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Urethritis
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Urethritis

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Contributors: Neil Mendoza MD, Paritosh Prasad MD
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Synopsis

Urethritis is inflammation of the urethra typically caused by infectious organisms including Chlamydia trachomatis or Neisseria gonorrhoeae.

Patients have urethral discharge which, depending on the etiology of the urethritis, can vary in amount and appearance. In some cases, the discharge may be scant and clear. Gonococcal urethritis typically causes frankly purulent discharge. Patients may also have dysuria or urethral pruritus. In some cases, urethritis may be accompanied by epididymitis (usually unilateral epididymal pain), proctitis (depending on exposure), and/or fever.

Multiple pathogens cause urethritis including N. gonorrhoeae, C. trachomatis, Mycoplasma genitalium, and Trichomonas vaginalis. Less common pathogens include Ureaplasma spp., adenovirus, and herpes simplex virus. In addition, patients should be tested for other sexually transmitted diseases including human immunodeficiency virus (HIV) since co-infection is possible (especially in high-risk patient populations).

Codes

ICD10CM:
N34.1 – Nonspecific urethritis

SNOMEDCT:
31822004 – Urethritis

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Diagnostic Pearls

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Differential Diagnosis & Pitfalls

  • Prostatitis or epididymitis due to enteric pathogens (eg, Escherichia coli)
  • Chronic prostatitis / chronic pelvic pain syndrome – Does not present with urethral discharge.
  • Cystitis – Presents with dysuria but not urethral discharge.
  • Chemical irritation (eg, from spermicides)

Best Tests

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Management Pearls

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Therapy

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References

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Last Reviewed: 06/27/2017
Last Updated: 07/18/2017
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Urethritis
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Urethritis : Dysuria, Urethral discharge
Copyright © 2019 VisualDx®. All rights reserved.