Urethritis is inflammation of the urethra. The main symptom is dysuria, which is painful or difficult urination.
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.
The physician sometimes performs a digital rectal exam (DRE) to inspect the prostate gland for swelling or infection.
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.
- ''Escherichia coli''
- 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).
Discharge (milky or pus-like) from the penis, stinging or burning during urination, itching, tingling, burning or irritation inside the penis.
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.
(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.
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