Urethral Discharge Syndrome (UDS)

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UDS refers to the presence of abnormal secretions in the distal portion of the urethra.  

Causes 

  • Neisseria gonorrhoeae and  
  • Chlamydia trachomatis 

Clinical Presentation

  • Urethral discharge
  • Burning or painful micturition
  • Itchy urethra and increased frequency and urgency of micturition

Note:  

Persistent  or  recurrent  symptoms  of  urethritis  may  be  due  to  drug  resistance,  poor  compliance  or  re-infection.  In  some  cases,  there  may  be  infection  with  Trichomonas  vaginalis (TV). 

Male  patients  complaining  of  urethral  discharge  and/or  dysuria  should  be  examined  for  evidence of discharge. If none is seen per inspection, the urethra should be gently milked  from the ventral part of the penis towards the meatus. 

Delayed  or  inadequate  treatment  may  result  into  orchitis,  epididymitis,  urethral  stricture and/or infertility. 

Investigation(s) if the HF has a laboratory capable of doing:  

  • Culture and Sensitivity 
  • Gram stain 
  • ELISA 
  • Quantitative or qualitative PCR
  • Genetic sequencing

Management and Treatment of UDS (see flow chart 12.1)