Urethritis Secondary to External and Internal Irritants

NON-SPECIFIC urethritis is one of the most perplexing conditions ·encountered in the venereal diseases clinic today. In Britain it was thrown into sharp relief during World War 11 as ,those affected in the military hospitals were daily examined for the gonococcus which was found wanting. Altliough non-specific 'urethritis had been recognized as an entity for many years, many venereologists still considered it to be a manifestation of gonorrhrea. Its full recognition in the United States came even later and, when it appeared in force amongst the American troops in the Pacific theatre, it was at first believed to be penicillinresistant gonorrhrea. In 1953, in the clinics of England and Wales, 13,157 cases were treated as compared with 15,242 male cases of gonorrhrea. ' The causes of non-gonococcal urethritis are legion. They fall into four main groups: 1. Secondary to external and internal irritants. 2. Secondary to intra-urethral sores and tumours. 3. Secondary to other urethral, bladder and kidney disease. 4. Primary urethritis. The commonest is a primary urethritis of unknown retiology. Before considering these groups in detail it should be recorded that certain conditions may simulate urethritis. , Thus in phimotic persons a subpreputial discharge, due to balanitis, primary syphilis, chancroid or condylomata acuminata may lead the patient (and sometimes the doctor)' erroneously to believe that a urethritis exists. Similarly, excessive physiological secretions due to prostatorrhrea or spermatorrhrea may bring the patient to the clinic in the belief that he has a urethritis. In the latter condition, usually seen in unmarried young men, the "discharge" comes from the prostate and seminal vesicles. In prostatorrhrea there is a clear sticky glycerine-like discharge, which is most noticeable .after defrecation due to pressure of the freces on the prostate.