Urethritis Follow-up

Updated: Sep 08, 2016
  • Author: Martha K Terris, MD, FACS; Chief Editor: Edward David Kim, MD, FACS  more...
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Follow-up

Further Outpatient Care

See the list below:

  • Only patients who remain symptomatic require follow-up cultures to ensure eradication of infection.
  • If symptoms persist following adequate treatment, the disease is most likely nongonococcal urethritis (NGU). Prior to improved culture methods and increased awareness of the causes of NGU, symptom recurrences were thought to be psychological in nature. This is usually not the case, and most cases of recurrent NGU are related to persistent chlamydial, ureaplasmal, or mycoplasmal infection. These patients benefit from prolonged (14-28 d) therapy with erythromycin. Consider also quinolone resistance in gonococcal urethritis, based on local epidemiologic data.
  • Most infections after treatment are due to reinfection by the same or a new partner, stressing the need to educate patients and to treat partners.
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Deterrence/Prevention

See the list below:

  • Educate at-risk patients on how to prevent disease recurrence.
  • Educate patients on risks of other sexually-transmitted infections, including HIV. [7]
  • Try to find asymptomatic patients and symptomatic patients who are unlikely to seek treatment.
  • Early diagnosis and treatment of infected individuals is essential.
  • Evaluate and treat sexual partners of known infected persons.
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Complications

Complications, such as stricture, stenosis, or abscess formation, are quite rare. Concomitant epididymitis or prostatitis is not uncommon.

PID and tubo-ovarian abscess are known complications of urethritis in females that may predispose to infertility. In addition, increasing evidence shows that genital chlamydial infection in males may predispose to infertility. In addition, both Chlamydia and U urealyticum can impair sperm and adversely affect semen parameters. [8, 9, 10]

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Prognosis

All patients with uncomplicated urethritis spontaneously recover with or without treatment.

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Patient Education

Instruct patients to avoid the following high-risk behaviors are associated with STDs:

  • Intercourse at a young age, which with rare exceptions is associated with multiple sex partners and unprotected intercourse
  • Intercourse with multiple partners
  • Drug abuse
  • Unprotected sex
  • Intercourse with partners known to have infections

Instruct patients to use barrier devices with all partners at all times.

For patient education information, see Urinary Tract Infections, Birth Control Spermicides, Birth Control Methods, and Birth Control Overview.

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