IADVL
Indexed with PubMed and Science Citation Index (E) 
 
Users online: 1778 
     Home | Feedback | Login 
About Current Issue Archive Ahead of print Search Instructions Online Submission Subscribe What's New Contact  
  Navigate here 
  Search
 
   Next article
   Previous article 
   Table of Contents
  
 Resource links
   Similar in PUBMED
    Search Pubmed for
    Search in Google Scholar for
  Related articles
   [PDF Not available] *
   Citation Manager
   Access Statistics
   Reader Comments
   Email Alert *
   Add to My List *
* Registration required (free)  

 
  In this article
   Abstract
   Introduction
   Materials and Me...
   Observation and ...
   Discussion
   References

 Article Access Statistics
    Viewed6069    
    Printed58    
    Emailed2    
    PDF Downloaded0    
    Comments [Add]    

Recommend this journal

 


 
ORIGINAL CONTRIBUTIONS
Year : 1999  |  Volume : 65  |  Issue : 3  |  Page : 128-130

Assessment of the aetiological factors of non-specific (non gonococcal) urethritis, taking burning micturition as criteria



Correspondence Address:
Anandam Kuravi


Login to access the Email id

Source of Support: None, Conflict of Interest: None


PMID: 20921633

Rights and PermissionsRights and Permissions

  Abstract 

Out of 90 cases of non-specific urethritis investigated, aetiological factors could be found in 58 cases. However, in 45 cases i.e. 50%, the causative factors turned out to be common factors like pyogenic, fungal, and trichomonal infections only.


Keywords: Non-specific urethritis, Gonococci, Trichomoniasis, spina bifida, prostatitis


How to cite this article:
Kuravi A. Assessment of the aetiological factors of non-specific (non gonococcal) urethritis, taking burning micturition as criteria. Indian J Dermatol Venereol Leprol 1999;65:128-30

How to cite this URL:
Kuravi A. Assessment of the aetiological factors of non-specific (non gonococcal) urethritis, taking burning micturition as criteria. Indian J Dermatol Venereol Leprol [serial online] 1999 [cited 2019 Sep 17];65:128-30. Available from: http://www.ijdvl.com/text.asp?1999/65/3/128/4786



  Introduction Top


The terms non-specific urethritis connotes urethritis not caused by the commonest aetiological agent i.e.,  Neisseria More Details gonorrhoea. Many aetiological factors are incriminated in the causation of the same and some of them are trichomoniasis, moniliasis, chlamydia, mycoplasma, allergy and many pyogenic bacteria.[1][2] In the present work, we have investigated some of these factors that lead to the causation of this condition.


  Materials and Methods Top


The clinical material for the work was obtained form the Department of S.T.D. Kurnool Medical College, Kurnool. In all cases detailed history was taken. The criteria for the selection of the cases were 1. Burning micturition of more than 2 months duration 2. No discharge from urethra even on milking. The cases thus selected were subjected to 1. Complete urinalysis 2. Urine culture.

3. Prostatic massage was done in 70 cases and the discharge was subjected to (a) routine microscopic examinations (b) Search was made for i. Gonococci by Gram's stain ii. for Trichomonas vaginalis by wet smear iii. Fungal elements by 10% KOH preparation. (c) The discharge was cultured for gonococci and pyogenic group of organisms. 4. Blood V.D.R.L. test was done in all 90 cases. 5. X-ray survey was done in 10 cases 5. Urethroscopic examination was done in 10 cases.


  Observation and Results Top


Majority (60) of the patients belonged to the age group 20 to30 and duration of disease ranged from 2 months to 7 years. Burning micturition was present in all 90 cases, while 1 patient had burning with itching. Morning gleet was noticed in 8 cases and in 4 stained smears showed intracellular gonococci. Incubation period could be assessed by interrogation in 33 cases. In 18 patients it ranged from 1-10 days, in 3 cases it ranged from 11-20 days, in 6 patients, from 20-30 days, in 3 cases, from 30-60 days while in 3 others it ranged from 60-120 days.

Urinalysis revealed pus cells above 5 in 55 cases. Albumin was found in 2 and sugar in 3 cases. Two of them were diabetic. R.B.C. was found in 3 cases and in 9 cases epithelial cells were found. Threads were seen in 4, sperms in 2 and casts and crystals in 1 case each.

Urine culture was done in 82 cases and pyogenic organisms were cultured in 11 cases. Klebsiela and pseudomonas were cultured in 2 patients each. Atypical coliforms and E.coli were cultured in 3 cases each. In 1 case Alkalagenes faecalis was cultured. As regards culture and sensitivity it is given in [Table:1]. Blood VDRL test was reactive 1:4 in 4 patients.

