Etiology of Nongonococcal Urethritis

Abstract

Chlamydia trachomatis was isolated from the urethra from 48 (42 per cent) of 113 men with non-gonococcal urethritis (NGU), four (7 per cent) of 58 without overt urethritis, and 13 (19 per cent) of 69 with gonorrhea. Postgonococcal urethritis (PGU) developed in 11 of 11 men who had C. trum antibody to C. trachomatisis developed. The immunotype specificity of chlamydial antibody corresponded to the immunotype isolated. Among culture-negative patients. chlamydial antibody prevalence correlated with the number of past sex partners and with previous NGU. Herpesvirus hominis, cytomegalovirus, T-mycoplasma, Mycoplasma hominis, other bacteria, and Trichomonas vaginalis were not implicated in NGU or PGU. Thus, the cause of chlamydia-negative NGU and PGU remains obscure. Endocervical chlamydia were found in sex partners of 15 of 22 NGU patients with and two of 24 without urethral chlamydial infection (p smaller than 0.001). Tetracycline treatment of both sex partners appears advisable.

Etiology of nongonococcal urethritis. Evidence for Chlamydia trachomatis and Ureaplasma urealyticum.

“…Since the initial discovery of U. urealyticum 740 Bowie et al by Shepard in 1954 (31), the role of this organism in NGU has been debated, as summarized by McCormack et al (8). In the present study, the demonstration of an association between urethral U. urealyticum infection and NGU may be attributable to, (1) selection of patients with no past history of urethritis, (2) separation of cases of NGU into chlamydiapositive and chlamydia-negative groups, (3) quantitative cultures for U. urealyticum, (4) matching of patients with chlamydia-negative NGU with patients having no urethritis with respect to age, race and total number of sex partners, and (5) separate analysis of patients who had had .5 sex partners.…”

“…Chlamydia trachomatis has been recovered from the urethra from 30-50% of men with nongonococcal urethritis (NGU)l (1)(2)(3)(4), and from a significantly lower proportion of controls without urethritis (1,2), or with gonorrhea (1). Serologic evidence suggests chlamydia infection is recently acquired in many men with NGU (1,5,6).…”

“…Serologic evidence suggests chlamydia infection is recently acquired in many men with NGU (1,5,6). Chlamydia can be recovered from the endocervix of sex partners of most NGU patients with chlamydia infection, but seldom from sex partners of NGU patients without chlamydia infection (3).…”

“…The etiology of chlamydia-negative NGU has not been elucidated by previous qualitative analysis of the urethral flora of men with and without NGU (1), but Ureaplasma urealyticuim (8) and Hemophiltus vaginalis (9, 10) have been suspected to be possible causes of NGU. Previous studies indicate 22-90% of NGU cases respond to sulfonamide therapy (11)(12)(13)(14)(15)(16).…”

Epidemiologic aspects of male infertility

“…15,16 Obstruction of male genital tract ductal system may account for around 15 percent of all infertility in the male. 17 A label of infertile in the male has been associated with a significant decrease in health-related quality of life and sexual function which should be discussed during the evaluation process and gives us further impeties to treat these men expeditiously.…”