Sexually Transmitted Infections
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Background
Causes
Diagnosis & Evaluation
Ureaplasma and Mycobacteria
These are probably uncommon causes of urethritis in males, but may be a cause of 'non-gonococcal non-chlamydial urethritis'. There are several different emperic treatment recommendations but a commonly used one is azithromycin 1 g single dose. These organisms are very difficult to culture and therefore specialized testing is required (this is not available in British Columbia). The BC Centre for Disease Control can, however, send urine for DNA PCR to Winnipeg to test for both bacteria under special circumstances.
Urethral Condyloma
Genital warts are caused by the HPV virus. Typically serotypes 6 and 11 but there are several others
External warts:
Urethral meatal warts:
Cryotherapy - every 2 weeks until eradicated. First choice if accessible
Podophyllin 10%-25% weekly until eradicated; applied, I for 1 minute, wash after 2-4 hours every 1-2 weeks
Fluorouracil gel 5% - 2 g of Gel (with 5% fluorouracil) with urethral applicator LEFT in urethra for 30 minutes weekly; probably the best treatment for lesions not amenable to cryotherapy
Surgical removal if large
Treatment
On the Web
BC Centre for Disease Control offers open access clinics for the diagnosis and management of STI's.
Canadian Guidelines on the Diagnosis and Management of Sexually Transmitted Infections (Updated 2010)
Verruca-Freeze is a treatment which can be applied in the office to treat topical HPV.
General Urology Websites
Canadian Urological Association Extensive library of downloadable pamphlets on a wide range of urological conditions
Medline Plus Produced by the US National Institutes of Health with information on virtually every health topic and extensive list of links
UrologyHealth.org The patient information site of the American Urological Association.