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Query: UMLS:C0152447 (urethral discharge)
 296 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The incidence and mode of presentation of trichomonal urethritis in Nigerian males have been investigated. 19 (10.6%) of 179 patients presenting with nongonococcal urethritis were found to harbor the parasite. The most common symptoms were urethral discharge and/or urethral irritation. The usefulness of examining wet preparations of the urethral exudate in diagnosis is stressed. No significant difference has been found between the incidence of the condition in Nigerians as compared with other ethnic groups. Attention is drawn to the possibility of T. Vaginalis playing a role in male infertility, its superinfection in longstanding urethritis is stressed, and therapeutic efficacy of metronidazole is appraised.
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PMID:Trichomonal urethritis in Nigerian males. 454 52

The attempt is made in this discussion to provide a more precise and detailed description of gonorrhea among men and women of a remote rural area of Uganda. The study was part of an intensive Demographic Research Project that had as its objectives investigation of the cultural, social, medical and economic factors related to differential rates of population growth and testing methods of collecting accurate data on vital events. 2 rural districts were selected as having low and high fertility respectively--the Teso District in the Eastern Region with low fertility and Anokole District in the Western Region with high fertility--and gonorrhea was found to be 1 of the most important factors responsible for these differences. Of the 166 men examined in Ankole, only 7 were found to have gonorrhea. Of the 168 women who were adequately examined, only 4 were found to have gonorrhea. Gonorrhea was found to be highly prevalent in the Teso District. Due to the fact that 1/3 of those affected were symptomless, there is little question that many more cases would have been diagnosed if other diagnostic procedures had been included, such as obtaining urethral material from all subjects. In addition to the current evidence of gonorrhea, the following features were noted in the Teso men, and these may be considered as diagnostic concomitants (and some as determinants) of the gonorrhea status of the community. Of the 270 men interviewed, 70 indicated that they were unable to pass urine freely or easily. This total included 15 cases of currently diagnosed gonorrhea. 150 of the 270 men gave a past history of urethral discharge. 1 of the most significant features encountered was the nodular thickening of the lower pole (globus minor) of the epididymis, or more extensive involvement in some cases. 61 of the 270 men gave a past history of genital sores. Of those with more than 1 wife, 75.0% reported a past history of discharge, as compared with 55.6% of those who only had 1 wife. This difference was significant.
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PMID:Clinical, cultural, and demographic aspects of gonorrhoea in a rural community in Uganda. 454 85

To determine the most effective, economical therapy for gonorrhea in Uganda, 5 single-session penicillin schedules were compared in a group of 460 university students with urethral discharge. A total of 590 episodes of gonococcal urethritis were treated. Patients were randomly allocated to 1 of 5 schedules. Treatment schedules and cure rates were as follows: 1) aqueous procaine penicillin 2.4 m.u. (125 cases), 90.3%; 2) procaine penicillin 2.4 m.u. plus ampicillin 1 gm (143 cases), 97.1%; 3) procaine penicillin 3 m.u. (90 cases), 89.8%; 4) procaine penicillin 3 m.u. plus probenecid 1 gm (103 cases), 97.1%; and 5) probenecid 1 gm orally followed by benzyl penicillin 5 m.u. (129 cases), 96.8%. 30 of the 31 treatment failures were successfully treated with an alternate schedule. The results obtained with procaine penicillin alone are considered unfavorable. Although highly effective, the probenecid and benzyl penicillin regimen is expensive and requires the preparation of penicillin with lignocaine solution and an extra 30-minute wait, making it inappropriate for Uganda's busy multipurpose clinics. The procaine-ampicillin combination was also highly effective, but its high cost limits it use to private practice. The 3rd highly effective schedule, the combination of procaine penicillin and probenecid, appears to most closely approximate the ideal single-session penicillin schedule for treatment of gonorrhea in Uganda. It is both inexpensive and easily administered. Moreover, the prolonged penicillinemia achieved by 3 m.u. procaine penicillin may be more effective in eliminating cases of incubating syphilis than benzyl penicillin. Long-acting procaine penicillin in oil with aluminum monostearate (PAM), which is the most widely used treatment regimen in the rural medical units of Uganda, is no longer indicated and may, in fact, be encouraging the spread of less sensitive strains of gonorrhea. Any change toward a more effective treatment schedule must, however, be accompanied by improvement in the diagnostic and treatment facilities in the country.
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PMID:In search of an ideal single-session penicillin schedule for the treatment of gonorrhoea in Uganda. 474 9

This paper explores the frequency of different etiological agents causing urethritis among cases in the University College Hospital, Ibadan; the prevalence of gonococcal infections among housewives and prostitutes, and the incidence of isolation of T-strain mycoplasmas in the urethra of patients with nongonococcal urethritis (NGU) and a control group of Nigerian males. 6 groups of patients were studied: 442 men with urethral discharge and/or urethritis; 228 women with heavy vaginal discharge or consorts of male patients with symptoms; 130 symptomless women aged 15-45; 19 local prostitutes; 93 men diagnosed as having NGU; and 65 men aged 15-44 presenting at the outpatient department of the hospital with no genitourinary symptoms or history of urethral discharge in the last 6 months. 69% of the 442 male and 62% of the 228 female cases were aged 25 and above. Among them, 147 of the males and 38 of the females had gonorrhea, 15 males and 44 females had Trichomonas vaginalis, 9 men and 63 women had Candida albicans, and 271 men had NGU. 47.1% of men were infected by casual consorts, 21% by prostitutes, and 20.4% by their wives. 11.4% of females were infected by casual consorts and 63.1% by their husbands. T-strain mycoplasmas were isolated from 18 (19.3%) of the 93 patients with NGU and from 13 (20%) of the 65 controls. Among the 130 symptomless women, 19 had Trichomonas vaginalis, 15 had Candida albicans, 7 had gonorrhea, and 89 had no abnormal findings. Among the 19 prostitutes, 3 each had gonorrhea and trichomonas vaginalis, none had Candida albicans, and there were no abnormal findings in 13. A likely reason for the prevailing patterns of infection is that self-treatment of symptomatic disease is widely practiced, broad spectrum antibiotics being freely available. All the prostitutes took regular prophylactic treatments.
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PMID:Epidemiology of urethritis in Ibadan. 503 71

