Non-Gonococcal Urethritis
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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 among more than 20 known organisms.
Clinical FeaturesSymptoms usually occur 7 to 28 days after intercourse; usually mild dysuria and discomfort in the urethra and a clear to purulent mucoid discharge. Although the discharge may be slight and the symptoms mild, they are frequently more marked in the morning when the lips of the meatus are often stuck together with dried secretions.
On examination, the meatus may be red, with evidence of dried secretion on underwear. Occasionally the onset is more acute, with dysuria, frequency and a copious purulent discharge.
DiagnosisThis is based on bacteriological examination of the discharge to exclude gonorrhoea.
ComplicationsThese include epididymitis and urethral stricture. Perihepatitis could also occur.
Treatment
| Syndrome | Causal Pathogens | Recommended Regime | Recommended Rigime for Children |
| Urethral Discharge |
Neisseria Gonorrhea |
Ciprofloxacin 500mg stat Plus Doxycycline 100 bd X 7/7 |
Spectinomycin 40mg/kg IM stat (maximum 2g stat) |
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.