Urethral Discharge

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This is a condition in which there is dysuria coupled with often copious, mucoid discharge from the urethral meatus. 

Gonococcal urethritis

Description

This is an acute inflammatory condition of the columnar epithelial lining of the urethra. It is caused by a gram-negative intracellular diplococcus, Neisseria gonorrhoea. The incubation period is 3 to 5 days.

Signs and Symptoms

  • Dysuria
  • Urethral discharge of copious, mucoid fluid which sometimes contains pus
  • Urinary frequency and urgency
  • Lips of the meatus may be red and swollen

Complications

  • Acute epididymo-orchitis
  • Urethral strictures
  • Disseminated Gonococcal Infection

Non-Gonococcal Urethritis

Description

The term non-gonococcal urethritis is used to describe other causes of urethritis apart from Neisseria gonorrhoeae. The organisms commonly responsible are Chlamydia trachomatis and Ureaplasma urealyticum. Symptoms usually occur 7 to 28 days after intercourse

Signs and Symptoms

  • Mild dysuria
  • Discomfort in the urethra
  • A clear to purulent mucoid discharge.
  • The lips of the meatus are often stuck together with dried secretions.
  • The meatus may be red, with evidence of dried secretion on underwear

Investigations

This is based on bacteriological examination of the discharge to exclude gonorrhoea.

Treatment

Refer to Recommended treatment regimens for syndromic treatment of STIs

NB: Persistent urethral discharge one week after treatment consider Trichomonas vaginalis, then treatment with Metronidazole 2g PO single dose for adults and 5mg/kg body weight for children.

PreventionAvoiding multiple sexual partners and unprotected casual sexual intercourse. Condom use is advised.

Complications

These include epididymitis and urethral stricture. Perihepatitis could also occur.