Incidence and prevalence
There is no exact data on the prevalence of NSU. In STD clinics, this syndrome is detected in 20-30% of men.
Ways of infection
The first episode of NSU is almost always associated with sexual contact. Part of non-chlamydial NSU is due to oral sexual contacts. Recurrent non-chlamydial NSU is most likely an exacerbation of a chronic infection, and not re-infection.
The disease occurs at any age, but most often at 15-35 years.
NSU, by definition, happens only in men. In women, the sexual partners of men with NSU, cervicitis with mucopurulent discharge is possible.
It occurs in both heterosexual men and homosexuals and bisexual men. Among homosexuals and bisexual men, Chlamydia trachomatis accounts for less than 10% of NSU cases. Many cases of NSU in this group are associated with oral sex.
Clinic of non-gonococcal urethritis
The incubation period is
usually 1-3 weeks. NSU is often asymptomatic.
In most cases, patients are concerned about discharge from the urethra; itching in the urethra is possible, pain during urination is usually slight or absent. Severe pain during urination is characteristic of urethritis caused by HSV. Epidemiological history Often, information about a new or random sexual partner is revealed. Clinical examination Discharge from the urethra, usually mucous or mucopurulent, sometimes purulent, is observed. The severity of discharge depends on the time elapsed after urination. Therefore, in many patients, examination does not reveal discharge from the urethra. Possible hyperemia of the sponges of the urethra. Pain on palpation of the urethra is characteristic of urethritis caused by HBV. Penile edema is a rare complication of urethritis or genital herpes, which usually occurs in the absence of erythema of the penis. Laboratory research Gram stain at NSU confirms the detection of more than 5 neutrophils in the field of view with a magnification of 1000 times in the absence of gram-negative diplococci. The number of leukocytes is determined in the zone of the maximum number of cells within the monolayer. Microbiological studies Studies are shown on Chlamydia trachomatis by amplification DNA analysis or culture. In addition, sowing or other accurate studies on Neisseria gonorrhoeae are required. Gram stain material and studies on Chlamydia trachomatis and Neisseria gonorrhoeae are taken with a swab, which is introduced into the urethra at 2-4 cm. It is possible to study the first 30 ml of urine exclusively by DNA amplification methods. Studies on Ureaplasma urealyticum are not shown. Freelance practicing active anal intercourse is shown urine culture. In some cases, studies on ING and Trichomonas vaginalis are necessary. Other research methods. It is possible to determine the number of leukocytes (by microscopy or determination of leukocyte esterase) in the urine sediment obtained by centrifugation of the first 30 ml of urine.