Urethritis in men

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Urethral anatomy

Genitourinary infection

(1) Human urinary system: (2) kidney; (3) renal pelvis; (4) ureter; (5) urinary bladder (6) urethra.
Additional structures: (7) adrenal gland; (8) renal artery and vein; (9) inferior vena cava; (10) abdominal aorta; (11) common iliac artery and vein; (12) liver; (13) large intestine; (14) pelvis.

"UTI" frequently refers specifically to acute cystitis, but may also be used as a general term for all urinary infections; use location-specific diagnosis.

Clinical Features

  • Dysuria
  • Urethral discharge

Differential Diagnosis




  • Urinalysis
  • Urine GC/chlamydia
  • Consider M. genitalium and trichomonas testing


  • Typically initially a clinical diagnosis with empiric treatment


Uncomplicated Infection

Treatment to cover both gonorrhea and chlamydia Typically, treatment for both gonorrhea and chlamydia is indicated, if one entity is suspected.


  • Gonorrhea
    • Ceftriaxone IM x 1
      • 500 mg, if weight <150 kg
      • 1 g, if weight ≥150 kg
  • Chlamydia

Ceftriaxone contraindicated

^Additional chlamydia coverage only needed if treated with cefixime only

Partner Treatment

Recurrent or Persistent

Target M. genitalium

Consider coverage of trichomonas, among men who have sex with women


  • Outpatient

See Also