Materiały źródłowe

• #1 Urethritis – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK537282/

  Urethritis is a lower urinary tract infection that causes inflammation of the urethra, the fibromuscular tube responsible for expelling urine from the body in both males and females. Urethritis is commonly associated with sexually transmitted infections (STIs) and is classified as either gonococcal or nongonococcal. Neisseria gonorrhoeae and Chlamydia trachomatis are the main causative agents of this condition. The etiology of urethritis varies depending on geographical location and sexual practices, underscoring the importance of obtaining a detailed patient history. Inflammation of the urethra commonly stems from an infectious origin, with STIs being the primary cause. […] Sexually transmitted urethritis is categorized into 2 types: nongonococcal urethritis, typically caused by C trachomatis or Mycoplasma genitalium, and gonococcal urethritis, resulting from infections with N gonorrhoeae. Chlamydia trachomatis is the most prevalent nongonococcal cause of urethritis and can be transmitted through sexual intercourse. This bacterium is a small, gram-negative obligate intracellular parasite with an average incubation period of 7 to 14 days. Chlamydial urethritis is often asymptomatic and commonly associated with M genitalium and N gonorrhoeae (which causes gonorrhea). Neisseria gonorrhoeae is the leading cause of urethritis. N gonorrhoeae is a gram-negative diplococcus transmitted through sexual intercourse with an incubation period of 2 to 5 days.

• #2 Urethritis: Practice Essentials, Pathophysiology, Etiology

  https://emedicine.medscape.com/article/438091-overview

  Urethritis is an inflammatory condition that can be infectious or posttraumatic in nature. Infectious causes of urethritis are typically sexually transmitted and categorized as either GU (ie, due to infections with Neisseria gonorrhoeae) or NGU (eg, due to infections with Chlamydia trachomatis, Ureaplasma urealyticum, Mycoplasma hominis, Mycoplasma genitalium, or Trichomonas vaginalis). The presence of Gram-negative intracellular diplococci on urethral smear is suggestive of gonococcal urethritis. Gonococcal infection is typically accompanied by chlamydial infection, which accounts for 15%-40% of NGU cases. It is essential to document chlamydial infections due to the need for partner evaluation and treatment to prevent complications from chlamydial infections, especially in female partners.

• #3 Urethritis – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK537282/

  Urethritis is a lower urinary tract infection that causes inflammation of the urethra, the fibromuscular tube responsible for expelling urine from the body in both males and females. Urethritis is commonly associated with sexually transmitted infections (STIs) and is classified as either gonococcal or nongonococcal. Neisseria gonorrhoeae and Chlamydia trachomatis are the main causative agents of this condition. The etiology of urethritis varies depending on geographical location and sexual practices, underscoring the importance of obtaining a detailed patient history. Inflammation of the urethra commonly stems from an infectious origin, with STIs being the primary cause. […] Sexually transmitted urethritis is categorized into 2 types: nongonococcal urethritis, typically caused by C trachomatis or Mycoplasma genitalium, and gonococcal urethritis, resulting from infections with N gonorrhoeae. Chlamydia trachomatis is the most prevalent nongonococcal cause of urethritis and can be transmitted through sexual intercourse. This bacterium is a small, gram-negative obligate intracellular parasite with an average incubation period of 7 to 14 days. Chlamydial urethritis is often asymptomatic and commonly associated with M genitalium and N gonorrhoeae (which causes gonorrhea). Neisseria gonorrhoeae is the leading cause of urethritis. N gonorrhoeae is a gram-negative diplococcus transmitted through sexual intercourse with an incubation period of 2 to 5 days.

• #4 Urethritis pathophysiology – wikidoc

  https://www.wikidoc.org/index.php/Urethritis_pathophysiology

  Gonorrheal: N. gonorrhea is usually transmitted via the genital tract to the human host. Following attachment to host cell, which is mediated by pili, gonococci become engulfed in a process known as parasite-directed endocytosis. This organism will survive inside the vacuoles and replicate. […] Non-Gonorrheal: Among non-gonorrheal causes, Chlamydia trachomatis is the most common. The infectious process begins with cell surface attachment and phagocytosis by the host cell. The pathogen survives inside the cell by debilitating the cellular lysosomes and replicating as elementary bodies which is considered as the infective form of the pathogen.

• #5 Urethritis pathophysiology – wikidoc

  https://www.wikidoc.org/index.php/Urethritis_pathophysiology

  Gonorrheal: N. gonorrhea is usually transmitted via the genital tract to the human host. Following attachment to host cell, which is mediated by pili, gonococci become engulfed in a process known as parasite-directed endocytosis. This organism will survive inside the vacuoles and replicate. […] Non-Gonorrheal: Among non-gonorrheal causes, Chlamydia trachomatis is the most common. The infectious process begins with cell surface attachment and phagocytosis by the host cell. The pathogen survives inside the cell by debilitating the cellular lysosomes and replicating as elementary bodies which is considered as the infective form of the pathogen.

• #6 Urethritis | Obgyn Key

  https://obgynkey.com/urethritis/

  Urethritis is an inflammation of the urethra and periurethral tissues in males and females. It may be associated with a variety of infectious and noninfectious disorders. […] The cause of urethritis varies with the age of the patient, sexual practices, and hygienic standards. […] Infection caused by N. gonorrhoeae usually is localized to the urethra in boys and to the vagina in girls; however, rectal and pharyngeal carriage sometimes occurs in the absence of urethral colonization. […] Gonococcal virulence factors include pili, the ability to attach to urethral epithelial cells, and production of extracellular proteases that cleave IgA. […] Local invasion involves multiple adhesins interacting with host receptors at the mucosal cell level. After attachment occurs, gonococci become internalized in a process known as membrane ruffling. The organisms are able to undergo intracellular replication within phagocytic vacuoles and columnar epithelial cells, which is a successful adaptive response promoting survival.

• #7 Urethritis | Obgyn Key

  https://obgynkey.com/urethritis/

  Urethritis is an inflammation of the urethra and periurethral tissues in males and females. It may be associated with a variety of infectious and noninfectious disorders. […] The cause of urethritis varies with the age of the patient, sexual practices, and hygienic standards. […] Infection caused by N. gonorrhoeae usually is localized to the urethra in boys and to the vagina in girls; however, rectal and pharyngeal carriage sometimes occurs in the absence of urethral colonization. […] Gonococcal virulence factors include pili, the ability to attach to urethral epithelial cells, and production of extracellular proteases that cleave IgA. […] Local invasion involves multiple adhesins interacting with host receptors at the mucosal cell level. After attachment occurs, gonococci become internalized in a process known as membrane ruffling. The organisms are able to undergo intracellular replication within phagocytic vacuoles and columnar epithelial cells, which is a successful adaptive response promoting survival.

• #8 Neisseria gonorrhoeae host adaptation and pathogenesis | Nature Reviews Microbiology

  https://www.nature.com/articles/nrmicro.2017.169

  The host-adapted human pathogen Neisseria gonorrhoeae is the causative agent of gonorrhoea. […] N. gonorrhoeae is an obligate human pathogen with the ability to evade and modulate both the innate and adaptive immune systems to benefit its replication and survival. […] As N. gonorrhoeae progresses through the stages of disease pathogenesis (transmission, adherence, colonization and invasion, and immune evasion), the bacterium expresses many virulence factors to promote survival and replication while remaining minimally invasive and minimally discoverable by immune cells. […] This study shows that gonococcal LOS binds to asialoglycoprotein receptor 1 (ASGPR1) on human sperm, possibly contributing to male-to-female transmission. […] This study demonstrates that transcription of a small, cis-acting, non-coding RNA initiates within the guanine quartet (G4) coding sequence enables the formation of the G4 structure required for pilin antigenic variation.

• #9 Neisseria gonorrhoeae host adaptation and pathogenesis | Nature Reviews Microbiology

  https://www.nature.com/articles/nrmicro.2017.169

  This study shows that sialylation of gonococcal LOS prevents opsonophagocytosis by immune sera, which led to the later confirmation that sialylation of LOS prevents complement activation and killing. […] This study demonstrates how sialylated LOS binds human factor H and prevents complement-mediated killing of N. gonorrhoeae. […] This study presents and characterizes a transgenic mouse model for gonorrhoea infection wherein the mouse has been made to express a humanized CEACAM receptor molecule important for adherence and colonization, enabling N. gonorrhoeae to intravaginally colonize the mouse.

• #10 Urethritis: Practice Essentials, Pathophysiology, Etiology

  https://emedicine.medscape.com/article/438091-overview

  There has been a notable increase in the incidence of urethritis associated with Mycoplasma genitalium, now the second most common cause of NGU, although there is currently a lack of US Food and Drug Administration (FDA) approved tests for diagnostic use. This organism can be sexually transmitted, accounts for 15%-25% of NGU cases in the United States and should be suspected in cases of recurrent or persistent urethritis. […] Haemophilus species are an increasing cause of NGU, particularly in patients who have unprotected oral sex. […] Rare infectious causes of urethritis include lymphogranuloma venereum, herpes simplex virus types 1 and 2, adenovirus, syphilis, mycobacterial infection, Corynebacterium, and bacterial infections that are typically associated with cystitis (usually gram-negative rods) in the presence of urethral stricture. Other rare but reported causes of urethritis include viral, streptococcal, anaerobic, and meningococcal infections. However, in up to 35% of NGU cases, no pathogen is found. […] Posttraumatic urethritis can occur in 2%-20% of patients practicing intermittent catheterization and following instrumentation or foreign body insertion. Urethritis is 10 times more likely to occur with latex catheters than with silicone catheters.

• #11 Urethritis – Urinary Tract Infections (UTIs) – Nephrology – Diseases – McMaster Textbook of Internal Medicine

  https://empendium.com/mcmtextbook/chapter/B31.II.14.8.11.

  Urethritis is usually a sexually transmitted disease (STD). Gonococcal urethritis is caused by Neisseria gonorrhoeae, while the more common nongonococcal urethritis is predominantly due to infection with Chlamydia trachomatis but also secondary to infections by Ureaplasma urealyticum, Mycoplasma genitalium, Trichomonas vaginalis, or less frequently other microorganisms. […] Rarely urethritis may be caused by repeated trauma, for example, with bladder catheterization. […] Infection with C trachomatis can be asymptomatic in up to 50% of women and over time may lead to pelvic inflammatory disease and its consequences. In men it can cause urethritis, prostatitis, epididymitis, and infertility.

