URETHRITIS

dr. Moh. Rauben B.

RSU Indrasari Rengat Akper
Pemprof Riau Rengat
2010

Urethra
The adult female urethra is about 4 cm long
and is muscular in its proximal four-fifths.
This musculature is arranged in an inner
longitudinal coat that is continuous with
the inner longitudinal fibers of the bladder
and an outer circular coat that is
continuous with the outer longitudinal coat
of the bladder.
These outer circular fibers comprise the
sphincteric mechanism.
The striated external sphincter surrounds the
middle third of the urethra.

In the male, the prostatic urethra is

heavily muscular and sphincteric.
The membranous urethra is within the
urogenital diaphragm and is surrounded
by the striated external sphincter.
The penile urethra is poorly muscularized
and traverses the corpus spongiosum to
open at the tip of the glans.

URETHRITIS

Types of Urethritis

Infection/inflammation of the
urethra can be categorized into
those types caused by Neisseria
gonorrhoeae and by other
organisms (Chlamydia
trachomatis, Ureaplasma
urealyticum, Trichomonas
vaginalis, and herpes simplex

Most cases are

acquired during sexual
intercourse.

PRESENTATION AND
FINDINGS

Patients with urethritis

may present with urethral
discharge
and dysuria.

The amount of discharge

may vary significantly,
from profuse to scant
amounts.

Obstructive voiding
symptoms are primarily
present in patients with
recurrent infection, in
whom urethral strictures
subsequently develop.

It is important to note that

approximately 40% of
patients with gonococcal
urethritis are
asymptomatic (John and
Donald, 1978).

The diagnosis is made

from examination and
culture of the urethra.
It is important to obtain
the specimen from within
the urethra, rather than
from just the discharge.

Approximately 30% of
men
infected with N.
gonorrhoeae will have
concomitant infection
with C. trachomatis.

RADIOLOGIC IMAGING

Retrograde urethrogram is
only indicated in patients
with
recurrent infection and
obstructive voiding
symptoms.
Most patients with
uncomplicated urethritis do

MANAGEMENT

Pathogen-directed
antibiotic therapy is
required.

In patients with
gonococcalurethritis,
ceftriaxone (250 mg
intramuscularly) or
fluoroquinolones
(ciprofloxacin 250 mg)
(David, Wildman, and
Rajamanoharan, 2000) or

For patients with

nongonococcal urethritis,
treatment is with
tetracycline or
erythromycin (500 mg 4
times daily) or doxycycline
(100 mg twice daily) for 7

However, the most

essential component of
treatment is prevention.
Sexual partners of the
affected patients should
be treated, and protective
sexual practices (such as

Thank You