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Urethritis

Urethritis


Non-Gonococcal Urethritis and Chlamydia Cervicitis

Non-gonococcal urethritis and Chlamydia cervicitis are sexually transmitted diseases commonly caused by Chlamydia trachomatis or, in men, by Ureaplasma urealyticum, and sometimes by Trichomonas vaginalis or herpes simplex virus.

These infections are called "non-gonococcal" to indicate that they are not caused by Neisseria gonorrhoeae, the bacterium that causes gonorrhea (gonorrhea).

Chlamydia trachomatis accounts for approximately 50% of urethral infections in men not caused by gonorrhea and most pyogenic infections of the cervix not caused by gonorrhea.

Most of the remaining cases of urethritis are caused by Ureaplasma urealyticum, a bacterium similar to mycoplasmas.

Chlamydia are small bacteria that can reproduce only inside the cells.

Ureaplasmas are very small bacteria that do not have a rigid cell wall, but can reproduce outside the cells.

Symptoms and Diagnosis

Usually, between 4 and 28 days after having sex with an infected person, an infected man feels a slight burning sensation in the urethra when urinating.

It is common for it to have a urethral discharge, which may be clear or cloudy, but is usually less thick than the secretion of gonorrhea.

In the morning, the penile orifice is often hyperemic and adhered by the secreted secretion.
Occasionally, the disease begins more dramatically.

The man presents pain with urination, needs to urinate more frequently and presents a purulent urethral secretion.
Although most women infected with Chlamydia are asymptomatic, some have a frequent urge to urinate, pain on urination, lower abdominal pain, intercourse pain, and yellow mucopurulent vaginal discharge.

Anal or oral sex with an infected partner can lead to infection of the rectum or throat.
These infections can cause pain and a mucopurulent yellow discharge.

In most cases, an infection caused by Chlamydia trachomatis can be diagnosed by laboratory examination of urethral or cervical secretions.

Infections caused by Ureaplasma urealyticum are not specifically diagnosed in common clinical settings.

Because the culture of this microorganism is difficult and the other diagnostic techniques are expensive, the physician generally assumes a diagnosis of Chlamydia infection or Ureaplasma based on the characteristic symptoms concomitantly with the evidence against the presence of gonorrhea.

Complications and Prognosis

When an infection caused by Chlamydia trachomatis is not treated, symptoms disappear within 4 weeks in approximately 60 to 70% of individuals.
However, a Chlamydia infection can cause a lot of complications.
It is unclear whether Ureaplasma plays any role in these complications.

When untreated, a Chlamydia infection in women often ascends to the uterine tubes where inflammation can cause pain and healing can cause infertility and ectopic pregnancy.
These latter complications can occur without previous symptoms and lead to considerable suffering and medical costs.

In men, Chlamydia can cause epididymitis, which produces painful edema of the scrotal sac, uni or bilateral.

Treatment

Chlamydia and Ureaplasma infections are usually treated with oral tetracycline or doxycycline for at least 7 days or with a single dose of azithromycin.

Pregnant women should not take tetracycline.

In approximately 20% of individuals, the infection recurs after treatment. In these cases, the treatment is repeated for a longer period.

Infected individuals who have sex before the end of treatment can infect their partners.
Thus, when possible, sexual partners should be treated simultaneously.

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