• #12 Urethritis – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK537282/

  Urethritis in men has the potential to result in infertility. In women, 10% to 40% of those with urethritis may advance to pelvic inflammatory disease, even among individuals who are initially asymptomatic. Urethritis is diagnosed based on any of the following signs or laboratory tests: urethral mucopurulent or purulent discharge; gram stain of urethral secretions revealing 2 or more white blood cells (WBCs) per oil immersion field; a positive leukocyte esterase test on first-void urine or a microscopic examination of first-void urine sediment reveals 10 or more WBCs per high-power field; utilization of nucleic acid amplification testing (NAAT). […] The primary cause of nongonococcal urethritis is C trachomatis, which, like N gonorrhoeae, is an intracellular bacterial organism. However, C trachomatis lacks cell wall peptidoglycans, resulting in its inability to take up visible gram staining. Other organisms can be causative agents of urethritis, such as enteric organisms introduced via rectal exposure, such as gram-negative rods typically associated with UTIs or anal intercourse. Pathogens such as Haemophilus spp, N meningitides, Moraxella catarrhalis, and Streptococcus pneumonia, which are linked to oral sex, can also cause nongonococcal urethritis.

• #13 STI-associated syndromes guide: Urethritis – Canada.ca

  https://www.canada.ca/en/public-health/services/infectious-diseases/sexual-health-sexually-transmitted-infections/canadian-guidelines/sti-associated-syndromes/urethritis.html

  There are limited data on the incidence and prevalence of urethritis. However, it is well established that STIs are important infectious causes of urethritis. […] Neisseria gonorrhoeae (GC) is the most common cause of urethritis. In one study, 30% of males with acute urethritis had GC. […] In cases of non-gonococcal urethritis, Chlamydia trachomatis (CT) was identified in 15-40% of people and M. genitalium was identified in 15-25% of people. Other possible infectious causes include Trichomonas vaginalis, Herpes simplex virus (HSV), adenovirus and Candida albicans. In almost half of the cases of non-gonococcal urethritis, the specific microbial etiology is unknown and no specific organism is identified. […] A „test and wait” approach (versus empiric treatment) may be best in certain circumstances. This is because many cases of urethritis are of unknown etiology and rates of antimicrobial resistance (AMR) are increasing. […] In the case of recurrent or persistent urethritis, assess the possibility of poor adherence to treatment, use of alternate rather than preferred (first-line) treatment, reinfection, AMR, presence of other pathogens that were not part of initial testing, and presence of other etiologies.

• #14 Urethritis – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK537282/

  Urethritis is a lower urinary tract infection that causes inflammation of the urethra, the fibromuscular tube responsible for expelling urine from the body in both males and females. Urethritis is commonly associated with sexually transmitted infections (STIs) and is classified as either gonococcal or nongonococcal. Neisseria gonorrhoeae and Chlamydia trachomatis are the main causative agents of this condition. The etiology of urethritis varies depending on geographical location and sexual practices, underscoring the importance of obtaining a detailed patient history. Inflammation of the urethra commonly stems from an infectious origin, with STIs being the primary cause. […] Sexually transmitted urethritis is categorized into 2 types: nongonococcal urethritis, typically caused by C trachomatis or Mycoplasma genitalium, and gonococcal urethritis, resulting from infections with N gonorrhoeae. Chlamydia trachomatis is the most prevalent nongonococcal cause of urethritis and can be transmitted through sexual intercourse. This bacterium is a small, gram-negative obligate intracellular parasite with an average incubation period of 7 to 14 days. Chlamydial urethritis is often asymptomatic and commonly associated with M genitalium and N gonorrhoeae (which causes gonorrhea). Neisseria gonorrhoeae is the leading cause of urethritis. N gonorrhoeae is a gram-negative diplococcus transmitted through sexual intercourse with an incubation period of 2 to 5 days.

• #15 Urethritis pathophysiology – wikidoc

  https://www.wikidoc.org/index.php/Urethritis_pathophysiology

  Gonorrheal: N. gonorrhea is usually transmitted via the genital tract to the human host. Following attachment to host cell, which is mediated by pili, gonococci become engulfed in a process known as parasite-directed endocytosis. This organism will survive inside the vacuoles and replicate. […] Non-Gonorrheal: Among non-gonorrheal causes, Chlamydia trachomatis is the most common. The infectious process begins with cell surface attachment and phagocytosis by the host cell. The pathogen survives inside the cell by debilitating the cellular lysosomes and replicating as elementary bodies which is considered as the infective form of the pathogen.

• #16 Urethritis | Treatment & Management | Point of Care

  https://www.statpearls.com/point-of-care/30837

  Patients are commonly coinfected with chlamydia. […] Gonorrhea may also contribute to abnormal semen parameters and male infertility. […] M genitalium causes recurrent or persistent urethritis and is a common causative agent in men with nongonococcal urethritis, not due to chlamydia. […] This organism is a microscopic, self-replicating bacteria that lacks a cell wall, which explains why it does not take up the gram stain. […] Given its slow-growing and fastidious nature, M genitalium can be challenging to detect by culture. […] The primary cause of nongonococcal urethritis is C trachomatis, which, like N gonorrhoeae, is an intracellular bacterial organism. […] However, C trachomatis lacks cell wall peptidoglycans, resulting in its inability to take up visible gram staining.

• #17 STI-associated syndromes guide: Urethritis – Canada.ca

  https://www.canada.ca/en/public-health/services/infectious-diseases/sexual-health-sexually-transmitted-infections/canadian-guidelines/sti-associated-syndromes/urethritis.html

  There are limited data on the incidence and prevalence of urethritis. However, it is well established that STIs are important infectious causes of urethritis. […] Neisseria gonorrhoeae (GC) is the most common cause of urethritis. In one study, 30% of males with acute urethritis had GC. […] In cases of non-gonococcal urethritis, Chlamydia trachomatis (CT) was identified in 15-40% of people and M. genitalium was identified in 15-25% of people. Other possible infectious causes include Trichomonas vaginalis, Herpes simplex virus (HSV), adenovirus and Candida albicans. In almost half of the cases of non-gonococcal urethritis, the specific microbial etiology is unknown and no specific organism is identified. […] A „test and wait” approach (versus empiric treatment) may be best in certain circumstances. This is because many cases of urethritis are of unknown etiology and rates of antimicrobial resistance (AMR) are increasing. […] In the case of recurrent or persistent urethritis, assess the possibility of poor adherence to treatment, use of alternate rather than preferred (first-line) treatment, reinfection, AMR, presence of other pathogens that were not part of initial testing, and presence of other etiologies.

• #18 Urethritis | Treatment & Management | Point of Care

  https://www.statpearls.com/point-of-care/30837

  Patients are commonly coinfected with chlamydia. […] Gonorrhea may also contribute to abnormal semen parameters and male infertility. […] M genitalium causes recurrent or persistent urethritis and is a common causative agent in men with nongonococcal urethritis, not due to chlamydia. […] This organism is a microscopic, self-replicating bacteria that lacks a cell wall, which explains why it does not take up the gram stain. […] Given its slow-growing and fastidious nature, M genitalium can be challenging to detect by culture. […] The primary cause of nongonococcal urethritis is C trachomatis, which, like N gonorrhoeae, is an intracellular bacterial organism. […] However, C trachomatis lacks cell wall peptidoglycans, resulting in its inability to take up visible gram staining.

• #19 Mycoplasma genitalium – STI Treatment Guidelines

  https://www.cdc.gov/std/treatment-guidelines/mycoplasmagenitalium.htm

  M. genitalium causes symptomatic and asymptomatic urethritis among men and is the etiology of approximately 15%20% of NGU, 20%25% of nonchlamydial NGU, and 40% of persistent or recurrent urethritis. […] Data are insufficient to implicate M. genitalium infection with chronic complications among men (e.g., epididymitis, prostatitis, or infertility). […] The consequences of asymptomatic infection with M. genitalium among men are unknown. […] Men with recurrent NGU should be tested for M. genitalium using an FDA-cleared NAAT. […] If resistance testing is available, it should be performed and the results used to guide therapy. […] Testing should be accompanied with resistance testing, if available. […] In clinical practice, if testing is unavailable, M. genitalium should be suspected in cases of persistent or recurrent urethritis or cervicitis and considered for PID.

• #20 Mycoplasma genitalium – STI Treatment Guidelines

  https://www.cdc.gov/std/treatment-guidelines/mycoplasmagenitalium.htm

  M. genitalium lacks a cell wall, and thus antibiotics targeting cell-wall biosynthesis (e.g., -lactams including penicillins and cephalosporins) are ineffective against this organism. […] Because of the high rates of macrolide resistance with treatment failures and efficient selection of additional resistance, a 1-g dose of azithromycin should not be used. […] Two-stage therapy approaches, ideally using resistance-guided therapy, are recommended for treatment. […] Resistance-guided therapy has demonstrated cure rates of 90% and should be used whenever possible; however, it requires access to macrolide-resistance testing. […] As part of this approach, doxycycline is provided as initial empiric therapy, which reduces the organism load and facilitates organism clearance, followed by macrolide-sensitive M. genitalium infections treated with high-dose azithromycin; macrolide-resistant infections are treated with moxifloxacin.

• #21 Are Ureaplasma spp. a Cause of Nongonococcal Urethritis? A Systematic Review and Meta-Analysis | PLOS One

  https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0113771

  Nongonococcal urethritis (NGU) is the most common male reproductive tract syndrome. Ureaplasmas spp. including U. urealyticum and U. parvum, have been increasingly reported to be implicated in NGU. However, there are still many contradictions about their pathogenic role in NGU. […] Our analysis supports that U. urealyticum, but not U. parvum, is an etiological agent in NGU. More detailed studies of these two species in China and the world could contribute to a better understanding of the epidemiology and pathogenesis, and facilitate the development of better strategies for treatment and prevention of NGU. […] There has been a great deal of disagreement about the role of Ureaplasma spp. in NGU. While there are numerous epidemiologic data collected from various study populations examined for either undifferentiated Ureaplasma spp. or differentiated U. parvum and U. urealyticum, it remains inconclusive whether undifferentiated or differentiated species play a pathogenic role in NGU.

