Clinical meaning
Urethritis is inflammation of the urethra, most commonly caused by sexually transmitted pathogens. The two main types are gonococcal urethritis (caused by Neisseria gonorrhoeae) and non-gonococcal urethritis (most often caused by Chlamydia trachomatis, but also Mycoplasma genitalium and Ureaplasma urealyticum). The bacteria infect the urethral mucosal epithelium, triggering an inflammatory response that causes mucosal swelling, discharge production, and pain with urination. Urethritis is more symptomatic in men (with visible urethral discharge and dysuria) than in women, where it may be asymptomatic or mimic a urinary tract infection. If untreated, the infection can ascend and cause more serious complications such as epididymitis in men or pelvic inflammatory disease in women.
Exam relevance
Risk factors: - Multiple sexual partners - Unprotected sexual intercourse - History of sexually transmitted infections - Age 15-24 years (highest risk group) - New sexual partner in the past 60 days - Men who have sex with men
Diagnostics: - Expect nucleic acid amplification test (NAAT) for Chlamydia and Gonorrhea - Expect urethral swab or first-void urine specimen collection - Monitor for urethral discharge characteristics (color, consistency) - Expect urinalysis to rule out UTI - Expect testing for other STIs (HIV, syphilis, hepatitis B)