Abnormal urethral discharge in men

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This refers to the presence of abnormal secretion in the distal portion of the urethra.

Causes

  • Neisseria gonorrhoeae.
  • Chlamydia trachomatis

Signs and symptoms

  • Staining of underwear, frequent urination
  • Mucus or pus at the tip of the penis
  • Burning pain on passing urine (dysuria)

Evaluation/Investigations

  • Take patient’s history and examine patient carefully to confirm discharge
  • Urethral swab: Gram stain, culture and sensitivity
  • Blood: screen for syphilis and HIV

Treatment objectives

  • Treat underlying cause
  • Manage the signs and symptoms
  • Prevent complications
  • Prevent transmission of the disease

Non-pharmacological treatment

  • Advice on avoidance of alcohol consumption during treatment
  • Advice patient and partner(s) to abstain from sex while on treatment or use condom
  • Advice patient on personal hygiene

Pharmacological treatment

Treatment of chlamydial infection

Doxycycline oral

100 mg 2 times daily for 7 days

Note: Treat partner (s) with similar drugs

If partner is pregnant use

Azithromycin 1g single dose

OR

Erythromycin oral

500 mg every 6hrs for 7 days

Note:

-          If gonorrhoea is present refer to section on treatment for gonorrhoea

-          Supportive treatment e.g. for pain

Referral

  • If infection persists refer for specialist care