Urethral polyp-like lesions on prostatic urethra caused by Chlamydia trachomatis infection: a case report

Takashi Muranaka1, Satoshi Takahashi2, Takaoki Hirose1

  • 1Department of Urology, Hokkaido Social Health Insurance Hospital, Sapporo, Japan.

Insights

This case report highlights a rare instance of urethral polyp-like lesions in a male patient caused by Chlamydia trachomatis infection. Prompt diagnosis and antibiotic treatment led to symptom resolution and negative test results.

Area of Science:

  • Urology
  • Infectious Diseases
  • Pathology

Background:

  • Urethral polyps are a differential diagnosis for male patients presenting with gross hematuria and/or hematospermia.
  • Infectious etiologies for such lesions are infrequently reported, necessitating broader diagnostic considerations.

Observation:

  • A 25-year-old male with a history of frequent sexual intercourse presented with gross hematuria and hematospermia.
  • Endoscopic examination revealed non-specific hemorrhagic polyp-like lesions in the prostatic urethra.
  • Transurethral resection was performed for diagnosis, with pathological findings suggesting a possible infectious cause.

Findings:

  • Pathological findings were consistent with chlamydial proctitis, prompting further investigation.
  • Nucleic acid amplification test (NAAT) for Chlamydia trachomatis in urine was positive.
  • Immunohistochemical staining confirmed Chlamydia trachomatis antigen in the resected urethral specimen.

Implications:

  • This case underscores Chlamydia trachomatis as a potential, albeit rare, cause of urethral polyp-like lesions in men.
  • Successful treatment with minocycline resolved symptoms and eradicated the infection, as confirmed by negative urine NAAT.
  • The findings suggest that infectious causes, particularly Chlamydia trachomatis, should be considered in the differential diagnosis of urethral lesions presenting with hematuria or hematospermia.

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