Aetiologies and Management of Urethritis in Men: A Systematic Review and Meta-Analysis

Abstract

Chlamydia trachomatis and Neisseria gonorrhoea are amongst the most common causes for urethritis and epididymitis in men. Management consists of taking a complete sexual history, examinations of the genital area, assessment of laboratory proof of infection, antimicrobial treatment guided towards the significant aetiologies, and therapy of sexual partners. Therapy of N. gonorrhoea calls for making use of a single-dose program targeting this microorganism, plus a 7-to 10-day tetracycline regimen against C. trachomatis and non-gonococcal urethritis. Microbiologic failure is seldom seen in patients taking the proper treatment regimens. However, recurrent urethritis is commonly seen nevertheless. Patients with consistent or recurring symptoms require a cautious re-evaluation, and re-treatment if cultures of polymorphonuclear leukocytes were found in urethral secretions. Although some patients will stay symptomatic and have an increased number of polymorphonuclear leukocytes in urethral secretions, additional treatment is typically not indicated. One of the most vital causes of prostatitis and epididymitis in older males or males with structural anomalies of the urethra are classic urinary system microorganisms as opposed to sexually transferred pathogens. Treatment of these infections consists of getting laboratory evidence of infection and medications against specific pathogens. Men with signs of "prostatitis" need to be assessed making use of both urine and prostatic secretions to look for infection and inflammation. Most of the males with these signs do not have an infection that can be laboratory documented. These patients react poorly to the medication regimen. Males with recorded persistent microbial prostatitis need lengthy regimens of antimicrobials to have an effective treatment. In many cases, nevertheless, the illness is resistant, and persistent treatment with antimicrobials might be needed for the best outcome. Our aim in this article, we will review the causes of urethritis in men and the management plan to treat this common disease.