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Urethritis - male - Management
How should I assess a man with suspected urethritis?

A sexually transmitted infection (STI) is generally considered to be the underlying cause of urethritis in most, (but not all), men. Ideally, urethritis should be managed in a service specializing in sexual health, or a general practice providing an enhanced sexual health service.

  • If urethritis is suspected, test for:
    • Chlamydia trachomatis — send a first-void urine sample for nucleic acid amplification testing (NAAT).
    • Gonorrhoea — check with the local laboratory whether a urethral swab is needed (see testing). Some laboratories use NAAT for gonococcal infection (see the CKS topic on Gonorrhoea).
    • Trichomoniasis (see the CKS topic on Trichomoniasis).
    • Other STIs (such as HIV, syphilis, hepatitis). It is recommended that everybody at risk of an STI should be offered an HIV test.
  • If a urinary tract infection is suspected, send a mid-stream urine sample for culture and sensitivity (see the CKS topic on Urinary tract infection (lower) - men).
  • If the man is at low risk for an STI, consider other causes of urethritis, and check for:
    • Penile irritation or trauma (for example catheterization, sexual trauma).
    • Urethral stricture and penile ulceration (see the CKS topic on Herpes simplex - genital).
    • Urinary tract infection, prostatitis, epididymitis, and inguinal lymphadenopathy (see the CKS topic on Prostatitis - acute).
    • Adenoviral infection.
    • Skin rashes which also involve mucosal surfaces (for example Stevens–Johnson Syndrome).
    • Urinary calculi.

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