• #22

  https://www.jci.org/articles/view/108694/citations

  Chlamydia trachomatis, Ureaplasma urealyticum (T-mycoplasma), and Hemophilus vaginalis have previously been considered possible etiological agents in nongonococcal urethritis (NGU). […] Thus, culture, serology, and response to therapy support the etiologic role of chlamydia in NGU. Quantitative culture and response to therapy suggest U. unrealyticum may cause many cases of chlamydia-netative NGU.

• #23 Urethritis – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK537282/

  Urethritis in men has the potential to result in infertility. In women, 10% to 40% of those with urethritis may advance to pelvic inflammatory disease, even among individuals who are initially asymptomatic. Urethritis is diagnosed based on any of the following signs or laboratory tests: urethral mucopurulent or purulent discharge; gram stain of urethral secretions revealing 2 or more white blood cells (WBCs) per oil immersion field; a positive leukocyte esterase test on first-void urine or a microscopic examination of first-void urine sediment reveals 10 or more WBCs per high-power field; utilization of nucleic acid amplification testing (NAAT). […] The primary cause of nongonococcal urethritis is C trachomatis, which, like N gonorrhoeae, is an intracellular bacterial organism. However, C trachomatis lacks cell wall peptidoglycans, resulting in its inability to take up visible gram staining. Other organisms can be causative agents of urethritis, such as enteric organisms introduced via rectal exposure, such as gram-negative rods typically associated with UTIs or anal intercourse. Pathogens such as Haemophilus spp, N meningitides, Moraxella catarrhalis, and Streptococcus pneumonia, which are linked to oral sex, can also cause nongonococcal urethritis.

• #24 Urethritis – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK537282/

  Urethritis in men has the potential to result in infertility. In women, 10% to 40% of those with urethritis may advance to pelvic inflammatory disease, even among individuals who are initially asymptomatic. Urethritis is diagnosed based on any of the following signs or laboratory tests: urethral mucopurulent or purulent discharge; gram stain of urethral secretions revealing 2 or more white blood cells (WBCs) per oil immersion field; a positive leukocyte esterase test on first-void urine or a microscopic examination of first-void urine sediment reveals 10 or more WBCs per high-power field; utilization of nucleic acid amplification testing (NAAT). […] The primary cause of nongonococcal urethritis is C trachomatis, which, like N gonorrhoeae, is an intracellular bacterial organism. However, C trachomatis lacks cell wall peptidoglycans, resulting in its inability to take up visible gram staining. Other organisms can be causative agents of urethritis, such as enteric organisms introduced via rectal exposure, such as gram-negative rods typically associated with UTIs or anal intercourse. Pathogens such as Haemophilus spp, N meningitides, Moraxella catarrhalis, and Streptococcus pneumonia, which are linked to oral sex, can also cause nongonococcal urethritis.

• #25 Urethritis: Causes, Symptoms, and Treatment

  https://www.webmd.com/a-to-z-guides/urethritis-symptoms-causes-treatments

  Urethritis is inflammation of the urethra. That’s the tube that carries urine from the bladder to outside the body. […] Urethritis is commonly due to infection by bacteria, most often through sexual contact. […] Most episodes of urethritis are caused by infection by bacteria that enter the urethra from the skin around the urethra’s opening. […] The herpes simplex virus (HSV-1 and HSV-2) can also cause urethritis. […] Sexually transmitted infections like gonorrhea and chlamydia are usually confined to the urethra. […] In men, gonorrhea and chlamydia sometimes cause epididymitis, an infection of the epididymis, a tube on the outside of the testes. […] The main symptom of urethra inflammation from urethritis is pain with urination (dysuria). […] Urethritis can also cause itching, pain, or discomfort when a person is not urinating.

• #26 Urethritis: Practice Essentials, Pathophysiology, Etiology

  https://emedicine.medscape.com/article/438091-overview

  There has been a notable increase in the incidence of urethritis associated with Mycoplasma genitalium, now the second most common cause of NGU, although there is currently a lack of US Food and Drug Administration (FDA) approved tests for diagnostic use. This organism can be sexually transmitted, accounts for 15%-25% of NGU cases in the United States and should be suspected in cases of recurrent or persistent urethritis. […] Haemophilus species are an increasing cause of NGU, particularly in patients who have unprotected oral sex. […] Rare infectious causes of urethritis include lymphogranuloma venereum, herpes simplex virus types 1 and 2, adenovirus, syphilis, mycobacterial infection, Corynebacterium, and bacterial infections that are typically associated with cystitis (usually gram-negative rods) in the presence of urethral stricture. Other rare but reported causes of urethritis include viral, streptococcal, anaerobic, and meningococcal infections. However, in up to 35% of NGU cases, no pathogen is found. […] Posttraumatic urethritis can occur in 2%-20% of patients practicing intermittent catheterization and following instrumentation or foreign body insertion. Urethritis is 10 times more likely to occur with latex catheters than with silicone catheters.

• #27 Urethritis: Practice Essentials, Pathophysiology, Etiology

  https://emedicine.medscape.com/article/438091-overview

  There has been a notable increase in the incidence of urethritis associated with Mycoplasma genitalium, now the second most common cause of NGU, although there is currently a lack of US Food and Drug Administration (FDA) approved tests for diagnostic use. This organism can be sexually transmitted, accounts for 15%-25% of NGU cases in the United States and should be suspected in cases of recurrent or persistent urethritis. […] Haemophilus species are an increasing cause of NGU, particularly in patients who have unprotected oral sex. […] Rare infectious causes of urethritis include lymphogranuloma venereum, herpes simplex virus types 1 and 2, adenovirus, syphilis, mycobacterial infection, Corynebacterium, and bacterial infections that are typically associated with cystitis (usually gram-negative rods) in the presence of urethral stricture. Other rare but reported causes of urethritis include viral, streptococcal, anaerobic, and meningococcal infections. However, in up to 35% of NGU cases, no pathogen is found. […] Posttraumatic urethritis can occur in 2%-20% of patients practicing intermittent catheterization and following instrumentation or foreign body insertion. Urethritis is 10 times more likely to occur with latex catheters than with silicone catheters.

• #28 Urethritis: MedlinePlus Medical EncyclopediaLock

  https://medlineplus.gov/ency/article/000439.htm

  Urethritis is inflammation (swelling and irritation) of the urethra. The urethra is the tube that carries urine from the body. […] Both bacteria and viruses may cause urethritis. Some of the bacteria that cause this condition include E coli, chlamydia, and gonorrhea. These bacteria also cause urinary tract infections (UTIs) and some sexually transmitted diseases. Viral causes are herpes simplex virus and cytomegalovirus. […] Urethritis caused by trauma or chemical irritants is treated by avoiding the source of injury or irritation. […] However, urethritis can lead to long-term damage to the urethra and scar tissue called a urethral stricture. It can also cause damage to other urinary organs in both men and women. In women, the infection could lead to fertility problems if it spreads to the pelvis. […] After a severe infection, the urethra may become scarred and then narrowed.

• #29 Non-gonococcal urethritis – Wikipedia

  https://en.wikipedia.org/wiki/Non-gonococcal_urethritis

  Nongonococcal urethritis (NGU) is inflammation of the urethra that is not caused by gonorrheal infection. […] There are many causes of NGU. This is in part due to the large variety of organisms living in the urinary tract. Ureaplasma urealyticum and Mycoplasma genitalium are some of the culprits. […] The most common bacterial cause of NGU is Chlamydia trachomatis, but it can also be caused by Ureaplasma urealyticum, Haemophilus vaginalis, Mycoplasma genitalium, Mycoplasma hominis, Neisseria meningitidis, Gardnerella vaginalis, Acinetobacter lwoffii, Acinetobacter calcoaceticus, and E.coli. […] Urethritis can be caused by mechanical injury (from a urinary catheter or a cystoscope), or by an irritating chemical (antiseptics or some spermicides). […] Non-gonococcal urethritis (NGU) is diagnosed if a person with urethritis has no signs of gonorrhea bacteria on laboratory tests.

• #30 Urethritis: Causes, Symptoms, Diagnosis & Treatment

  https://my.clevelandclinic.org/health/diseases/22858-urethritis

  Urethritis is an inflammation (swelling and irritation) of the urethra, the tube that takes urine (pee) from your bladder to the outside of your body. Typically, urethritis is caused by an infection. Most commonly, but not always, the cause is a sexually transmitted infection (STI). […] Sexually transmitted infections are a common cause of urethritis. Apart from gonorrhea, other STIs are related to urethritis, including: Chlamydia, Trichomoniasis, Genital herpes. […] However, you can also get urethritis from: Urinary tract infections, Yeast infections, Exposure to irritants like spermicides, douches and soaps, Squeezing your penis roughly, Activities that put pressure on your urethra, like riding a bicycle or some sexual acts, Putting something up inside your urethra, such as a catheter to help you pee.

• #31 Urethritis: Causes, Symptoms, Diagnosis & Treatment

  https://my.clevelandclinic.org/health/diseases/22858-urethritis

  Urethritis is an inflammation (swelling and irritation) of the urethra, the tube that takes urine (pee) from your bladder to the outside of your body. Typically, urethritis is caused by an infection. Most commonly, but not always, the cause is a sexually transmitted infection (STI). […] Sexually transmitted infections are a common cause of urethritis. Apart from gonorrhea, other STIs are related to urethritis, including: Chlamydia, Trichomoniasis, Genital herpes. […] However, you can also get urethritis from: Urinary tract infections, Yeast infections, Exposure to irritants like spermicides, douches and soaps, Squeezing your penis roughly, Activities that put pressure on your urethra, like riding a bicycle or some sexual acts, Putting something up inside your urethra, such as a catheter to help you pee.

