Penile discharge: Difference between revisions
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Revision as of 04:52, 31 January 2013
Template:Search infobox Steven C. Campbell, M.D., Ph.D.
Overview
Penile discharge is commonly associated with STDs. A thorough sexual history along with a complete medical history and physical exam are necessary. In addition, cultures for STDs should be taken though rarely are nonsexually transmitted diseases the cause. A patient that is not circumscised is at higher risk for STDs.
Causes
- Carcinoma of the urethra
- Foreign body in the urethra
- Infection
- Nonspecific urethritis
- Prostatitis
- Reiter's syndrome
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 practice