |
- Interstitial nephritis
- Pyelonephritis
- Danubian endemic familial nephropathy
|
|
| Any/all |
| General syndromes |
- Renal failure
- Acute renal failure
- Chronic kidney disease
- Uremic pericarditis
- Uremia
|
|
| Vascular |
- Renal artery stenosis
- Renal ischemia
- Hypertensive nephropathy
- Renovascular hypertension
- Renal cortical necrosis
|
|
| Other |
- Analgesic nephropathy
- Renal osteodystrophy
- Nephroptosis
- Abderhalden–Kaufmann–Lignac syndrome
|
|
|
|
| Ureter |
- Ureteritis
- Ureterocele
- Megaureter
|
|
|
| Pelvic |
| Bladder |
- Cystitis
- Interstitial cystitis
- Hunner's ulcer
- Trigonitis
- Hemorrhagic cystitis
- Neurogenic bladder dysfunction
- Bladder sphincter dyssynergia
- Vesicointestinal fistula
- Vesicoureteral reflux
|
|
| Urethra |
- Urethritis
- Non-gonococcal urethritis
- Urethral syndrome
- Urethral stricture/Meatal stenosis
- Urethral caruncle
|
|
|
| Any/all |
- Obstructive uropathy
- Urinary tract infection
- Retroperitoneal fibrosis
- Urolithiasis
- Bladder stone
- Kidney stone
- Renal colic
- Malakoplakia
- Urinary incontinence
|
|
Index of the urinary system
|
|
| Description |
- Anatomy
- Physiology
- Development
- Cells
|
|
| Disease |
- Electrolyte and acid-base
- Congenital
- Neoplasms and cancer
- Other
- Symptoms and signs
- Urine tests
- Blood tests
|
|
| Treatment |
- Procedures
- Drugs
- Intravenous fluids
|
|
|
|
Inflammation
|
|
| Acute |
| Plasma derived mediators |
- Bradykinin
- complement
- coagulation
- Factor XII
- Plasmin
- Thrombin
|
|
| Cell derived mediators |
| preformed: |
- Lysosome granules
- biogenic amines
|
|
| synthesized on demand: |
- cytokines
- 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 locations |
|
|