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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.
Abstract:
Urethral polyp is one of differential diagnoses for the male patients complain of gross-hematuria and/or hematospermia. However, there have been limited numbers of case reports including infectious etiology. Here we reported clinical course and pathological findings of one rare case who was diagnosed and treated as urethral polyp-like lesions on the prostatic urethra caused by Chlamydia trachomatis infection. A 25 year-old man who had a past history of frequent sexual intercourse with unspecified female sexual partner visited the clinic. His chief complaint was gross-hematuria and hematospermia. Endoscopic findings showed that non-specific hemorrhagic polyp-like lesions. To determine the pathological findings including malignant diseases and diagnosis, transurethral resection was performed. Because the pathological findings were similar to those of chlamydial proctitis, additional examination was done. As the results, nucleic acid amplification test of C. trachomatis in urine specimen was positive and immunohistochemical staining of specific chlamydia antigen in resected specimen was also positive. Treatment by orally minocyline 100 mg twice daily for 4 weeks was introduced. After the treatment, symptom was disappeared and nucleic acid amplification test of C. trachomatis in urine specimen turned to be negative. No recurrence was reported 2 years posttreatment.
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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