• #32 Urethritis: Causes, Symptoms, Diagnosis & Treatment

  https://my.clevelandclinic.org/health/diseases/22858-urethritis

  Urethritis is an inflammation (swelling and irritation) of the urethra, the tube that takes urine (pee) from your bladder to the outside of your body. Typically, urethritis is caused by an infection. Most commonly, but not always, the cause is a sexually transmitted infection (STI). […] Sexually transmitted infections are a common cause of urethritis. Apart from gonorrhea, other STIs are related to urethritis, including: Chlamydia, Trichomoniasis, Genital herpes. […] However, you can also get urethritis from: Urinary tract infections, Yeast infections, Exposure to irritants like spermicides, douches and soaps, Squeezing your penis roughly, Activities that put pressure on your urethra, like riding a bicycle or some sexual acts, Putting something up inside your urethra, such as a catheter to help you pee.

• #33 Urethritis: Practice Essentials, Pathophysiology, Etiology

  https://emedicine.medscape.com/article/438091-overview

  There has been a notable increase in the incidence of urethritis associated with Mycoplasma genitalium, now the second most common cause of NGU, although there is currently a lack of US Food and Drug Administration (FDA) approved tests for diagnostic use. This organism can be sexually transmitted, accounts for 15%-25% of NGU cases in the United States and should be suspected in cases of recurrent or persistent urethritis. […] Haemophilus species are an increasing cause of NGU, particularly in patients who have unprotected oral sex. […] Rare infectious causes of urethritis include lymphogranuloma venereum, herpes simplex virus types 1 and 2, adenovirus, syphilis, mycobacterial infection, Corynebacterium, and bacterial infections that are typically associated with cystitis (usually gram-negative rods) in the presence of urethral stricture. Other rare but reported causes of urethritis include viral, streptococcal, anaerobic, and meningococcal infections. However, in up to 35% of NGU cases, no pathogen is found. […] Posttraumatic urethritis can occur in 2%-20% of patients practicing intermittent catheterization and following instrumentation or foreign body insertion. Urethritis is 10 times more likely to occur with latex catheters than with silicone catheters.

• #34 Male Urethritis: Practice Essentials, Pathophysiology

  https://emedicine.medscape.com/article/778374-overview

  Urethritis involves local mucous membrane epithelial cell damage or invasion by an infectious agent (bacterial, viral, or fungal) followed by inflammatory changes, including accumulation of leukocytes and chemical mediators (antibodies, cytokines, and interleukins) with resultant swelling, discharge, and pain. […] Inflammation of the urethra is more frequently infectious than posttraumatic, with sexually transmitted infections (STIs) being the most common cause. Sexually transmitted urethritis is classified either as gonococcal urethritis (GU) following infection with Neisseria gonorrhoeae or as nongonococcal urethritis (NGU). […] For cases of NGU, Chlamydia trachomatis remains a primary concern, although Mycoplasma genitalium and Trichomonas vaginalis are increasingly recognized as important pathogens, and, less commonly, Ureaplasma parvum, Ureaplasma urealyticum, Mycoplasma hominis, and Gardnerella vaginalis.

• #35

  https://step2.medbullets.com/renal/120635/urethritis

  bacterial invasion results in an inflammatory response […] urethritis describes inflammation of the urethra

• #36 Urethritis | Obgyn Key

  https://obgynkey.com/urethritis/

  Chlamydia infections are the most frequent cause of sexually transmitted infection in the United States. […] Attachment, which is not understood completely, is the first step in the infectious process of the susceptible host cell. It is followed by phagocytosis and then the failure of cellular lysosomes to fuse with the phagosome containing the elementary body, which may be mediated partly by macromolecules in the chlamydial cell envelope. […] Inflammation may be related to bubble baths and other chemical and physical irritants. […] Edema of the mucosa and the presence of inflammation and red blood cells are common histopathologic features of urethritis that lead to dysuria, hematuria, and microscopic pyuria. […] The most common forms of urethritis in sexually active adolescents and young adults are gonococcal and so-called nongonococcal urethritis. They may occur together or sequentially.

• #37 Diagnosis and Treatment of Urethritis in Men | AAFP

  https://www.aafp.org/pubs/afp/issues/2010/0401/p873.html

  The role of Mycoplasma genitalium in non-gonococcal urethritis has attracted much attention in the past decade. […] Numerous studies have concluded that M. genitalium is a common cause of non-gonococcal urethritis and that eradication is associated with symptomatic improvement. […] A number of other pathogens have been implicated in non-gonococcal urethritis. […] Urethritis caused by HSV or adenovirus is associated with insertive oral sex among men who have sex with men. […] There is evidence that the intact urethral endothelium is an important barrier to infection. The disruption of this lining by urethritis may foster the spread of bloodborne pathogens. […] It has been demonstrated that men with urethritis who are HIV positive have higher HIV RNA titers in their semen than men without urethritis who are HIV positive. […] Furthermore, treatment of urethritis leads to decreases in HIV-1 expression in semen.

• #38 Diagnosis and Treatment of Urethritis in Men | AAFP

  https://www.aafp.org/pubs/afp/issues/2010/0401/p873.html

  The role of Mycoplasma genitalium in non-gonococcal urethritis has attracted much attention in the past decade. […] Numerous studies have concluded that M. genitalium is a common cause of non-gonococcal urethritis and that eradication is associated with symptomatic improvement. […] A number of other pathogens have been implicated in non-gonococcal urethritis. […] Urethritis caused by HSV or adenovirus is associated with insertive oral sex among men who have sex with men. […] There is evidence that the intact urethral endothelium is an important barrier to infection. The disruption of this lining by urethritis may foster the spread of bloodborne pathogens. […] It has been demonstrated that men with urethritis who are HIV positive have higher HIV RNA titers in their semen than men without urethritis who are HIV positive. […] Furthermore, treatment of urethritis leads to decreases in HIV-1 expression in semen.

• #39 Urethritis – Knowledge and References – Taylor & Francis

  https://taylorandfrancis.com/knowledge/Medicine_and_healthcare/Immunology/Urethritis/

  Urethritis is a medical condition characterized by inflammation and swelling of the urethra, which is responsible for transporting urine from the bladder to the outside of the body. It can be caused by various microorganisms such as bacteria, viruses, and protozoa. […] 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). […] Treatment of MG infections remains in most countries based on syndromic management for urethritis, cervicitis, and PID. However, resistance in MG to therapeutic antimicrobials, including the first-line macrolide azithromycin, has rapidly increased during the last 1–2 decades internationally, which often results in failure to eradicate the infection.

• #40 Urethritis – Knowledge and References – Taylor & Francis

  https://taylorandfrancis.com/knowledge/Medicine_and_healthcare/Immunology/Urethritis/

  The resistance to azithromycin is primarily caused by mutations at nucleotide position A2058 or A2059 (Escherichia coli numbering) in the 23S rRNA gene. […] Accordingly, accurate detection of MG, including testing for macrolide resistance-associated mutations in all MG-positive samples, is necessary for proper management of MG infections.

• #41 Urethritis – Knowledge and References – Taylor & Francis

  https://taylorandfrancis.com/knowledge/Medicine_and_healthcare/Immunology/Urethritis/

  The resistance to azithromycin is primarily caused by mutations at nucleotide position A2058 or A2059 (Escherichia coli numbering) in the 23S rRNA gene. […] Accordingly, accurate detection of MG, including testing for macrolide resistance-associated mutations in all MG-positive samples, is necessary for proper management of MG infections.

• #42 Urethritis in Men

  http://www.urocenterofnewyork.com/for-men/urinary-infections/urethritis-in-men/

  Non-gonococcal urethritis may be caused by several different organisms, but many times, no specific cause is found. The most important one is Chlamydia trachomatis which is commonly spread by sexual contact. […] Treatment of urethritis depends upon the cause, but in all cases it is essential to treat the sexual partners of men with urethritis. […] Over the years, however, there has been an emergence of strains of N. gonorrhoea which are resistant to penicillin and other antibiotics. […] Non-gonoccocal urethritis is best treated by tetracycline or, one if its newer forms called doxycycline, the same drug used to treat gonorrhea.

• #43 Mycoplasma genitalium – STI Treatment Guidelines

  https://www.cdc.gov/std/treatment-guidelines/mycoplasmagenitalium.htm

  M. genitalium lacks a cell wall, and thus antibiotics targeting cell-wall biosynthesis (e.g., -lactams including penicillins and cephalosporins) are ineffective against this organism. […] Because of the high rates of macrolide resistance with treatment failures and efficient selection of additional resistance, a 1-g dose of azithromycin should not be used. […] Two-stage therapy approaches, ideally using resistance-guided therapy, are recommended for treatment. […] Resistance-guided therapy has demonstrated cure rates of 90% and should be used whenever possible; however, it requires access to macrolide-resistance testing. […] As part of this approach, doxycycline is provided as initial empiric therapy, which reduces the organism load and facilitates organism clearance, followed by macrolide-sensitive M. genitalium infections treated with high-dose azithromycin; macrolide-resistant infections are treated with moxifloxacin.

• #44 Urethritis in Men

  http://www.urocenterofnewyork.com/for-men/urinary-infections/urethritis-in-men/

  Urethritis in men is quite different from that in women. In men urethritis isnt really a urinary tract infection at all; its a sexually transmitted disease. The usual symptoms are fluid leakage from the tip of the penis, burning during urination and an itch at the tip of the penis. […] Urethritis is classified as either gonocococcal or non-gonococcal. Gonococcal urethritis is caused by a bacteria called Neisseria gonorrhea and is always transmitted during sexual intercourse. […] Proper treatment is essential because, when untreated, it easily spreads to sexual partners and may cause serious complications, the worst of which is a periurethral abscess or a urethral blockage called a stricture. A periurethral abscess results from an untreated urethritis. The infection gets so bad that it goes through the wall of the urethra and affects the surrounding tissue, eventually turning into a painful, tender, swollen pocket of pus which is called an abscess. Treatment at this stage requires surgical drainage. A urethral stricture is a scar formed by healing of the infection. It results in a narrowing of the urethra which causes a blockage. The only treatment for this is also surgical.

