Urinary Tract Disease: Lower: Urethritis (gay + STI)

Question 1

Definition

Answer 1

Inflammation of the urethra - most often due to infection. most common co-infection with other STDs
- non-gonococcal more common than gonococcal
- chlamydia = most common STI in young people 15-24 years

Question 2

Epidemiology

Answer 2

Females
15-24

Question 3

Risk factors

Answer 3

MSM
Unprotected sex
Recent sexual partner
Low socioeconomic status
More than one sexual partner

Question 4

Aetiology

Answer 4

Chlamydia trachomatis + Neisseria gonorrhoea = most common STI in 15- 24 yrs
Non-gonococcal = mycoplasma genitalium, trichomonas vaginalis
Non-infective = trauma, catheterisation, foreign body insertion, urethral stricture, urinary calculi

Question 5

Pathophysiology

Answer 5

Attaches to the mucosa which activates the immune system which triggers cytokines release at site of colonisation

Question 6

Signs and symptoms

Answer 6

Penile irritation/pruritus
Inflammation
Urethral pain + irritation/itching
Orchialgia
May be asymptomatic (95% gonorrhoea, 50% chlamydia)
Refer to GUM clinic if:
- Dysuria
- Discharge from the urethral meatus

Question 7

Diagnosis

Answer 7

NAAT (nucleic acid amplification test) -> detect STI
Urine dipstick + mc + s

Question 8

Treatment

Answer 8

NG = IM ceftriaxone + azithromycin
CT = azithromycin (or doxycycline)

Question 9

REACTIVE ARTHRITIS

Answer 9

CANT SEE (CONJUNCTIVITIS)
CANT PEE (URETHERITIS)
CANT CLIMB A TREE (ARTHRITIS)