Methyl green-pyronin (MGP) was used in a one-step procedure to stain smears of urethral discharge from 169 men. Duplicate smears were stained by Gram's method and discharge was cultured for Neisseria gonorrhoeae. The organisms were isolated from 67 specimens and intracellular diplococci were seen in 74 smears after Gram staining and in 77 after staining by MGP. Furthermore, more extracellular and intracellular diplococci were seen in smears stained by MGP than by Gram's method and the proportion of polymorphonuclear leucocytes found to contain the organisms was greater after staining with MGP. Staining with MGP is simple, rapid, inexpensive, and easily automated.
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PMID:One-step staining of Neisseria gonorrhoeae in urethral discharge by methyl green-pyronin. 615 54

A total of 50 patients with recent spinal cord injury secondary to trauma participated in a prospective study of urinary complications during an interval of clean intermittent catheterization at initial hospitalization in a spinal cord injury unit. Patients were assigned randomly to groups receiving or not receiving a prophylactic antibacterial preparation. Both groups were divided further into subgroups in which laboratory infections (bacteriuria more than 100,000 organisms per ml.) were treated with definitive antibiotics or in which antibiotic treatment was given only for clinical infections (fever more than 100F or urethral discharge and bacteriuria). Antibacterial prophylaxis significantly reduced the probability of laboratory infection but not the probability of clinical infection, although a trend was noted toward fewer clinical infections. No significant reduction was noted in the probability of clinical infection in subgroups treated promptly for laboratory infection.
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PMID:Urinary infection and complications during clean intermittent catheterization following spinal cord injury. 633 18

A prospective study was undertaken to assess the incidence of urethral stricture in 105 men undergoing coronary artery by-pass grafting. A pre-operative urological history was taken and peak urine flow rates measured before surgery, and 1 week and between 6 and 8 weeks after operation. All patients were catheterised in theatre with a standard type and size of urethral catheter and details recorded of the by-pass time and the degree of hypothermia. Postoperative urological problems such as urethral discharge and haematuria were noted. In addition, 100 patients completed a postal questionnaire about urinary symptoms between 4 and 12 months after surgery. The overall incidence of urethral stricture was 2%.
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PMID:Urethral stricture following cardiac surgery: a prospective study. 633 76

We describe a case of urethritis caused by group B streptococci. The diagnosis was confirmed by examination of a Gram stained smear, isolation of the organism from the urethral discharge, and also by the clinical response to treatment with phenoxymethyl penicillin.
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PMID:Urethritis caused by group B streptococci: a case report. 636 37

We compared the diagnostic value of an enzyme immunoassay method for detection of gonococcal antigen in genital secretions with culture results and direct Gram stain for Neisseria gonorrhoeae in 1,171 men and 723 women attending a sexually transmitted disease clinic. When compared with culture results in men, the immunoassay provided a sensitivity of 94% and a specificity of 98% and was essentially equivalent to the urethral Gram stain. The predictive value of a positive immunoassay was 97% in men with a urethral discharge in whom the prevalence of gonorrhea was 36%, and 30% in men without urethral discharge, who had a 2% prevalence of gonorrhea (P less than 0.001). The sensitivity of the immunoassay was 95% in men with and 67% in men without urethral discharge (P less than 0.01). In women, the immunoassay resulted in a sensitivity of 78% and a specificity of 98% compared with cervical culture and had a significantly better sensitivity than the cervical Gram stain (78 versus 48%, P less than 0.001). Analysis of patients with discrepant culture and immunoassay results suggested that most culture-negative, immunoassay-positive patients probably did not have gonorrhea. After treatment, all but 1 of 59 originally culture- and immunoassay-positive patients became negative in both tests by 3 days. Results of the immunoassay were not affected by transport or by refrigeration for up to 30 days.
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PMID:Antigen detection for the diagnosis of gonorrhea. 642 57

The efficacy of a single 2.5-g dose of thiamphenicol against infection with penicillinase-producing strains of Neisseria gonorrhoeae (PPNG) or non-penicillinase-producing strains (non-PPNG) was studied in a two-phase clinical trial in Nairobi. The first phase included men who had had a urethral discharge for less than seven days, were infected with either PPNG or non-PPNG, and had not received previous treatment. The second phase included men with PPNG infections that had not responded to treatment with penicillin. The overall cure rate (determined by follow-up examinations and cultures three and ten days after treatment) was 90.6% in the first phase of the study and 92.1% in the second phase. A second 2.5-g dose of thiamphenicol was administered to four of the six patients in the second phase whose cultures yielded gonococci after the initial dose; the infections of all four patients were cured. The results of disk diffusion tests of gonococcal isolates did not correlate well with the outcome of treatment.
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PMID:Treatment of gonorrhea with single-dose thiamphenicol in Kenya. 644 Dec 81


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