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Urethritis is one of the most common STD in our sexually active society. It means inflammation of urethra. Urethra is the tube which carries the urine from urinary bladder out. Various issue could cause this inflammation which include virus, bacteria, trauma, surgery, etc.
Gonorrhea:
It is rising in california, in our facility diagnosis of gonorrhea
almost doubled since last year. Unfortunately almost everyone use routine gonorrhea urine test on symptomatic patient, however, the gold standard for gonorrhea is direct testing and analysis from urethra.
"Gonorrhea
is a sexually transmitted disease
(STD). Gonorrhea is caused by Neisseria
gonorrhoeae, a bacterium that
can grow and multiply easily in the
warm, moist areas of the reproductive
tract, including the cervix (opening
to the womb), uterus (womb), and fallopian
tubes (egg canals) in women, and in
the urethra (urine canal) in women
and men. The bacterium can also grow
in the mouth, throat, eyes, and anus."
It is very common and it is usually
get treated by antibiotic injection.
In asymptomatic patient we may use
nucleic acid testing to increase the
sensitivity of the test which might
take 1-7 days ,but we usually make
it ready for you within 24 hours.
however, in symptomatic male patient
we give the gonorrhea test result
in 20 min.
Chlamydia :
Chlamydia
is a common sexually transmitted disease
(STD) caused by the bacterium, Chlamydia
trachomatis. It effects
both men and women. It could
damage a woman's reproductive
organs. Even though symptoms of chlamydia
are usually mild or absent in female
but it could cause irreversible
damage to reproductive system.Many
different test available such as culture,
DFA, DNA or Amplification DNA etc,
may take 1-7 days for result depend
of procedure. Treatment is antibiotic.
If You had sex with someone who had Gonorrhea or Chlamydia
If
your partner call you and inform you
that she/he has Chlamydia or Gonorrhea
then you might be at risk.
You must strongly consider to get
treated as well as carry the risk
of exposure or being origin of the
infection, In California we would
provide medicine and treatment for
your partner. Your main concern after
such a phone call is treatment and
testing.
NGU Test Result in 20 minutes only
NGU
It stands for non-gonococcal urethritis
It is the inflammation of urethra by other cause than gonorrhea. It could be chlamydia or may not be. It could be Virus such as herpes, Ureaplasma urealyticum, Trichomonas vaginalis, Adenovirus, Haemophilus vaginalis, Mycoplasm genitalium, urethral injury, surgery, and non-specific causes etc.
Chlamydia trachomatis (CT) |
15% to 40% |
Ureaplasma urealyticum (UU) |
10% to 40% |
Neither |
20% to 40% |
Mycoplasma genitalium |
15% to 25% |
Trichomonas vaginalis (TV) |
up to 13% |
Herpes Simplex Virus (HSV) |
< 5% |
Candida albicans |
<1% |
Miscellaneous bacteria |
<1% |
Other (E.Coli, Haemophilus spp gram positive organisms) |
? |
Unknown |
20-30% |
"Adapted from Holmes KK et al. Sexually Transmitted Diseases. 3rd Ed. 1999. Ch. 60, page 834"
"Specifics
- Chlamydia- in some areas of the US the proportion of NGU due to this organism is declining perhaps as a result of increased screening efforts.
- Ureaplasma- urethral colonization in men without urethritis is common but has been associated with clinical urethritis in men without any other discernible cause. However, the role of this organism in clinical disease remains unclear.
- Mycoplasma genitalium- isolated more frequently in men with NGU than from those without but the causal role is still not proven.
- Trichomonas- implicated in higher proportion on NGU cases in eastern Europe, Africa, and India compared with the US. Recent data suggests, however, that trichomoniasis is increasing as a cause of NGU (about 10%). Incidence of trichomonal NGU may be higher in men more than 30 years of age.
- HSV- Urethritis in 15-30% of men with primary HSV. Less frequent with recurrent HSV. Most, but not all patients with HSV urethritis have visible penile lesions.
- Yeast- rarely detected in urethritis study but some men with balanitis have symptoms of urethritis.
- Urethral gram stain may demonstrate WBC and gram negative rods. Maybe associated with cystitis and occasionally with insertive anal sex. Treatment should be directed towards gram negative rods.
- Noninfectious causes of urethritis- trauma, chemical irritation, Steven-Johnson syndrome." Boston University education
Symptoms of non-gonococcal urethritis
Up to 1/3 of men presenting at an STD clinic with laboratory confirmed NGU have no signs (discharge) or symptoms (dysuria/itching).
- A white discharge from the end of the penis, but does not occur in every case.
- Pain or burning when you pass urine. This may be confused with a urine infection.
- Irritation
- urinary frequency
- tingling
Diagnosis:
So just getting negative test on Gonorrhea and Chlamydia for STD testing does not mean you do not have NGU. It needs experience for testing and skilled physician will diagnose this condition.
Urine Infection:
We often see male patients in our clinic with chief complaint that" Doctor, I think I have urine infection" and not STD. We usually test for urine as well as part of STD evaluation. Urethra is shorter in female than in male, so simple Urine infection is more common in young female than male. In men the diagnosis of urethritis must always be in clinician mind when evaluating the patient
Term of "Honeymoon Cystitis" given to female patients after have a lot of sex during their honeymoon.
Cystitis:
It is an inflammation or infection of urinary bladder when it caused by bacteria then it will call bacterial urinary tract infection (UTI).
Prostatitis:
It is inflammation of prostate gland. Prostate gland produce semen. It could be by bacterial or non-bacterial. Treatment will be administer by your doctor after the diagnosis has been established
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