BackgroundUrethral discharge syndrome (UDS) is characterized by the presence of
purulent or mucopurulent urethral discharge.The main etiological agents of
this syndrome are Neisseria gonorrhoeae and
Chlamydia trachomatis.ObjectivesTo evaluate the effectiveness of the syndromic management to resolve symptoms
in male urethral discharge syndrome cases in Manaus, Amazonas, Brazil.MethodsRetrospective cohort of male cases of urethral discharge syndrome observed at
a clinic for sexually transmitted disease (STD) in 2013. Epidemiological and
clinical data, as well as the results of urethral swabs, bacterioscopy,
hybrid capture for C.trachomatis, wet-mount examination,
and culture for N.gonorrhoeae, were obtained through
medical chart reviews.ResultsOf the 800 urethral discharge syndrome cases observed at the STD clinic, 785
(98.1%) presented only urethral discharge syndrome, 633 (79.1%) returned for
follow-up, 579 (91.5%) were considered clinically cured on the first visit,
41(6.5 %) were considered cured on the second visit, and 13(2.0%) did not
reach clinical cure after two appointments. Regarding the etiological
diagnosis, 42.7% of the patients presented a microbiological diagnosis of
N.gonorrhoeae, 39.3% of non-gonococcal and
non-chlamydia urethritis, 10.7% of C.trachomatis and 7.3%
of co-infection with chlamydia and gonococcus. The odds of being considered
cured in the first visit were greater in those who were unmarried, with
greater schooling, and with an etiological diagnosis of gonorrhea. The
diagnosis of non-gonococcal urethritis reduced the chance of cure in the
first visit.Study limitationA study conducted at a single center of STD treatment.ConclusionSyndromic management of male urethral discharge syndrome performed in
accordance with the Brazilian Ministry of Health STD guidelines was
effective in resolving symptoms in the studied population. More studies with
microbiological outcomes are needed to ensure the maintenance of the
syndromic management.