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nongonococcal urethritis

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Nongonococcal Urethritis 

Definition

Any inflammation of the urethra not due to gonorrhea, almost always contracted through sexual intercourse and found far more often in men.

Description

Men between the ages of 15 and 30 who have multiple sex partners are most at risk for nongonococcal urethritis (NGU), which is believed to be the most common sexually transmitted disease in the United States.

Causes and symptoms

NGU is spread almost exclusively via sexual contact, and appears most often in men because a woman's urethra is less easily infected during sex. The infection is most often due to Chlamydia trachomatis, the organism that causes chlamydia. Those that aren't caused by Chlamydia trachomatis are usually due to another bacterium, Ureaplasma urealyticum. In 10% to 20% of NGU cases, the cause is unknown.
Symptoms appear within one to five weeks after infection, and include a slight clear discharge (the color of the discharge can vary from one patient to the next), and itching or burning during or after urination.
However, some men never develop symptoms, and women almost never show signs of infection. However, it's possible that symptoms of burning or itching in or around the vagina may be due to NGU.
The disease is communicable from the time of first infection until the patient is cured. Past infection doesn't make a person immune.

Diagnosis

Nongonococcal urethritis is diagnosed by excluding other causes, since inflammation that is not caused by gonorrhea is classified as NGU. A microscopic and/or culture test of the discharge or urine can reveal the infection.
Since many people are infected with both NGU and syphilis at the same time, infected patients also should have a test for syphilis before treatment for NGU begins, and three months after treatment ends.

Treatment

Antibiotics such as tetracycline or azithromycin will cure NGU; both sexual partners should be treated at the same time.
Patients taking tetracycline should avoid milk or milk products and take the medication at least one hour before or two hours after meals. On the last day of treatment, a male should have a urine test to make sure the infection has cleared. If it hasn't, he should take a second course of therapy. Men should use a condom during treatment and for several months after treatment is completed.
If urine tests indicate the infection is gone but symptoms persist, the doctor will check for signs of prostate inflammation.

Key terms

Chlamydia — One of the most common sexually transmitted diseases in the United States. It causes discharge, inflammation and burning during urination. About half of the cases of nongonococcal urethritis are due to chlamydia.
Gonorrhea — A sexually transmitted disease that affects the genital mucous membranes of men and women.
Urethra — The tube that carries urine from the bladder through the outside of the body.

Prognosis

NGU is completely curable with proper antibiotic treatment. Untreated, NGU can lead to sterility in both men and women, inflammation of the mouth of the uterus, and infections of the woman's internal sexual organs. An infection during pregnancy may lead to pneumonia or eye infections in the newborn child. Untreated men may develop swelling of the testicles and an infected prostate gland.

Prevention

People can prevent the spread of NGU by:
  • using a condom
  • limiting the number of sex partners
  • washing the genital area after sex
  • if infected, avoid sexual contact; take antibiotics, notify all partners

Resources

Organizations

American Social Health Association. P.O. Box 13827, Research Triangle Park, NC 27709. (800) 227-8922. http://www.ashastd.org.

Other

Sexually Transmitted Diseases Hotline. (800) 227-8922.

urethritis /ure·thri·tis/ (u″re-thri´tis) inflammation of the urethra.
urethritis cys´tica  urethritis with formation of multiple submucosal cysts.
nongonococcal urethritis , nonspecific urethritis urethritis without evidence of gonococcal infection.
simple urethritis  nongonococcal u.

non·gon·o·coc·cal urethritis (nngn--kkl)
n. Abbr. NGU
Inflammation of the urethra similar to that of gonorrhea but usually caused by infection with the rickettsia Chlamydia trachomatis and occurring mostly in males.

nongonococcal urethritis (NGU)
[-gon′əkok′əl]
Etymology: L, non + Gk, gone, seed, kokkos, berry
an infectious condition of the urethra in males that is characterized by mild dysuria and a small to moderate amount of penile discharge. The discharge may be white or clear, thin or mucoid, or, less often, purulent. The infection is often caused by the obligate intracellular parasite Chlamydia trachomatis. Untreated NGU may result in urethral stricture, epididymitis, proctitis, and chronic inflammation of the urethra. Women exposed to the exudate during coitus may develop a hypertrophic erosion of the cervix and purulent cervical mucus. An infant passing through the cervix and vagina of a mother infected with C. trachomatis may develop conjunctivitis and nasopharyngeal infection in the first few days after birth and pneumonia at 3 to 4 months. Diagnosis of NGU is made by excluding gonococcal urethritis through microscopic examination and bacteriologic culture of the exudate. Nearly 50% of all cases of urethritis are nongonococcal. Most cases of NGU are successfully treated with tetracycline or erythromycin. Sexual contacts are treated whether or not they are symptomatic.

nongonococcal urethritis (non´gon´ōkok´l yoor´ithrī´tis),
n an infection of the reproductive system caused by the bacterium
C. trachomatis. Transmitted through sexual contact and can lead to infertility in women. See also C. trachomatis.


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