Urethritis overview
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Seyedmahdi Pahlavani, M.D. [2]
Historical Perspective
The urithritis was first described by Albert Neisser, a german doctor in 1879.[1]
Classification
Based on etiology of urethritis, it is classified in to two main group, infectious and non-infectious. The non-infectious causes further divided to gonococcal and non-gonococcal.
Pathophysiology
Urethritis is a genital tract inflammation mostly due to infectious causes. Its pathogenesis depends on underlying pathogen.
- N. gonorrhoeae is usually transmitted via the genital tract to the human host
- Following attachment to host cell which is mediated by pili, gonococci become engulfed in a process known as parasite-directed endocytosis. This organism will survive inside the vacuoles and replicate.[2]
- Chlamydia trachomatis is the most common pathogen among non gonorrheal causes.
- Infectious process starts by cell surface attachment and phagocytosis by host cell. This pathogen survives inside the cell by debilitating the cellular lysosomes and replicate as elementary bodies (the infective form of pathogen).[3][4]
Causes
Urethritis may be caused by either infectious or non infectious causes. Infectious causes are divided to gonorrheal and non-gonorrheal.[5] Non-gonorrheal pathogens are the most common cause of urethritis, Chlamydia trachomatis on top of them.[6][5][7]
Differential Diagnosis of urethritis
Urethritis must be differentiated from other causes of dysuria and urethral discharge which include acute cystitis[8][9][10], epididimitis[11], prostatitis[12], cervicitis[13] and vulvovaginitis.[14]
References
- ↑ Oriel JD (1996). "The history of non-gonococcal urethritis". Genitourin Med. 72 (5): 374–9. PMC 1195709. PMID 8976858.
- ↑ Scheuerpflug I, Rudel T, Ryll R, Pandit J, Meyer TF (1999). "Roles of PilC and PilE proteins in pilus-mediated adherence of Neisseria gonorrhoeae and Neisseria meningitidis to human erythrocytes and endothelial and epithelial cells". Infect. Immun. 67 (2): 834–43. PMC 96394. PMID 9916098.
- ↑ Beatty, Wandy L., Richard P. Morrison, and Gerald I. Byrne. "Persistent chlamydiae: from cell culture to a paradigm for chlamydial pathogenesis." Microbiological reviews 58.4 (1994): 686-699.
- ↑ Baron, Samuel. Medical microbiology. Galveston, Tex: University of Texas Medical Branch at Galveston, 1996. Print.
- ↑ 5.0 5.1 Al-Sweih NA, Khan S, Rotimi VO (2011). "The prevalence of Chlamydia trachomatis and Neisseria gonorrhoeae infections among men with urethritis in Kuwait". J Infect Public Health. 4 (4): 175–9. doi:10.1016/j.jiph.2011.07.003. PMID 22000844.
- ↑ Kimberly A. Workowski & Gail A. Bolan (2015). "Sexually transmitted diseases treatment guidelines, 2015". MMWR. Recommendations and reports : Morbidity and mortality weekly report. Recommendations and reports / Centers for Disease Control. 64 (RR-03): 1–137. PMID 26042815. Unknown parameter
|month=ignored (help) - ↑ Le Roux MC, Ramoncha MR, Adam A, Hoosen AA (2010). "Aetiological agents of urethritis in symptomatic South African men attending a family practice". Int J STD AIDS. 21 (7): 477–81. doi:10.1258/ijsa.2010.010066. PMID 20852197.
- ↑ Stephen Bent, Brahmajee K. Nallamothu, David L. Simel, Stephan D. Fihn & Sanjay Saint (2002). "Does this woman have an acute uncomplicated urinary tract infection?". JAMA. 287 (20): 2701–2710. PMID 12020306. Unknown parameter
|month=ignored (help) - ↑ W. E. Stamm (1981). "Etiology and management of the acute urethral syndrome". Sexually transmitted diseases. 8 (3): 235–238. PMID 7292216. Unknown parameter
|month=ignored (help) - ↑ W. E. Stamm, K. F. Wagner, R. Amsel, E. R. Alexander, M. Turck, G. W. Counts & K. K. Holmes (1980). "Causes of the acute urethral syndrome in women". The New England journal of medicine. 303 (8): 409–415. doi:10.1056/NEJM198008213030801. PMID 6993946. Unknown parameter
|month=ignored (help) - ↑ A. Stewart, S. S. Ubee & H. Davies (2011). "Epididymo-orchitis". BMJ (Clinical research ed.). 342: d1543. PMID 21490048.
- ↑ Felix Millan-Rodriguez, J. Palou, Anna Bujons-Tur, Mireia Musquera-Felip, Carlota Sevilla-Cecilia, Marc Serrallach-Orejas, Carlos Baez-Angles & Humberto Villavicencio-Mavrich (2006). "Acute bacterial prostatitis: two different sub-categories according to a previous manipulation of the lower urinary tract". World journal of urology. 24 (1): 45–50. doi:10.1007/s00345-005-0040-4. PMID 16437219. Unknown parameter
|month=ignored (help) - ↑ Kimberly A. Workowski & Gail A. Bolan (2015). "Sexually transmitted diseases treatment guidelines, 2015". MMWR. Recommendations and reports : Morbidity and mortality weekly report. Recommendations and reports / Centers for Disease Control. 64 (RR-03): 1–137. PMID 26042815. Unknown parameter
|month=ignored (help) - ↑ Daniel V. Landers, Harold C. Wiesenfeld, R. Phillip Heine, Marijane A. Krohn & Sharon L. Hillier (2004). "Predictive value of the clinical diagnosis of lower genital tract infection in women". American journal of obstetrics and gynecology. 190 (4): 1004–1010. doi:10.1016/j.ajog.2004.02.015. PMID 15118630. Unknown parameter
|month=ignored (help)