• #45 Urethritis – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK537282/

  Urethritis in men has the potential to result in infertility. In women, 10% to 40% of those with urethritis may advance to pelvic inflammatory disease, even among individuals who are initially asymptomatic. Urethritis is diagnosed based on any of the following signs or laboratory tests: urethral mucopurulent or purulent discharge; gram stain of urethral secretions revealing 2 or more white blood cells (WBCs) per oil immersion field; a positive leukocyte esterase test on first-void urine or a microscopic examination of first-void urine sediment reveals 10 or more WBCs per high-power field; utilization of nucleic acid amplification testing (NAAT). […] The primary cause of nongonococcal urethritis is C trachomatis, which, like N gonorrhoeae, is an intracellular bacterial organism. However, C trachomatis lacks cell wall peptidoglycans, resulting in its inability to take up visible gram staining. Other organisms can be causative agents of urethritis, such as enteric organisms introduced via rectal exposure, such as gram-negative rods typically associated with UTIs or anal intercourse. Pathogens such as Haemophilus spp, N meningitides, Moraxella catarrhalis, and Streptococcus pneumonia, which are linked to oral sex, can also cause nongonococcal urethritis.

• #46 Urethritis – Urinary Tract Infections (UTIs) – Nephrology – Diseases – McMaster Textbook of Internal Medicine

  https://empendium.com/mcmtextbook/chapter/B31.II.14.8.11.

  Urethritis is usually a sexually transmitted disease (STD). Gonococcal urethritis is caused by Neisseria gonorrhoeae, while the more common nongonococcal urethritis is predominantly due to infection with Chlamydia trachomatis but also secondary to infections by Ureaplasma urealyticum, Mycoplasma genitalium, Trichomonas vaginalis, or less frequently other microorganisms. […] Rarely urethritis may be caused by repeated trauma, for example, with bladder catheterization. […] Infection with C trachomatis can be asymptomatic in up to 50% of women and over time may lead to pelvic inflammatory disease and its consequences. In men it can cause urethritis, prostatitis, epididymitis, and infertility.

• #47 Urethritis (inflammation of the urethra) – USZ

  https://www.usz.ch/en/disease/urethritis/

  In addition to unprotected sexual intercourse, other factors can also promote urethritis. These include mechanical irritation of the urethra, for example from a urinary catheter. […] Furthermore, a so-called self-infection often occurs, especially in women. […] A common sign of urethritis is pain when urinating. […] This is because the symptoms of urethritis are generally more pronounced in men than in women. […] To confirm a suspected urethritis, you will usually have to give a urine sample. […] In rare cases it is necessary to take a smear from the urethra. […] If your partner suffers from urethritis, you should definitely have an examination even if you have no symptoms. […] As a rule, urethritis heals well without causing any long-term consequences especially if the right treatment is given as early as possible. […] However, as many sufferers often feel no or only very mild symptoms, urethritis often remains undetected. […] The most important thing in the treatment of urethritis is to identify the causative pathogen and treat it specifically with medication.

• #48 Female chronic posterior urethritis is underestimated in patients with lower urinary tract symptoms – Xie – Translational Andrology and Urology

  https://tau.amegroups.org/article/view/76231/html

  Chronic posterior urethritis is a chronic non-specific inflammation condition of the intraurethral, results from a response to injury in the urethral mucosa. It has chronic posterior urethritis symptoms, including urethral pain, gross/microscopic hematuria, urinary frequency, urinary urgency, and dysuria and other lower urinary tract (LUT) symptoms. As these symptoms overlap with those of recurrent urinary tract infection, overactive bladder (OAB), and interstitial cystitis/bladder pain syndrome (IC/BPS), chronic posterior urethritis can be misdiagnosed. Research has shown that the mucosal layer of the LUT is involved in mechanosensory functions that regulate both bladder contractile activity and the urethral sensation. Changes to the mucosa are usually associated with disorders, including IC/BPS and OAB. However, compared to the urinary bladder, much less is known about the urothelium and lamina propria of the bladder neck and proximal urethra.

• #49 Female chronic posterior urethritis is underestimated in patients with lower urinary tract symptoms – Xie – Translational Andrology and Urology

  https://tau.amegroups.org/article/view/76231/html

  Chronic posterior urethritis is a chronic non-specific inflammation condition of the intraurethral, results from a response to injury in the urethral mucosa. It has chronic posterior urethritis symptoms, including urethral pain, gross/microscopic hematuria, urinary frequency, urinary urgency, and dysuria and other lower urinary tract (LUT) symptoms. As these symptoms overlap with those of recurrent urinary tract infection, overactive bladder (OAB), and interstitial cystitis/bladder pain syndrome (IC/BPS), chronic posterior urethritis can be misdiagnosed. Research has shown that the mucosal layer of the LUT is involved in mechanosensory functions that regulate both bladder contractile activity and the urethral sensation. Changes to the mucosa are usually associated with disorders, including IC/BPS and OAB. However, compared to the urinary bladder, much less is known about the urothelium and lamina propria of the bladder neck and proximal urethra.

• #50 Female chronic posterior urethritis is underestimated in patients with lower urinary tract symptoms – Xie – Translational Andrology and Urology

  https://tau.amegroups.org/article/view/76231/html

  Chronic posterior urethritis is a chronic non-specific inflammation condition of the intraurethral, results from a response to injury in the urethral mucosa. It has chronic posterior urethritis symptoms, including urethral pain, gross/microscopic hematuria, urinary frequency, urinary urgency, and dysuria and other lower urinary tract (LUT) symptoms. As these symptoms overlap with those of recurrent urinary tract infection, overactive bladder (OAB), and interstitial cystitis/bladder pain syndrome (IC/BPS), chronic posterior urethritis can be misdiagnosed. Research has shown that the mucosal layer of the LUT is involved in mechanosensory functions that regulate both bladder contractile activity and the urethral sensation. Changes to the mucosa are usually associated with disorders, including IC/BPS and OAB. However, compared to the urinary bladder, much less is known about the urothelium and lamina propria of the bladder neck and proximal urethra.

• #51 Female chronic posterior urethritis is underestimated in patients with lower urinary tract symptoms – Xie – Translational Andrology and Urology

  https://tau.amegroups.org/article/view/76231/html

  The cause and pathogenic factors of female chronic posterior lesions are not yet completely known. It has been suggested that many factors, including non-specific infection, urethral obstruction, urethral-hymenal fusion, senile atrophy, traumatic causes, inflamm-ageing, and estrogen deficiency, may be implicated in its pathogenesis. Urethritis is classified as gonococcal or nongonococcal urethritis (NGU) based on its causative organisms that may be sexually and non-sexually transmitted. The major causes of NGU are Chlamydia trachomatis and Mycoplasma genitalium, which account for 75% of cases. However, other pathogenic organisms include Trichomonas vaginalis, anaerobes, herpes simplex virus, and adenovirus. In the present study, we identified Mycoplasma as the most common etiological agent.

• #52 TrustCare | Urethritis Causes, Treatment, and Prevention

  https://trustcarehealth.com/blog/urethritis-causes-treatment-and-prevention

  The complications of urethritis can vary depending on the cause, but the most common long-term effect of untreated urethritis in men is a narrowing of the urethra, known as urethral stricture. This may increase the chances of developing an infection in the bladder or kidneys. It is even possible that an abscess may form around the urethra, or urethral diverticula could form, which can also host further infection. […] Urethritis is not on this list. While it is possible for urethritis to clear up on its own, there is also a possibility your infection could spread to other areas of the urinary or reproductive system. If left long enough, it is even possible that an infection could spread to your bloodstream and result in sepsis, which can be fatal. […] For women, untreated urethritis carries a danger of long-term pelvic pain and pelvic inflammatory disease (PID), which can lead to infertility. For men, it is possible for the prostate to become infected, or for the urethra to narrow due to the development of scar tissue.

• #53 Urethritis | HealthLink BC

  https://www.healthlinkbc.ca/healthlinkbc-files/urethritis

  Urethritis is an inflammation of the urethra. […] Urethritis is often caused by sexually transmitted infections (STIs) like gonorrhea, chlamydia or herpes simplex virus. […] Other organisms that are not sexually transmitted can infect the urethra. […] Sometimes infections of the bladder or prostate, or recent procedures that may involve the urethra can cause urethritis. […] The sexually transmitted organisms that cause urethritis spread through unprotected oral, vaginal or anal sex. […] If the bacteria that caused urethritis are not treated, they can lead to pain and swelling in one or both testicles and may cause infertility. […] Urethritis that is caused by bacteria may be treated with antibiotic pills. […] If the infection was sexually transmitted, sexual partners should be tested and treated.

• #54 Azthena logo with the word Azthena

  https://www.news-medical.net/health/What-is-Urethritis.aspx

  Some of the etiological vectors of NGU are Chlamydia trachomatis, Ureaplasma urealyticum, Trichomonas vaginalis, Mycoplasma genitalium, the Herpes simplex virus, cytomegalovirus, and the sore throat causing adenovirus. Injury to the urethra during vigorous masturbation or sex or damage to the urethra during a medical procedure, such as inserting a urinary catheter, can also cause NGU. […] Timely diagnosis and treatment of urethritis almost certainly clear up the symptoms. However, a severe infection that is not treated adequately may lead to further complications, such as an infection of the bladder, the testicles, or the cervix, depending on the gender of the individual. […] Untreated gonococcal urethritis can lead to systemic infections, tenosynovitis, and reactive arthritis. If the infection spreads through the bloodstream, it could also cause endocarditis and meningitis. In addition, if left untreated, NGU can cause pelvic inflammatory disease (PID) in women, which manifests as severe pain near the pelvis and lower abdomen, discomfort in the pelvic region during and bleeding after sexual intercourse, high temperature, and green or yellow vaginal discharge. […] Both types of urethritis can cause abscesses in the tissue surrounding the urethra and lead to urethral fibrosis and stricture. Other complications include epididymitis infection of the epididymis, testicular atrophy and infertility, and prostatitis.

