Urethritis
Charles Theisler in Adjuvant Medical Care, 2023
Urethritis is inflammation and swelling of the urethra, the structure that transports urine from the bladder to the outside of the body. Pain or burning with urination is the main symptom of urethritis along with increased urinary frequency and/or urgency. The urethral opening is typically red due to inflammation. Urethritis can be caused by bacterial infections (e.g., Staphylococcus aureus or E. coli) and STDs (Neisseria gonorrhoeae, non-gonococcal urethritis, Chlamydia trachomatis, or Mycoplasma genitalium) and also by trauma or irritating chemicals (e.g., antiseptics or spermicides). In females, pelvic inflammatory disease and tubo-ovarian abscess are well-known complications. In males, complications such as epididymitis and prostatitis can occur.
Other lower urinary tract disorders
David M. Luesley, Mark D. Kilby in Obstetrics & Gynaecology, 2016
Urethritis is inflammation of the urethra leading to symptoms of frequency, urgency, dysuria and localised urethral pain. It is caused either by an infectious pathogen or by chemical irritation. Evidence of the use of causative chemical agents, such as bubble baths, vaginal deodorants and perfumed cosmetics, should be sought as part of the medical history in women with such symptoms. Responsible infectious agents include many of the microorganisms associated with sexually transmitted infections, such as herpes simplex virus, Neisseria gonorrhoeae and Chlamydia. The group of organisms that typically cause acute bacterial cystitis, such as Escherichia coli, may also cause urethritis. Where urethritis is suspected, appropriate cultures should be taken from the urethra and vagina, as well as a midstream urine culture. Urine microscopy typically shows evidence of pyuria and bacteria.
Genital
Keith Hopcroft, Vincent Forte in Symptom Sorter, 2020
SMALL PRINT: INR, clotting screen, seminal fluid culture, transrectal ultrasound, prostate biopsy, urethroscopy. Urinalysis: protein, nitrites, leucocytes and possible haematuria in any genito-urinary infection or prostatitis. Haematuria possible in malignancy and schistosomiasis.MSU: to confirm infection and identify pathogen.FBC and ESR/CRP: WCC may be elevated in infection; Hb may be reduced and ESR/CRP raised in malignancy; ESR/CRP also raised in infection.PSA: the pros and cons of this test might be discussed as a pointer to prostatic carcinoma.Urethral swab: if urethritis suspected (best taken at GUM clinic).INR, clotting screen: if patient on warfarin or a bleeding disorder suspected.Other investigations (usually hospital-based): these might include seminal fluid culture to investigate deep-seated infection; transrectal ultrasound and prostatic biopsy for detailed investigation of prostate; urethroscopy/cystoscopy if felt to be a structural urethral or bladder problem.
Conception and development of Urinary Tract Infection indicators to advance the quality of spinal cord injury rehabilitation: SCI-High Project
Published in The Journal of Spinal Cord Medicine, 2019
B. Catharine Craven, S. Mohammad Alavinia, Jerzy B. Gajewski, Raj Parmar, Sandi Disher, Karen Ethans, John Shepherd, Maryam Omidvar, Farnoosh Farahani, Magdy Hassouna, Blayne Welk
There is significant controversy in the field as to what constitutes a UTI. Although there is consensus that the term “UTI” refers to significant bacteriuria among individuals with SCI/D and NLUTD, with symptoms or signs of infection. For example, most clinicians agree fever is a symptom of UTI,12 although health care providers use a variety of less established symptoms and signs to diagnose UTI, many of which have low sensitivity and specificity for UTI diagnosis.13 Previously, thought leaders in the field have proposed that UTI is an umbrella term which represents a “heterogeneous group of clinical diagnoses” that encompasses several clinical entities including urethritis, vaginitis, interstitial cystitis, pyelonephritis, etc. Further, catheter-associated UTI rates vary by the infection definition and the method of bladder drainage.14 To further conflate the lack of clinical clarity regarding UTI diagnosis, many studies report different colony count criteria for defining bacteriuria, without distinguishing symptomatic from asymptomatic patients.15 In response to the terminology conundrums, the European Association of Urology (2017) has developed and disseminated several UTI definitions for uncomplicated UTIs, complicated UTIs, recurrent UTIs, catheter-associated UTIs, and urosepsis in their most recent Urological Infections Guidelines.9
Syphilis incidence in men who have sex with men with human immunodeficiency virus comorbidity and the importance of integrating sexually transmitted infection prevention into HIV care
Published in Expert Review of Anti-infective Therapy, 2018
Oliver N Refugio, Jeffrey D Klausner
Furthermore, screening for asymptomatic urethritis by testing for gonorrhea and chlamydia alone may not be sufficient given that other pathogens (e.g. Trichomonas vaginalis, Herpes simplex viruses, Adenoviruses, Mycoplasma genitalium) can cause urethritis. In a study by Cohen and colleagues in 135 HIV-infected men, seminal HIV RNA concentration was found to be 8 times greater in those with urethritis compared to those without urethritis (p = 0.035); after antibiotic treatment, seminal HIV RNA levels significantly decreased [23]. If the goal is to detect and treat asymptomatic urethritis to reduce HIV-infectivity, then the current screening guidelines may miss other urethritis-inducing pathogens. More studies are needed to determine whether other screening methods for asymptomatic urethritis (e.g. Gram stain, urine microscopy, or urine leukocyte esterase) are cost-effective. Thus, in MSM living with HIV infection, prevention and treatment of syphilis and pathogenic causes of urethritis such as gonorrhea and chlamydia are vital. The question is: are HIV-infected MSM being appropriately screened for those infections as per guideline recommendations?
Pharmacotherapeutic interventions for the treatment of bacterial prostatitis
Published in Expert Opinion on Pharmacotherapy, 2022
Ester Marquez-Algaba, Joaquin Burgos, Benito Almirante
Gram-negative bacilli (GNB) are the most frequent pathogens in community acquired-ABP (CA-ABP), with Escherichia coli being the causative pathogen in 55–75% of cases. Other pathogens include members of the Enterobacterales family (Klebsiella, Proteus, Enterobacter, Citrobacter, and Serratia species) and Enterococcus species (2–10%) [4,6,11]. Nonfermenting GNB (Pseudomonas aeruginosa) is specifically related to urethral catheterization and urological procedures. Certain other gram-positive cocci (GPC) (including Staphylococcus aureus and Streptococcus agalactiae) have also been implicated in ABP [4,7]. Acute staphylococcal prostatitis, in particular, may result from bacteremia that accompanies a remote S. aureus infection elsewhere [25,26]. Neisseria gonorrhoeae and Chlamydia trachomatis in sexually active men with sexually transmitted urogenital infections, such as urethritis and epididymitis, can also acutely involve the prostate [27].
Related Knowledge Centers
- Bacteria
- Dysuria
- Epididymitis
- Inflammation
- Infection
- Urethra
- Neisseria Gonorrhoeae
- Sexually Transmitted Infection
- Idiopathic Disease
- NON-Gonococcal Urethritis