Prostatic secretions revealed puscells in 26 cases, epithelial cells in 4, R.B.C. in 1, bacteria in 3 cases (non gonococcal), fungal filaments in 1 and Trichomonas vaginalis in 1 case. Dead sperrms were found by staining in 5 cases, but gonococcal culture done in 28 cases was negative in all. Pyogenic culture was done in 67 cases and was positive in 47. Aerobic spores were cultured in 1 case. Out of 47 cases in whom pyogenic organism could be cultured, 23 grew coagulase negative -staphylococci, 19 grew coagulase positive staphylococci, 3 grew atypical coliforms and 2 grew klebsiela. As regards culture and sensitivity it is given in [Table:2].

Other features observed were benign prostatic hypertrophy in 1, cancer of prostate in one, and spermatorrhoea in 2. X-ray study revealed arthritis in 3 cases and 2 had calcanean spur [Figure:2]. Ankle joints and wrist joints were involved in 1 of these cases. These three cases were classified as Reiter's disease. Cervical spondylosis was seen in 1 case. Spina bifida with osteoporosis of right lumbar spine and fusion of L5 and 1 were found in 1 case [Figure:1].

Urethroscopic examination showed posterior urethritis with stricture in 1 case, pin hole meatus in 1 case, bladder neck congestion and prominent verrumontanum in 1 case.

After correlating and analysing all the observations, following results are obtained.

1. Though staphylococci, coag. negative and positive were isolated in 42 cases, in 10 cases other conditions were discovered and hence the primary infection of prostate by staphylococci was thought to be the cause in 32 cases only.

2. Though urine culture was positive in 11 cases, only in 1 atypical coliforms were cultured from both urine and prostatic fluid and this finding alone was considered significant. In another case Klebsiela was cultured from urine alone. This was considered as infection of lower urinary tract. In the rest of the 9 cases urine culture positivity was thought of as due to contaminants. In addition, atypical coliforms were cultured in 3 cases and Klebsiela in 2 cases in prostatic fluid. These 5 cases were considered as primary prostatic infection by the above mentioned organisms.

3. Fungus was isolated from prostatic fluid in 1 case and another turned out to be trichomonal infection.

Gonococci were found in gleet in 4 cases and in an another it was found in prostatic fluid. Hence chronic gonococcal infection was considered as the diagnosis in these 5.

5. Other diseases found with their numbers are Reiters-3, spina bifidal-1, diabetes-2, spermatorrhoea with impotence-2, cancer prostate-1, benign prostatic hypertrophy-1 and structural abnormalities-3. Though in some of these cases, urine culture or culture of prostatic flluid came positive, they were not given any significance as they were considered as secondary invaders.

6. Thus we could find the cause of non-specific (non-gonococcal) urethritis in 58 out of 90 (64%) patients.

The disease wise distribution as found in this work is given in [Table:3].


  Discussion Top


The present work proved that the commonest cause of chronic dysurea or burning micturition was only due to common infections like pyogenic, chronic gonococcal, protozoal and mycotic infections, as 45 out of 90 cases (50%) came under this category only. In another 13 cases, the picture was different. In 5 of them urinary obstructive pathology like stricture, pinhole meatus, prominent verrumontanum, prostatic hypertrophy and cancer were found. Evidently the dysurea is the result of pathology or secondary invasion in three cases Reiter's disease was the aetiological factor. Spina bifida as observed in one of our patients is known to produce incontinance and lead to secondary invasion and consequent dysurea.

As regards diabetes and spermatorrhoea, the dysurea is thought to be due to defect in neurological mechanism leading to secondary infection.

In the present stady, we could find the cause of non-specific (non-gonococcal) urethritis in 58 out of 90 cases. In the rest of the cases other causes alrready documented like chlamydia, mycoplasma, virus or allery might have played part.[1][2][3]

 
  References Top

1.King A, Nicol C, Rodin P. Venereal Diseases, 4th edn., ELBS, 1980,274-293.  Back to cited text no. 1    
2.Willcox RR. Textbook of Venereal Diseases and Treponematoses, London, William Heinmann Medical Books Ltd, 1964;88-110.  Back to cited text no. 2    
3.Sehgal VN: Textbook of Venereal Diseases. Vikas Publishing House Pvt.Ltd., 27-30.  Back to cited text no. 3    




 

Top
Print this article  Email this article
Previous article Next article

    

Online since 15th March '04
Published by Wolters Kluwer - Medknow