Male Paraurethral Duct Infection and Subsequent Paraurethral Duct Dilation

Correspondence To the Editor: Only a small amount of studies were reported about paraurethral duct infection in males. To investigate the pathogens causing paraurethral duct infection and the secondary paraurethral duct dilation in males, and to understand the clinical characteristics and treatment options in paraurethral duct dilation, we retrospectively analyzed the data of male patients with paraurethral duct infection and subsequent paraurethral duct dilation who were treated at the Department of Dermatology of Changshu First People's Hospital from January 2000 to October 2013. Twenty‑three patients (age range, 17–65 years; mean age, 31.5 years) with paraurethral duct infection and subsequent paraurethral duct dilation were enrolled in this study. All were presented with erythematous swelling of the external urethral orifice with a pinhead‑like ostium at the center of the swollen area, through which pus could be expressed with pressure. The mean duration of paraurethral duct infection symptoms was 17 days (range: 9–39 days). All lesions were solitary. All the patients experienced tenderness, and 17 felt spontaneous pain. Among the purulent excretion specimens from the patients' paraurethral ducts, 10 had detectable gonococci, 6 had Staphylococcus aureus, 5 had Chlamydia trachomatis, and 2 had Escherichia coli. Rapid plasma reagin test, Treponema pallidum hemagglutination assay, and human immunodeficiency virus antibody test results were also negative in all the patients. Patients with gonococcal infection were given intramuscular ceftriaxone sodium (1 g once daily for 5 days). Patients with S. aureus infection were treated with levofloxacin (0.5 g once daily for 8 days). Patients with C. trachomatis infection were treated with azithromycin (0.5 g once daily for 5 days). Patients with E. coli infection were treated with nitrofurantoin (0.1 g 3 times a day for 10 days). Re‑evaluation was performed after 6 weeks and results showed that erythematous swelling of the external urethral orifice and the purulent excretion from the ostium were eliminated. However, the ostium did not close and transparent liquid could be expressed with pressure [Figure 1a and b]. None of the patients felt pain or had tenderness. The discharge from paraurethral duct was re‑collected for Gram‑staining. The discharge results were negative for trichomonads and Gram‑negative diplococci were not visible within phagocytes, direct microscopic fungi tests were negative, and cultures for general bacteria, gonococci, Ureaplasma urealyticum, and fungi showed negative results. Fluorescence quantitative polymerase chain reaction for the DNA of gonococci, C. trachomatis, U. urealyticum, and herpes simplex virus types 1 and 2 also yielded …