• #55 TrustCare | Urethritis Causes, Treatment, and Prevention

  https://trustcarehealth.com/blog/urethritis-causes-treatment-and-prevention

  The complications of urethritis can vary depending on the cause, but the most common long-term effect of untreated urethritis in men is a narrowing of the urethra, known as urethral stricture. This may increase the chances of developing an infection in the bladder or kidneys. It is even possible that an abscess may form around the urethra, or urethral diverticula could form, which can also host further infection. […] Urethritis is not on this list. While it is possible for urethritis to clear up on its own, there is also a possibility your infection could spread to other areas of the urinary or reproductive system. If left long enough, it is even possible that an infection could spread to your bloodstream and result in sepsis, which can be fatal. […] For women, untreated urethritis carries a danger of long-term pelvic pain and pelvic inflammatory disease (PID), which can lead to infertility. For men, it is possible for the prostate to become infected, or for the urethra to narrow due to the development of scar tissue.

• #56 TrustCare | Urethritis Causes, Treatment, and Prevention

  https://trustcarehealth.com/blog/urethritis-causes-treatment-and-prevention

  The complications of urethritis can vary depending on the cause, but the most common long-term effect of untreated urethritis in men is a narrowing of the urethra, known as urethral stricture. This may increase the chances of developing an infection in the bladder or kidneys. It is even possible that an abscess may form around the urethra, or urethral diverticula could form, which can also host further infection. […] Urethritis is not on this list. While it is possible for urethritis to clear up on its own, there is also a possibility your infection could spread to other areas of the urinary or reproductive system. If left long enough, it is even possible that an infection could spread to your bloodstream and result in sepsis, which can be fatal. […] For women, untreated urethritis carries a danger of long-term pelvic pain and pelvic inflammatory disease (PID), which can lead to infertility. For men, it is possible for the prostate to become infected, or for the urethra to narrow due to the development of scar tissue.

• #57 Urethritis in Men

  http://www.urocenterofnewyork.com/for-men/urinary-infections/urethritis-in-men/

  Urethritis in men is quite different from that in women. In men urethritis isnt really a urinary tract infection at all; its a sexually transmitted disease. The usual symptoms are fluid leakage from the tip of the penis, burning during urination and an itch at the tip of the penis. […] Urethritis is classified as either gonocococcal or non-gonococcal. Gonococcal urethritis is caused by a bacteria called Neisseria gonorrhea and is always transmitted during sexual intercourse. […] Proper treatment is essential because, when untreated, it easily spreads to sexual partners and may cause serious complications, the worst of which is a periurethral abscess or a urethral blockage called a stricture. A periurethral abscess results from an untreated urethritis. The infection gets so bad that it goes through the wall of the urethra and affects the surrounding tissue, eventually turning into a painful, tender, swollen pocket of pus which is called an abscess. Treatment at this stage requires surgical drainage. A urethral stricture is a scar formed by healing of the infection. It results in a narrowing of the urethra which causes a blockage. The only treatment for this is also surgical.

• #58 Urethritis in Men

  http://www.urocenterofnewyork.com/for-men/urinary-infections/urethritis-in-men/

  Urethritis in men is quite different from that in women. In men urethritis isnt really a urinary tract infection at all; its a sexually transmitted disease. The usual symptoms are fluid leakage from the tip of the penis, burning during urination and an itch at the tip of the penis. […] Urethritis is classified as either gonocococcal or non-gonococcal. Gonococcal urethritis is caused by a bacteria called Neisseria gonorrhea and is always transmitted during sexual intercourse. […] Proper treatment is essential because, when untreated, it easily spreads to sexual partners and may cause serious complications, the worst of which is a periurethral abscess or a urethral blockage called a stricture. A periurethral abscess results from an untreated urethritis. The infection gets so bad that it goes through the wall of the urethra and affects the surrounding tissue, eventually turning into a painful, tender, swollen pocket of pus which is called an abscess. Treatment at this stage requires surgical drainage. A urethral stricture is a scar formed by healing of the infection. It results in a narrowing of the urethra which causes a blockage. The only treatment for this is also surgical.

• #59 Urethritis in Men

  http://www.urocenterofnewyork.com/for-men/urinary-infections/urethritis-in-men/

  Urethritis in men is quite different from that in women. In men urethritis isnt really a urinary tract infection at all; its a sexually transmitted disease. The usual symptoms are fluid leakage from the tip of the penis, burning during urination and an itch at the tip of the penis. […] Urethritis is classified as either gonocococcal or non-gonococcal. Gonococcal urethritis is caused by a bacteria called Neisseria gonorrhea and is always transmitted during sexual intercourse. […] Proper treatment is essential because, when untreated, it easily spreads to sexual partners and may cause serious complications, the worst of which is a periurethral abscess or a urethral blockage called a stricture. A periurethral abscess results from an untreated urethritis. The infection gets so bad that it goes through the wall of the urethra and affects the surrounding tissue, eventually turning into a painful, tender, swollen pocket of pus which is called an abscess. Treatment at this stage requires surgical drainage. A urethral stricture is a scar formed by healing of the infection. It results in a narrowing of the urethra which causes a blockage. The only treatment for this is also surgical.

• #60 Gonococcal urethritis | Radiology Reference Article | Radiopaedia.org

  https://radiopaedia.org/articles/gonococcal-urethritis?lang=us

  Gonococcal urethritis is an infection of the urethra caused by Neisseria Gonorrhoeae, a gram-negative diplococcus. […] Gonococcal urethritis can lead to fibrous scarring of anterior urethra, resulting in long irregular urethral narrowing several centimeters long, commonly in the bulbous urethra, especially the distal part. The stricture extends to membranous urethra in more than 90% of cases. […] The infection is also associated with dilatation of urethral glands of Littr. Obstruction of these glands may lead to a serious complication, a periurethral abscess. Urethral communication to periurethral abscess leads to pseudodiverticulum formation.

• #61 Gonococcal urethritis | Radiology Reference Article | Radiopaedia.org

  https://radiopaedia.org/articles/gonococcal-urethritis?lang=us

  Gonococcal urethritis is an infection of the urethra caused by Neisseria Gonorrhoeae, a gram-negative diplococcus. […] Gonococcal urethritis can lead to fibrous scarring of anterior urethra, resulting in long irregular urethral narrowing several centimeters long, commonly in the bulbous urethra, especially the distal part. The stricture extends to membranous urethra in more than 90% of cases. […] The infection is also associated with dilatation of urethral glands of Littr. Obstruction of these glands may lead to a serious complication, a periurethral abscess. Urethral communication to periurethral abscess leads to pseudodiverticulum formation.

• #62 Urethritis: Causes, Symptoms, Diagnosis & Treatment

  https://my.clevelandclinic.org/health/diseases/22858-urethritis

  Urethritis may clear up on its own in time. However, if its caused by sexually transmitted infections, those germs will stay in your system. Untreated STIs can cause problems later. These conditions include: Swelling of the penis, Swelling of lymph channels in the penis, Urethral strictures (blockages), Abscess in the urethra, Pelvic inflammatory disease, Infertility, Ectopic pregnancy, Reactive arthritis.

• #63 Urethritis: Causes, Symptoms, Diagnosis & Treatment

  https://my.clevelandclinic.org/health/diseases/22858-urethritis

  Urethritis may clear up on its own in time. However, if its caused by sexually transmitted infections, those germs will stay in your system. Untreated STIs can cause problems later. These conditions include: Swelling of the penis, Swelling of lymph channels in the penis, Urethral strictures (blockages), Abscess in the urethra, Pelvic inflammatory disease, Infertility, Ectopic pregnancy, Reactive arthritis.

• #64 Urethritis: Causes, Symptoms, Diagnosis & Treatment

  https://my.clevelandclinic.org/health/diseases/22858-urethritis

  Urethritis may clear up on its own in time. However, if its caused by sexually transmitted infections, those germs will stay in your system. Untreated STIs can cause problems later. These conditions include: Swelling of the penis, Swelling of lymph channels in the penis, Urethral strictures (blockages), Abscess in the urethra, Pelvic inflammatory disease, Infertility, Ectopic pregnancy, Reactive arthritis.

• #65 Azthena logo with the word Azthena

  https://www.news-medical.net/health/What-is-Urethritis.aspx

  Some of the etiological vectors of NGU are Chlamydia trachomatis, Ureaplasma urealyticum, Trichomonas vaginalis, Mycoplasma genitalium, the Herpes simplex virus, cytomegalovirus, and the sore throat causing adenovirus. Injury to the urethra during vigorous masturbation or sex or damage to the urethra during a medical procedure, such as inserting a urinary catheter, can also cause NGU. […] Timely diagnosis and treatment of urethritis almost certainly clear up the symptoms. However, a severe infection that is not treated adequately may lead to further complications, such as an infection of the bladder, the testicles, or the cervix, depending on the gender of the individual. […] Untreated gonococcal urethritis can lead to systemic infections, tenosynovitis, and reactive arthritis. If the infection spreads through the bloodstream, it could also cause endocarditis and meningitis. In addition, if left untreated, NGU can cause pelvic inflammatory disease (PID) in women, which manifests as severe pain near the pelvis and lower abdomen, discomfort in the pelvic region during and bleeding after sexual intercourse, high temperature, and green or yellow vaginal discharge. […] Both types of urethritis can cause abscesses in the tissue surrounding the urethra and lead to urethral fibrosis and stricture. Other complications include epididymitis infection of the epididymis, testicular atrophy and infertility, and prostatitis.

• #66 TrustCare | Urethritis Causes, Treatment, and Prevention

  https://trustcarehealth.com/blog/urethritis-causes-treatment-and-prevention

  The complications of urethritis can vary depending on the cause, but the most common long-term effect of untreated urethritis in men is a narrowing of the urethra, known as urethral stricture. This may increase the chances of developing an infection in the bladder or kidneys. It is even possible that an abscess may form around the urethra, or urethral diverticula could form, which can also host further infection. […] Urethritis is not on this list. While it is possible for urethritis to clear up on its own, there is also a possibility your infection could spread to other areas of the urinary or reproductive system. If left long enough, it is even possible that an infection could spread to your bloodstream and result in sepsis, which can be fatal. […] For women, untreated urethritis carries a danger of long-term pelvic pain and pelvic inflammatory disease (PID), which can lead to infertility. For men, it is possible for the prostate to become infected, or for the urethra to narrow due to the development of scar tissue.

