Urethral Infections in Men and Women

Gonococcal and nongonococcal urethritis (NGU) remain the two most common sexually transmitted diseases seen in males in developed countries (1, 2). The past decade has witnessed important developments in these diseases, including the emergence of penicillinase-producing Neisseria gonorrhoeae (3, 4), the recognition of Chlamydia trachomatis (5-8) and Ureaplasma urealyticum (6, 9, 10) as etiologic agents of NGU, a clearer understanding of the spectrum of illness caused by these agents, and the use of newer therapeutic regimens. In both sexes, these agents can either cause mucosal urogenital tract infection (urethritis, cervicitis) or spread contiguously or hematogenously to produce epididymitis, endometritis, pelvic inflammatory disease or disseminated gonococcal infection. In this paper we review important advances in the epidemiology, pathogenesis, diagnosis, and treatment of urethral infections in men and women, emphasizing particularly the acute urethral syndrome in women.