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Chlamydial urethritis - male

Chlamydial urethritis is a sexually transmitted illness involving infection of the urethra (the tube that drains urine from the bladder).

Causes, incidence, and risk factors

Chlamydial urethritis is caused by the bacteria Chlamydia trachomatis.

Chlamydia can cause a type of swelling (inflammation) of the urethra ( urethritis ). Chlamydia and gonorrhea often occur together.

People who are sexually active and those with multiple sexual partners are at highest risk for chlamydia infection.

Different strains of chlamydia cause genital, eye, lymph node, and respiratory infections. A child born to a woman with a chlamydia infection of the cervix may develop an eye or lung infection.

Symptoms

  • Difficulty urinating
  • Discharge from the penis
  • Redness, swelling, itching of the opening of the urethra at tip of the penis
  • Swelling and tenderness of the testicles

The symptoms can appear similar to those of infection with gonorrhea , but continue even after after treatment for gonorrhea.

Signs and tests

  • Taking a sample of secretions from the penis and sending it to a lab for a culture or a test called polymerase chain reaction (PCR)
  • Urethral discharge culture or genital fluid testing for gonorrhea
  • Urine test

Treatment

Chlamydia can be treated with a variety of antibiotics, including:

  • Azithromycin
  • Erythromycin
  • Quinolones
  • Tetracyclines

Both sexual partners must be treated for both gonorrhea and chlamydia to prevent passing the infections back and forth. Even partners without symptoms need to be treated.

Expectations (prognosis)

Antibiotic treatment is usually successful.

Complications

Narrowing (strictures) of the urethra may occur. This may require surgery to correct.

The infection may come back (recur) if you do not take your medicine as directed, or if your sexual partners are not treated.

Calling your health care provider

Call your health care provider if you have symptoms of a chlamydia infection.

Prevention

Screening for other sexually transmitted infections, including syphilis and HIV, is important when you've been diagnosed with a new chlamydia infection.

Having a sexual relationship with one partner (monogamous) who is not infected is one way to avoid chlamydia. The proper use of condoms during intercourse usually prevents infection.

References

U.S. Preventive Services Task Force. Screening for chlamydial infection: U.S. Preventive Services Task Force recommendation statement. Ann Intern Med. 2007;147:128-134.

Geisler WM. Diseases caused by chlamydiae. In: Goldman L, Schafer AI, eds. Cecil Medicine. 24th ed. Philadelphia, Pa: Saunders Elsevier;2011:chap 326.

Centers for Disease Control and Prevention. Sexually Transmitted Diseases Treatment Guidelines, 2010. MMWR. 2010;59 (RR-12):1-110.

Updated: 5/16/2012

Linda J. Vorvick, MD, Medical Director and Director of Didactic Curriculum, MEDEX Northwest Division of Physician Assistant Studies, Department of Family Medicine, UW Medicine, School of Medicine, University of Washington. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M. Health Solutions, Ebix, Inc.


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