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Urethritis - male - Background information
What causes it?

  • Urethritis is most commonly caused by a sexually transmitted infection.
  • Gonococcal urethritis is caused by Neisseria gonorrhoeae.
  • Non-gonococcal urethritis (NGU) has no identifiable cause in over 50% of men [BASHH, 2007].
    • If an organism is identified:
      • Chlamydia trachomatis accounts for up to 45% of cases of NGU [BASHH, 2007].
      • Mycoplasma genitalium accounts for 10–25% of cases, although there is no routine diagnostic test for this micro-organism.
    • Other infections that can cause NGU include:
      • Trichomonas vaginalis. This is an uncommon cause of NGU in the UK (< 5% of cases) but is more frequent worldwide (1–20%).
      • Ureaplasma urealyticum (5–10%).
      • Urinary tract infection (< 6%) [Leung et al, 2002].
      • Adenoviruses (2–4%).
      • Herpes simplex viruses (2–3%).
      • Occasionally, Candida species, Haemophilus species, or Neisseria meningitidis [BASHH, 2007].
    • Non-infective causes of NGU include:
      • Trauma (such as catheterization).
      • Irritation (for example soap, lotion, spermicide creams, deodorants).
      • Urethral stricture.
      • Autoimmune disorder (such as Lichen sclerosis et atrophicus, Stevens–Johnson syndrome).
      • Urinary calculi.
  • Persistent/recurrent urethritis — usually has no identifiable cause. However, Mycoplasma genitalium (20–40%), Ureaplasma urealyticum, and Trichomonas vaginalis have been implicated [Wikstrom and Jensen, 2006].

[BASHH, 2007; Shahmanesh et al, 2009]

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