Analysis of clinical manifestations of male patients with urethritis

Takahashi, Satoshi; Takeyama, Koh; Kunishima, Yasuharu; Takeda, Kohichi; Suzuki, Nobukazu; Nishimura, Masahiro; Furuya, Ryoji; Tsukamoto, Taiji

doi:10.1007/s10156-006-0466-7

Cited by 17 publications

(10 citation statements)

References 6 publications

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“…In addition to this, it is though that up to 42% of NGU cases may be caused by C. trachomatis ( 51 ). Importantly, C. trachomatis infection appears to be equally present in both symptomatic and asymptomatic urethral diseases ( 52 , 53 ).…”

Section: Chlamydiamentioning

confidence: 99%

The Role of the Immune Response in Chlamydia trachomatis Infection of the Male Genital Tract: A Double-Edged Sword

Redgrove

McLaughlin

2014

Front. Immunol.

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Chlamydia trachomatis (CT) is the most prevalent bacterial sexually transmitted infection in the world, with more than 100 million cases reported annually. While there have been extensive studies into the adverse effects that CT infection has on the female genital tract, and on the subsequent ability of these women to conceive, studies into the consequences on male fertility have been limited and controversial. This is in part due to the asymptomatic nature of the infection, where it is estimated that 50% of men with Chlamydia fail to show any symptoms. It is accepted, however, that acute and/or persistent CT infection is the causative agent for conditions such as urethritis, epididymitis, epididymo-orchitis, and potentially prostatitis. As with most infections, the immune system plays a fundamental role in the body’s attempts to eradicate the infection. The first and most important immune response to Chlamydia infection is a local one, whereby immune cells such as leukocytes are recruited to the site of infections, and subsequently secrete pro-inflammatory cytokines and chemokines such as interferon gamma. Immune cells also work to initiate and potentiate chronic inflammation through the production of reactive oxygen species (ROS), and the release of molecules with degradative properties including defensins, elastase, collagenase, cathespins, and lysozyme. This long-term inflammation can lead to cell proliferation (a possible precursor to cancer), tissue remodeling, and scarring, as well as being linked to the onset of autoimmune responses in genetically disposed individuals. This review will focus on the ability of the immune system to recognize and clear acute and persistent chlamydial infections in the male genital tract, and on the paradoxical damage that chronic inflammation resulting from the infection can cause on the reproductive health of the individual.

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Section: Chlamydiamentioning

confidence: 99%

The Role of the Immune Response in Chlamydia trachomatis Infection of the Male Genital Tract: A Double-Edged Sword

Redgrove

McLaughlin

2014

Front. Immunol.

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“…The diagnosis of male urethritis is mainly performed by microbiological examination [20][21][22][23]. However, the authors believe that knowledge of typical symptoms might help to distinguish each type.…”

Section: Discussionmentioning

confidence: 99%

Value of Office-Based Transrectal Three-Dimensional Ultrasound for Diagnosis of Acute Dysuria of the Prostatic Urethra

