Chlamydial urethritis - male

Definition
Chlamydial urethritis is a sexually transmitted disease involving infection of the urethra (the tube that drains urine from the bladder).

Causes, incidence, and risk factors
Chlamydial urethritis is caused by a type of microorganism that lives as a parasite within human cells and has properties of both viruses and bacteria.

Chlamydia can cause nonspecific urethritis with a discharge from the penis and swollen testes. The symptoms can appear similar to gonorrhea infection but persist after treatment for gonorrhea. Chlamydia and gonorrhea often occur together.

Chlamydia is a common sexually transmitted disease in the US and abroad. Approximately 5 out of 10,000 men are affected annually. Risk factors include multiple sexual partners and sexual contact without condoms.

Different strains of chlamydia cause genital, eye, lymph node, and respiratory infections. Chlamydia is the most common cause of blindness in the world. A child born to a woman with a chlamydia infection of the cervix may develop an acute eye or lung infection.

Symptoms

     
  • Difficlty urinating       o Painful urination       o Burning sensation during urination  
  • Discharge from the penis  
  • Testicular tenderness  
  • Redness, swelling of the opening of the urethra at tip of the penis

Signs and tests

     
  • Urethral discharge culture or seminal fluid culture  
  • Monoclonal antibody test

Treatment

The antibiotics doxycycline (100 mg twice a day for 7 days) or azithromycin (1 g as a single dose) are used to treat chlamydia infections. Patients with allergies may take ofloxacin or erythromycin base.

Both sexual partners must be treated for both gonorrhea and chlamydia to prevent passing the infections back and forth. Even partners without symptoms need to be treated. Both partners should also be screened for syphilis.

Expectations (prognosis)

Antibiotic treatment is usually successful.

Complications

Strictures (narrowing) of the urethra may occur. This may require surgical intervention to correct.

The infection may recur if compliance with therapy is not good, or if both sexual partners are not treated.

Calling your health care provider

Call your health care provider if symptoms indicate a chlamydia infection may be present.

Prevention

Having a monogamous sexual relationship with an uninfected partner is the best way to avoid this infection. The proper use of condoms during intercourse decreases the risk of infection.

Johns Hopkins patient information

Last revised: December 6, 2012
by Dave R. Roger, M.D.

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