• #67 Urethritis – Symptoms, diagnosis and treatment | BMJ Best Practice

  https://bestpractice.bmj.com/topics/en-gb/54

  Urethritis classically presents as acute urethral discharge following unprotected sex. […] The two most important aetiological agents are Neisseria gonorrhoeae and Chlamydia trachomatis. […] Urethritis is usually a sexually transmitted infection that typically presents with dysuria, urethral discharge, and/or pruritus at the end of the urethra. […] Urethritis is divided into 2 main categories: gonococcal, if Neisseria gonorrhoeae is isolated; non-gonococcal (NGU), if N gonorrhoeae is not isolated. […] The most common causes of NGU include Chlamydia trachomatis and Mycoplasma genitalium. […] Untreated gonococcal urethritis may disseminate, causing arthritis, meningitis, and endocarditis. […] Untreated non-gonococcal urethritis may present with complications such as reactive arthritis or infertility.

• #68 Urethritis – Symptoms, diagnosis and treatment | BMJ Best Practice

  https://bestpractice.bmj.com/topics/en-gb/54

  Urethritis classically presents as acute urethral discharge following unprotected sex. […] The two most important aetiological agents are Neisseria gonorrhoeae and Chlamydia trachomatis. […] Urethritis is usually a sexually transmitted infection that typically presents with dysuria, urethral discharge, and/or pruritus at the end of the urethra. […] Urethritis is divided into 2 main categories: gonococcal, if Neisseria gonorrhoeae is isolated; non-gonococcal (NGU), if N gonorrhoeae is not isolated. […] The most common causes of NGU include Chlamydia trachomatis and Mycoplasma genitalium. […] Untreated gonococcal urethritis may disseminate, causing arthritis, meningitis, and endocarditis. […] Untreated non-gonococcal urethritis may present with complications such as reactive arthritis or infertility.

• #69 Urethritis – Symptoms, diagnosis and treatment | BMJ Best Practice

  https://bestpractice.bmj.com/topics/en-gb/54

  Urethritis classically presents as acute urethral discharge following unprotected sex. […] The two most important aetiological agents are Neisseria gonorrhoeae and Chlamydia trachomatis. […] Urethritis is usually a sexually transmitted infection that typically presents with dysuria, urethral discharge, and/or pruritus at the end of the urethra. […] Urethritis is divided into 2 main categories: gonococcal, if Neisseria gonorrhoeae is isolated; non-gonococcal (NGU), if N gonorrhoeae is not isolated. […] The most common causes of NGU include Chlamydia trachomatis and Mycoplasma genitalium. […] Untreated gonococcal urethritis may disseminate, causing arthritis, meningitis, and endocarditis. […] Untreated non-gonococcal urethritis may present with complications such as reactive arthritis or infertility.

• #70 Azthena logo with the word Azthena

  https://www.news-medical.net/health/What-is-Urethritis.aspx

  Some of the etiological vectors of NGU are Chlamydia trachomatis, Ureaplasma urealyticum, Trichomonas vaginalis, Mycoplasma genitalium, the Herpes simplex virus, cytomegalovirus, and the sore throat causing adenovirus. Injury to the urethra during vigorous masturbation or sex or damage to the urethra during a medical procedure, such as inserting a urinary catheter, can also cause NGU. […] Timely diagnosis and treatment of urethritis almost certainly clear up the symptoms. However, a severe infection that is not treated adequately may lead to further complications, such as an infection of the bladder, the testicles, or the cervix, depending on the gender of the individual. […] Untreated gonococcal urethritis can lead to systemic infections, tenosynovitis, and reactive arthritis. If the infection spreads through the bloodstream, it could also cause endocarditis and meningitis. In addition, if left untreated, NGU can cause pelvic inflammatory disease (PID) in women, which manifests as severe pain near the pelvis and lower abdomen, discomfort in the pelvic region during and bleeding after sexual intercourse, high temperature, and green or yellow vaginal discharge. […] Both types of urethritis can cause abscesses in the tissue surrounding the urethra and lead to urethral fibrosis and stricture. Other complications include epididymitis infection of the epididymis, testicular atrophy and infertility, and prostatitis.

• #71 Urethral Pain Causes, Symptoms, and Treatment

  https://www.verywellhealth.com/urethral-pain-4174285

  Reactive arthritis (Reiter’s syndrome) is another potential cause of urethral pain. This condition is caused by a bacterial infection in the urinary or gastrointestinal tract. Then, the inflammation affects other body areas, including the large leg joints, causing joint pain, swelling, and redness. […] Some medications, such as Procardia (nifedipine), can irritate the urethra and cause pain. […] Noninfectious skin conditions that develop near the opening of the urethra may cause irritation, inflammation, and pain. […] Vaginal atrophy occurs after menopause, when the loss of estrogen causes thinning tissues, dryness, and loss of elasticity in the vagina and urethra. These changes lead to urethral pain, pain during sex, and urinary incontinence. […] Urethral pain may be caused by many things, including STIs, trauma, bacterial or fungal infections, and obstruction. […] Treatment depends on the cause and may include antibiotics, antiparasitics, antivirals, or symptom management.

• #72 Azthena logo with the word Azthena

  https://www.news-medical.net/health/What-is-Urethritis.aspx

  Some of the etiological vectors of NGU are Chlamydia trachomatis, Ureaplasma urealyticum, Trichomonas vaginalis, Mycoplasma genitalium, the Herpes simplex virus, cytomegalovirus, and the sore throat causing adenovirus. Injury to the urethra during vigorous masturbation or sex or damage to the urethra during a medical procedure, such as inserting a urinary catheter, can also cause NGU. […] Timely diagnosis and treatment of urethritis almost certainly clear up the symptoms. However, a severe infection that is not treated adequately may lead to further complications, such as an infection of the bladder, the testicles, or the cervix, depending on the gender of the individual. […] Untreated gonococcal urethritis can lead to systemic infections, tenosynovitis, and reactive arthritis. If the infection spreads through the bloodstream, it could also cause endocarditis and meningitis. In addition, if left untreated, NGU can cause pelvic inflammatory disease (PID) in women, which manifests as severe pain near the pelvis and lower abdomen, discomfort in the pelvic region during and bleeding after sexual intercourse, high temperature, and green or yellow vaginal discharge. […] Both types of urethritis can cause abscesses in the tissue surrounding the urethra and lead to urethral fibrosis and stricture. Other complications include epididymitis infection of the epididymis, testicular atrophy and infertility, and prostatitis.

• #73 Diagnosis and Treatment of Urethritis in Men | AAFP

  https://www.aafp.org/pubs/afp/issues/2010/0401/p873.html

  The role of Mycoplasma genitalium in non-gonococcal urethritis has attracted much attention in the past decade. […] Numerous studies have concluded that M. genitalium is a common cause of non-gonococcal urethritis and that eradication is associated with symptomatic improvement. […] A number of other pathogens have been implicated in non-gonococcal urethritis. […] Urethritis caused by HSV or adenovirus is associated with insertive oral sex among men who have sex with men. […] There is evidence that the intact urethral endothelium is an important barrier to infection. The disruption of this lining by urethritis may foster the spread of bloodborne pathogens. […] It has been demonstrated that men with urethritis who are HIV positive have higher HIV RNA titers in their semen than men without urethritis who are HIV positive. […] Furthermore, treatment of urethritis leads to decreases in HIV-1 expression in semen.

• #74 Female chronic posterior urethritis is underestimated in patients with lower urinary tract symptoms – Xie – Translational Andrology and Urology

  https://tau.amegroups.org/article/view/76231/html

  Chronic posterior urethritis is a chronic non-specific inflammation condition of the intraurethral, results from a response to injury in the urethral mucosa. It has chronic posterior urethritis symptoms, including urethral pain, gross/microscopic hematuria, urinary frequency, urinary urgency, and dysuria and other lower urinary tract (LUT) symptoms. As these symptoms overlap with those of recurrent urinary tract infection, overactive bladder (OAB), and interstitial cystitis/bladder pain syndrome (IC/BPS), chronic posterior urethritis can be misdiagnosed. Research has shown that the mucosal layer of the LUT is involved in mechanosensory functions that regulate both bladder contractile activity and the urethral sensation. Changes to the mucosa are usually associated with disorders, including IC/BPS and OAB. However, compared to the urinary bladder, much less is known about the urothelium and lamina propria of the bladder neck and proximal urethra.

• #75 Neisseria gonorrhoeae host adaptation and pathogenesis | Nature Reviews Microbiology

  https://www.nature.com/articles/nrmicro.2017.169

  The host-adapted human pathogen Neisseria gonorrhoeae is the causative agent of gonorrhoea. […] N. gonorrhoeae is an obligate human pathogen with the ability to evade and modulate both the innate and adaptive immune systems to benefit its replication and survival. […] As N. gonorrhoeae progresses through the stages of disease pathogenesis (transmission, adherence, colonization and invasion, and immune evasion), the bacterium expresses many virulence factors to promote survival and replication while remaining minimally invasive and minimally discoverable by immune cells. […] This study shows that gonococcal LOS binds to asialoglycoprotein receptor 1 (ASGPR1) on human sperm, possibly contributing to male-to-female transmission. […] This study demonstrates that transcription of a small, cis-acting, non-coding RNA initiates within the guanine quartet (G4) coding sequence enables the formation of the G4 structure required for pilin antigenic variation.

• #76 Neisseria gonorrhoeae host adaptation and pathogenesis | Nature Reviews Microbiology

  https://www.nature.com/articles/nrmicro.2017.169

  This study shows that sialylation of gonococcal LOS prevents opsonophagocytosis by immune sera, which led to the later confirmation that sialylation of LOS prevents complement activation and killing. […] This study demonstrates how sialylated LOS binds human factor H and prevents complement-mediated killing of N. gonorrhoeae. […] This study presents and characterizes a transgenic mouse model for gonorrhoea infection wherein the mouse has been made to express a humanized CEACAM receptor molecule important for adherence and colonization, enabling N. gonorrhoeae to intravaginally colonize the mouse.

