Sexually transmitted diseases. Urethritis in men

Gonococcal and nongonococcal urethritis (NGU) are among the most common syndromes afflicting men. NGU is caused primarily by Chlamydia trachomatis and Ureaplasma urealyticum, but the cause is unknown in approximately 20 to 30 percent of cases. Evaluation of a gram-stained urethral smear is generally sufficient to distinguish between gonococcal and nongonococcal urethritis. Owing to the frequent coexistence of Neisseria gonorrhoeae and C. trachomatis in heterosexual men, treatment regimens for gonococcal urethritis should generally include an effective antichlamydial regimen. Complications of urethritis are uncommon, but the causative pathogens produce serious morbidity in women. Prevention of urethritis is based on identification of asymptomatically infected persons who serve as the major reservoir of infection with both N. gonorrhoeae and C. trachomatis.