NGU
It stands for non-gonococcal urethritis
It is the inflammation of urethra by other causes than gonorrhea. It could be chlamydia or may not be. The proportion of NGU cases caused by chlamydia has been declining gradually, so NGU must be considered on evaluation of high risk patient or symptomatic patients.
It could be Virus such as herpes, Ureaplasma urealyticum, Trichomonas vaginalis, Adenovirus, Haemophilus vaginalis, Mycoplasm genitalium, urethral injury, surgery, and non-specific causes etc
Chlamydia trachomatis (CT) |
15% to 40% |
Ureaplasma urealyticum (UU) |
10% to 40% |
Neither |
20% to 40% |
Mycoplasma genitalium |
15% to 25% |
Trichomonas vaginalis (TV) |
up to 13% |
Herpes Simplex Virus (HSV) |
< 5% |
Candida albicans |
<1% |
Miscellaneous bacteria |
<1% |
Other (E.Coli, Haemophilus spp gram positive organisms) |
? |
Unknown |
20-30% |
"Adapted from Holmes KK et al. Sexually Transmitted Diseases. 3rd Ed. 1999. Ch. 60, page 834"
Mycoplasma genitalium (Mg) was first isolated from 2 of 13 men with nongonococcal urethritis (NGU) in 1982. Though subsequent attempts to culture the organism from men with NGU in the 1980's failed because of its fastidious growth requirements. Now in recent studies it make it presense clearly even stronger than gonorrhea.
Study: Relatively new STD eclipses gonorrhea Infection prevalence was 11 times higher in cohabiting couples, study finds http://www.msnbc.msn.com/id/19101160/
My test is negative for chlamydia and gonorrhea, could I have NGU ?
Yes, you could. NGU causes other than chlamydia is getting more common. Just in our clinical practice in Southern California it is the most comon type of urethritis (other than Chlamydia).
Symptoms of non-gonococcal urethritis
Up to 1/3 of men presenting at an STD clinic with laboratory confirmed NGU have no signs (discharge) or symptoms (dysuria/itching).
- A white discharge from the end of the penis, but does not occur in every case.
- Pain or burning when you pass urine. This may be confused with a urine infection.
- Irritation
- urinary frequency
- tingling
Diagnosis:
Positive test for urethritis and negative for gonorrhea will be diagnostic for NGU. So just getting negative test on Gonorrhea and Chlamydia for STD testing does not mean you do not have NGU. It demands experience for testing and evaluation for NGU. Skilled physician will be able to diagnose this condition.
Complication If Untreated: NGU may facilitate HIV transmission. Patients who have NGU and also are infected with HIV should receive the same treatment regimen as those who are HIV-negative.
Untreated NGU may lead to
Epididymitis (epididymis inflammation ) which can lead to infertility if left untreated.
Reiter's syndrome
Conjunctivitis
and more
Specifics
- Chlamydia- in some areas of the US the proportion of NGU due to this organism is declining perhaps as a result of increased screening efforts.
- Ureaplasma- urethral colonization in men without urethritis is common but has been associated with clinical urethritis in men without any other discernible cause. However, the role of this organism in clinical disease remains unclear.
- Mycoplasma genitalium- isolated more frequently in men with NGU than from those without but the causal role is still not proven.
- Trichomonas- implicated in higher proportion on NGU cases in eastern Europe, Africa, and India compared with the US. Recent data suggests, however, that trichomoniasis is increasing as a cause of NGU (about 10%). Incidence of trichomonal NGU may be higher in men more than 30 years of age.
- HSV- Urethritis in 15-30% of men with primary HSV. Less frequent with recurrent HSV. Most, but not all patients with HSV urethritis have visible penile lesions.
- Yeast- rarely detected in urethritis study but some men with balanitis have symptoms of urethritis.
- Urethral gram stain may demonstrate WBC and gram negative rods. Maybe associated with cystitis and occasionally with insertive anal sex. Treatment should be directed towards gram negative rods.
- Noninfectious causes of urethritis- trauma, chemical irritation, Steven-Johnson syndrome." Boston University education
Oral Sex & NGU
You may contract NGU with oral sex as well
Read latest article
(Jan. 6, 2006 -- Oral sex raises the risk of a common sexually
transmitted disease (STD) called nongonococcal urethritis (NGU) in men,
Australian researchers report.) http://www.webmd.com/content/article/117/112461.htm
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