• #77 Urethritis pathophysiology – wikidoc

  https://www.wikidoc.org/index.php/Urethritis_pathophysiology

  Gonorrheal: N. gonorrhea is usually transmitted via the genital tract to the human host. Following attachment to host cell, which is mediated by pili, gonococci become engulfed in a process known as parasite-directed endocytosis. This organism will survive inside the vacuoles and replicate. […] Non-Gonorrheal: Among non-gonorrheal causes, Chlamydia trachomatis is the most common. The infectious process begins with cell surface attachment and phagocytosis by the host cell. The pathogen survives inside the cell by debilitating the cellular lysosomes and replicating as elementary bodies which is considered as the infective form of the pathogen.

• #78 Urethritis

  https://www.nhs.uk/conditions/urethritis/

  Urethritis is usually caused by a sexually transmitted infection (STI) such as chlamydia. […] You can get it if you have unprotected sex (without a condom) with someone who has the infection. […] Rarely, it can be caused by damaging the urethra (for example, from a urinary catheter). […] Sometimes no cause for the urethritis can be found.

• #79 Urethritis – Wikipedia

  https://en.wikipedia.org/wiki/Urethritis

  Urethritis is the inflammation of the urethra. The most common symptoms include painful or difficult urination and urethral discharge. It is a commonly treatable condition usually caused by infection with bacteria. This bacterial infection is often sexually transmitted, but not in every instance; it can be idiopathic, for example. Some incidence of urethritis can appear asymptomatic as well. […] The disease is classified as either gonococcal urethritis, caused by Neisseria gonorrhoeae, or non-gonococcal urethritis (NGU), most commonly caused by Chlamydia trachomatis, which is accounted for 20-50% of routinely tested cases. NGU, sometimes called nonspecific urethritis (NSU), has both infectious and noninfectious causes. […] Bacterial infections leading to gonococcal and non-gonococcal urethritis can be prevented by: sexual abstinence, use of barrier contraception, such as condoms, pre-exposure vaccination: HPV and Hepatitis B vaccines, reducing number of sexual partners.

• #80 Urethritis

  https://www.nhs.uk/conditions/urethritis/

  Urethritis is usually caused by a sexually transmitted infection (STI) such as chlamydia. […] You can get it if you have unprotected sex (without a condom) with someone who has the infection. […] Rarely, it can be caused by damaging the urethra (for example, from a urinary catheter). […] Sometimes no cause for the urethritis can be found.

• #81 Non-gonococcal urethritis – Wikipedia

  https://en.wikipedia.org/wiki/Non-gonococcal_urethritis

  Nongonococcal urethritis (NGU) is inflammation of the urethra that is not caused by gonorrheal infection. […] There are many causes of NGU. This is in part due to the large variety of organisms living in the urinary tract. Ureaplasma urealyticum and Mycoplasma genitalium are some of the culprits. […] The most common bacterial cause of NGU is Chlamydia trachomatis, but it can also be caused by Ureaplasma urealyticum, Haemophilus vaginalis, Mycoplasma genitalium, Mycoplasma hominis, Neisseria meningitidis, Gardnerella vaginalis, Acinetobacter lwoffii, Acinetobacter calcoaceticus, and E.coli. […] Urethritis can be caused by mechanical injury (from a urinary catheter or a cystoscope), or by an irritating chemical (antiseptics or some spermicides). […] Non-gonococcal urethritis (NGU) is diagnosed if a person with urethritis has no signs of gonorrhea bacteria on laboratory tests.

• #82 Urethritis – PubMed

  https://pubmed.ncbi.nlm.nih.gov/30725967/

  Urethritis is a lower urinary tract infection (UTI) that causes inflammation of the urethra the fibromuscular tube responsible for expelling urine from the body in both males and females. Urethritis is commonly associated with sexually transmitted infections (STIs) and is classified as either gonococcal or nongonococcal. Neisseria gonorrhoeae and Chlamydia trachomatis are the main causative agents of this condition and are considered STIs. […] The etiology of urethritis varies depending on geographical location and sexual practices, underscoring the importance of obtaining a detailed patient history. Furthermore, appropriate testing is essential to corroborate the patient’s medical history.

• #83 Urethritis – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK537282/

  Urethritis is a lower urinary tract infection that causes inflammation of the urethra, the fibromuscular tube responsible for expelling urine from the body in both males and females. Urethritis is commonly associated with sexually transmitted infections (STIs) and is classified as either gonococcal or nongonococcal. Neisseria gonorrhoeae and Chlamydia trachomatis are the main causative agents of this condition. The etiology of urethritis varies depending on geographical location and sexual practices, underscoring the importance of obtaining a detailed patient history. Inflammation of the urethra commonly stems from an infectious origin, with STIs being the primary cause. […] Sexually transmitted urethritis is categorized into 2 types: nongonococcal urethritis, typically caused by C trachomatis or Mycoplasma genitalium, and gonococcal urethritis, resulting from infections with N gonorrhoeae. Chlamydia trachomatis is the most prevalent nongonococcal cause of urethritis and can be transmitted through sexual intercourse. This bacterium is a small, gram-negative obligate intracellular parasite with an average incubation period of 7 to 14 days. Chlamydial urethritis is often asymptomatic and commonly associated with M genitalium and N gonorrhoeae (which causes gonorrhea). Neisseria gonorrhoeae is the leading cause of urethritis. N gonorrhoeae is a gram-negative diplococcus transmitted through sexual intercourse with an incubation period of 2 to 5 days.

• #84 Urethritis pathophysiology – wikidoc

  https://www.wikidoc.org/index.php/Urethritis_pathophysiology

  Gonorrheal: N. gonorrhea is usually transmitted via the genital tract to the human host. Following attachment to host cell, which is mediated by pili, gonococci become engulfed in a process known as parasite-directed endocytosis. This organism will survive inside the vacuoles and replicate. […] Non-Gonorrheal: Among non-gonorrheal causes, Chlamydia trachomatis is the most common. The infectious process begins with cell surface attachment and phagocytosis by the host cell. The pathogen survives inside the cell by debilitating the cellular lysosomes and replicating as elementary bodies which is considered as the infective form of the pathogen.

• #85 Urethritis in Men

  http://www.urocenterofnewyork.com/for-men/urinary-infections/urethritis-in-men/

  Urethritis in men is quite different from that in women. In men urethritis isnt really a urinary tract infection at all; its a sexually transmitted disease. The usual symptoms are fluid leakage from the tip of the penis, burning during urination and an itch at the tip of the penis. […] Urethritis is classified as either gonocococcal or non-gonococcal. Gonococcal urethritis is caused by a bacteria called Neisseria gonorrhea and is always transmitted during sexual intercourse. […] Proper treatment is essential because, when untreated, it easily spreads to sexual partners and may cause serious complications, the worst of which is a periurethral abscess or a urethral blockage called a stricture. A periurethral abscess results from an untreated urethritis. The infection gets so bad that it goes through the wall of the urethra and affects the surrounding tissue, eventually turning into a painful, tender, swollen pocket of pus which is called an abscess. Treatment at this stage requires surgical drainage. A urethral stricture is a scar formed by healing of the infection. It results in a narrowing of the urethra which causes a blockage. The only treatment for this is also surgical.

• #86 Azthena logo with the word Azthena

  https://www.news-medical.net/health/What-is-Urethritis.aspx

  Some of the etiological vectors of NGU are Chlamydia trachomatis, Ureaplasma urealyticum, Trichomonas vaginalis, Mycoplasma genitalium, the Herpes simplex virus, cytomegalovirus, and the sore throat causing adenovirus. Injury to the urethra during vigorous masturbation or sex or damage to the urethra during a medical procedure, such as inserting a urinary catheter, can also cause NGU. […] Timely diagnosis and treatment of urethritis almost certainly clear up the symptoms. However, a severe infection that is not treated adequately may lead to further complications, such as an infection of the bladder, the testicles, or the cervix, depending on the gender of the individual. […] Untreated gonococcal urethritis can lead to systemic infections, tenosynovitis, and reactive arthritis. If the infection spreads through the bloodstream, it could also cause endocarditis and meningitis. In addition, if left untreated, NGU can cause pelvic inflammatory disease (PID) in women, which manifests as severe pain near the pelvis and lower abdomen, discomfort in the pelvic region during and bleeding after sexual intercourse, high temperature, and green or yellow vaginal discharge. […] Both types of urethritis can cause abscesses in the tissue surrounding the urethra and lead to urethral fibrosis and stricture. Other complications include epididymitis infection of the epididymis, testicular atrophy and infertility, and prostatitis.

• #87 Urethritis – Knowledge and References – Taylor & Francis

  https://taylorandfrancis.com/knowledge/Medicine_and_healthcare/Immunology/Urethritis/

  Urethritis is a medical condition characterized by inflammation and swelling of the urethra, which is responsible for transporting urine from the bladder to the outside of the body. It can be caused by various microorganisms such as bacteria, viruses, and protozoa. […] 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). […] Treatment of MG infections remains in most countries based on syndromic management for urethritis, cervicitis, and PID. However, resistance in MG to therapeutic antimicrobials, including the first-line macrolide azithromycin, has rapidly increased during the last 1–2 decades internationally, which often results in failure to eradicate the infection.

• #88 Female chronic posterior urethritis is underestimated in patients with lower urinary tract symptoms – Xie – Translational Andrology and Urology

  https://tau.amegroups.org/article/view/76231/html

  To identify whether lesions are the cause of female chronic posterior urethritis, we intervened by removing lesions by transurethral electroresection. Polyps and villi are the sites at which organisms persist and evade the immune response. Studies have suggested that uropathogenic bacteria can invade urothelial cells to form an intracellular bacterial community/quiescent intracellular reservoir in murine models, thus releasing strong pro-inflammatory factors that prompt an immune response and physiological changes in urothelial cells. Transurethral electroresection, an effective and minimally invasive procedure with a low complication rate, can address the polyps and villus which are the sites where organisms to persist and evade the immune response. In the present study, we used the following surgical indications: (I) LUT symptoms that lasted at least 6 months; (II) urethral inflammatory changes (as observed by cystoscopy and biopsy); and (III) ineffective repeated courses of antibiotics and ineffective preventive strategies. Unlike electrofulguration, transurethral electroresection can perfectly resolve the mucosa and submucosa lesions of polyps and villi.

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