Penile discharge: Difference between revisions
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__NOTOC__ | |||
{{Search infobox}} | {{Search infobox}} | ||
{{SCC}} | {{SCC}} | ||
==Overview== | ==Overview== | ||
Penile discharge is commonly associated with [[STD]]s. A thorough sexual history along with a complete medical history and physical exam are necessary. In addition, cultures for | Penile discharge is commonly associated with [[STD]]'s. A thorough sexual history along with a complete medical history and physical exam are necessary. In addition, cultures for STD's should be taken though rarely are nonsexually transmitted diseases the cause. | ||
== | == Causes== | ||
===Common Causes=== | |||
*[[Carcinoma]] of the [[urethra]] | *[[Carcinoma]] of the [[urethra]] | ||
*Foreign body in the [[urethra]] | *Foreign body in the [[urethra]] | ||
| Line 28: | Line 14: | ||
*Nonspecific [[urethritis]] | *Nonspecific [[urethritis]] | ||
*[[Prostatitis]] | *[[Prostatitis]] | ||
*[[Reiter's | *[[Reiter's syndrome]] | ||
==Risk Factors== | |||
A patient that is not circumscised is at higher risk for STD's. | |||
== Diagnosis == | == Diagnosis == | ||
=== History and Symptoms === | === History and Symptoms === | ||
*History includes: | *History includes: | ||
:* | :*Personal history | ||
:* | :*Sexual history | ||
*Note: onset, color, type and duration of discharge | *Note: onset, color, type and duration of discharge | ||
=== | === Physical Examination === | ||
*Genital exam | *Genital exam | ||
== Laboratory Findings == | === Laboratory Findings === | ||
*[[Blood culture]] | *[[Blood culture]] | ||
*[[CBC]] | *[[CBC]] | ||
| Line 48: | Line 36: | ||
*[[HIV]] | *[[HIV]] | ||
*[[RPR]] | *[[RPR]] | ||
*Urethral cultures - | *Urethral cultures - gold standard for [[gonorrhea]] and [[chlamydia]] | ||
*[[Urinalysis]] | *[[Urinalysis]] | ||
*Wet mount for [[trichomonas]] | *Wet mount for [[trichomonas]] | ||
=== X Ray === | === X Ray === | ||
*X-ray for detection of foreign bodies, when necessary | *X-ray for detection of foreign bodies, when necessary. | ||
== Treatment == | == Treatment == | ||
*Penile discharge should be treated as an STD until definitivly ruled out | *Penile discharge should be treated as an STD until definitivly ruled out. | ||
=== Acute Pharmacotherapies === | ===Medical Therapy=== | ||
==== Pharmacotherapy ==== | |||
===== Acute Pharmacotherapies ===== | |||
*[[Chlamydia]] - PO [[azithromycin]], [[ofloxacin]] for seven days, [[doxycycline]] for seven days or [[erythromycin]] for seven days | *[[Chlamydia]] - PO [[azithromycin]], [[ofloxacin]] for seven days, [[doxycycline]] for seven days or [[erythromycin]] for seven days | ||
*[[Trichomonas]] - Single dose [[metronidazole]] for seven days | *[[Trichomonas]] - Single dose [[metronidazole]] for seven days | ||
*[[Gonorrhea]] - [[Ceftriaxone]] single dose IM (in office) / PO [[cefixime]] / [[ciprofloxacin]] | *[[Gonorrhea]] - [[Ceftriaxone]] single dose IM (in office) / PO [[cefixime]] / [[ciprofloxacin]] | ||
== Primary Prevention == | === Primary Prevention === | ||
*Suggest the patient inform all sexual partners of disease so they can seek treatment | *Suggest the patient inform all sexual partners of disease so they can seek treatment. | ||
*Discuss safe sexual | *Discuss safe sexual practices. | ||
==Related Chapters== | |||
* [[Discharge]] | |||
* [[STD]]'s | |||
==References== | ==References== | ||
{{reflist|2}} | {{reflist|2}} | ||
{{WH}} | |||
{{WS}} | |||
{{ | |||
[[Category:Urology]] | [[Category:Urology]] | ||
[[Category:Medical signs]] | |||
[[Category:Symptoms]] | |||
[[Category:Signs and symptoms]] | [[Category:Signs and symptoms]] | ||
[[Category:Emergency medicine]] | [[Category:Emergency medicine]] | ||
[[Category:Needs causes]] | |||
Latest revision as of 23:37, 29 July 2020
Template:Search infobox Steven C. Campbell, M.D., Ph.D.
Overview
Penile discharge is commonly associated with STD's. A thorough sexual history along with a complete medical history and physical exam are necessary. In addition, cultures for STD's should be taken though rarely are nonsexually transmitted diseases the cause.
Causes
Common Causes
- Carcinoma of the urethra
- Foreign body in the urethra
- Infection
- Nonspecific urethritis
- Prostatitis
- Reiter's syndrome
Risk Factors
A patient that is not circumscised is at higher risk for STD's.
Diagnosis
History and Symptoms
- History includes:
- Personal history
- Sexual history
- Note: onset, color, type and duration of discharge
Physical Examination
- Genital exam
Laboratory Findings
- Blood culture
- CBC
- Hepatitis B
- Hepatitis C antibodies
- HIV
- RPR
- Urethral cultures - gold standard for gonorrhea and chlamydia
- Urinalysis
- Wet mount for trichomonas
X Ray
- X-ray for detection of foreign bodies, when necessary.
Treatment
- Penile discharge should be treated as an STD until definitivly ruled out.
Medical Therapy
Pharmacotherapy
Acute Pharmacotherapies
- Chlamydia - PO azithromycin, ofloxacin for seven days, doxycycline for seven days or erythromycin for seven days
- Trichomonas - Single dose metronidazole for seven days
- Gonorrhea - Ceftriaxone single dose IM (in office) / PO cefixime / ciprofloxacin
Primary Prevention
- Suggest the patient inform all sexual partners of disease so they can seek treatment.
- Discuss safe sexual practices.