Elwagdy¹,

Ramadan²,

A-Fatah³

et al. 2010

UIJ

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Value of Office-Based Transrectal Three-DimensionalUltrasound for Diagnosis of Acute Dysuria of the Prostatic Urethra Abbreviations and Acronyms2D = 2-dimensional 3D = 3-dimensional E. coli = Escherichia coli ROI = region of interest TRUS = transrectal ultrasound US = ultrasound ABSTRACT KEYWORDS: Three-dimensional transrectal ultrasound (3D TRUS); Prostatic urethra; acute dysuria CORRESPONDENCE: INTRODUCTION: The purpose of the study was to compare the accuracy of plain radiography, 2-dimensional (2D), and 3-dimensional (3D) transrectal ultrasound (TRUS) in diagnosing the causes of acute dysuria, as confirmed by urethroscopy or laboratory findings. METHODS: Participants were 122 men with clinical presentation of acute dysuria who were previously known to be healthy. Their mean age was 28 years (range, 17-49 years). All patients received a plain radiograph of the urinary tract. A SonoAce X8 ultrasound system (Medison America Inc; Cypress, CA, USA) was used to obtain both 2D and 3D TRUS. Voiding-related symptoms, cause of the dysuria, location, and morphology of the lesions were recorded. The results of the plain radiograph, 2D TRUS, and 3D TRUS were compared with the results of urethroscopy or laboratory findings to determine diagnostic accuracy. RESULTS: Of the total 122 patients, 113 patients (92.6%) had calcular obstruction of the prostatic urethra; 7 patients (5.7%) had variants of severe urethritis; 2 patients (1.6%) had benign urethral polyps. In cases of calcular obstruction, plain radiography revealed 76.7% of radiopaque stones, the 2D TRUS revealed 80.2% of stones, and the 3D TRUS with high threshold revealed 99.1%. Both 2D TRUS and 3D TRUS with low-threshold technique revealed the polyps and accurately defined their pattern and site. Three-dimensional TRUS descriptions of inflammatory lesions and their effect on periurethral tissues were dissimilar from each other and suggestive of different types. CONCLUSION: Three-dimensional TRUS imaging may play an important role in the pretreatment evaluation of acute dysuria that is caused by different impeding factors. UroToday International Journal ® UI J

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“…This clinical study included heterosexual male patients with both GU and NGU who were 20 years old or older. Diagnosis of GU was done based on both symptoms, urethral pain and pus discharge on external urethral meatus, suspecting urethritis, suspecting urethritis [ 14 ] and positive N. gonorrhoeae detected by microscopic examination of Gram staining, culture of urethral pus discharge or a nucleic acid amplification test (NAAT) of first-voided urine (FVU). Diagnosis of NGU was done based on both symptoms suspected to be urethritis and negative N. gonorrhoeae examined by microscopic examination of culture of urethral pus discharge or commercially available NAAT of FVU.…”

Section: Methodsmentioning

confidence: 99%

Clinical Efficacy of a Single Two Gram Dose of Azithromycin Extended Release for Male Patients with Urethritis

Takahashi

Kiyota

Ito³

et al. 2014

Antibiotics

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To clarify the clinical efficacy of a single oral 2 g dose of azithromycin extended-release for heterosexual male patients with urethritis, and the current antimicrobial sensitivity of Neisseria gonorrhoeae to azithromycin, a prospective clinical trial was conducted from 2011–2013. In patients with gonococcal urethritis, the eradication rate was 90.9% (30 of 33). The susceptibility rates of isolated Neisseria gonorrhoeae strains to ceftriaxone, spectinomycin, cefixime and azithromycin were 100%, 100%, 95.3% (41/43) and 37.2% (16/43), respectively. In the patients with nongonococcal urethritis, the eradication rate was 90.0% (45 of 50). The microbiological eradication rates for the pathogens were 90.9% (30/33) for Neisseria gonorrhoeae, 91.5% (43/47) for Chlamydia trachomatis, 71.4% (5/7) for Mycoplasma genitalium, and 100% (13/13) for Ureaplasma urealyticum. The main adverse event was diarrhea and its manifestation rate was 35.2% (32 of 120). The symptom of diarrhea was mostly temporary and resolved spontaneously. The conclusion was that the treatment regimen with a single oral 2 g dose of azithromycin extended-release would be effective for patients with urethritis. However, the antimicrobial susceptibilities of Neisseria gonorrhoeae and Mycoplasma genitalium should be carefully monitored because of possible treatment failure.

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Analysis of clinical manifestations of male patients with urethritis

Cited by 17 publications

References 6 publications

The Role of the Immune Response in Chlamydia trachomatis Infection of the Male Genital Tract: A Double-Edged Sword

The Role of the Immune Response in Chlamydia trachomatis Infection of the Male Genital Tract: A Double-Edged Sword

Value of Office-Based Transrectal Three-Dimensional Ultrasound for Diagnosis of Acute Dysuria of the Prostatic Urethra

Clinical Efficacy of a Single Two Gram Dose of Azithromycin Extended Release for Male Patients with Urethritis

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