title: Advances in the Understanding and Treatment of Male Urethritis.
abstract: Neisseria gonorrhoeae and Chlamydia trachomatis are well-documented urethral pathogens, and the literature supporting Mycoplasma genitalium as an etiology of urethritis is growing. Trichomonas vaginalis and viral pathogens (herpes simplex virus types 1 and 2 and adenovirus) can cause urethritis, particularly in specific subpopulations. New data are emerging regarding the potential role of bacterial vaginosis-associated bacteria in urethritis, although results are inconsistent regarding the pathogenic role of Ureaplasma urealyticum in men. Mycoplasma hominis and Ureaplasma parvum do not appear to be pathogens. Men with suspected urethritis should undergo evaluation to confirm urethral inflammation and etiologic cause. Although nucleic acid amplification testing would detect N. gonorrhoeae and C. trachomatis (or T. vaginalis if utilized), there is no US Food and Drug Administration-approved clinical test for M. genitalium available in the United States at this time. The varied etiologies of urethritis and lack of diagnostic options for some organisms present treatment challenges in the clinical setting.
authors.affiliation: Division of Infectious Diseases, Department of Medicine, Wake Forest University Health Sciences, Winston-Salem, North Carolina.
authors.forename: Laura H
authors.initials: LH
authors.lastname: Bachmann
authors.affiliation: Departments of Epidemiology and Global Health, University of Washington, Seattle.
authors.forename: Lisa E
authors.initials: LE
authors.lastname: Manhart
authors.affiliation: Division of Infectious Diseases, Department of Medicine, Louisiana State University, New Orleans.
authors.forename: David H
authors.initials: DH
authors.lastname: Martin
authors.affiliation: Division of Infectious Diseases, School of Medicine, University of North Carolina at Chapel Hill.
authors.forename: Arlene C
authors.initials: AC
authors.lastname: Seña
authors.affiliation: Division of Obstetrics/Gynecology and Reproductive Biology, Beth Israel Deaconess Hospital Harvard School of Public Health, Boston, Massachusetts Division of Bone, Reproductive and Urologic Products, United States Food and Drug Administration, Silver Spring, Maryland.
authors.forename: Jordan
authors.initials: J
authors.lastname: Dimitrakoff
authors.affiliation: Microbiology and Infection Control, Statens Serum Institut, Copenhagen, Denmark.
authors.forename: Jørgen Skov
authors.initials: JS
authors.lastname: Jensen
authors.affiliation: Division of Infectious Diseases, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland.
authors.forename: Charlotte A
authors.initials: CA
authors.lastname: Gaydos
mesh_terms: D002487:Centers for Disease Control and Prevention, U.S.; D002690:Chlamydia Infections / Q000175:diagnosis / Q000382:microbiology / Q000628:therapy; D002692:Chlamydia trachomatis / Q000235:genetics; D006801:Humans; D008297:Male; D009175:Mycoplasma Infections / Q000175:diagnosis / Q000382:microbiology / Q000628:therapy; D045704:Mycoplasma genitalium / Q000235:genetics; D009344:Neisseria gonorrhoeae / Q000235:genetics; D021141:Nucleic Acid Amplification Techniques; D016133:Polymerase Chain Reaction; D017410:Practice Guidelines as Topic; D014481:United States; D016990:Ureaplasma urealyticum / Q000235:genetics; D014526:Urethritis / Q000175:diagnosis* / Q000209:etiology / Q000382:microbiology / Q000628:therapy*
keywords: Chlamydia trachomatis; Mycoplasma genitalium; Neisseria gonorrhoeae; men; urethritis