Diagnosis and Treatment Outcomes of Urethritis-like Symptoms in Young Males: A Retrospective Cohort Study

Abstract

Abstract Background Urethritis in young males is most commonly caused by sexually transmitted pathogens, although other non-infectious diseases can cause similar symptoms. The study evaluated the prevalence of gonorrhoea and chlamydia infections in sexually active young males with urethritis-like symptoms and their treatment outcomes. Methods Data of 20–50-year-old males who visited our clinic with urethritis symptoms between March 2019 and April 2022 were retrospectively collected. All patients underwent urinalysis, urine culture, and urinary polymerase chain reaction (PCR) testing for gonorrhoea and chlamydia at the first visit. Student’s t-test and Pearson’s chi-square test were used to compare the differences between participants with at least one positive test result and those with negative results in all three tests. Regression analyses were used to evaluate the predictive factors for positive PCR results for gonorrhoea or chlamydia in patients with negative urinalysis and urine culture results. Results Of the 365 participants with urethritis symptoms, those with negative results (39%) in all tests were significantly older and showed less frequent urethral discharge than those with at least one positive result. Among the 202 patients with negative urinalysis and urine culture results, 29.7% were diagnosed with gonorrhoea or chlamydia using PCR. The presence of discharge was an independent predictor of positive PCR results for gonorrhoea or chlamydia. For patients showing negative results in all tests, the most common tentative diagnosis was balanitis. Patients with negative results for all three tests have good prognosis. Conclusion The present study outlined the high frequency of negative urinalysis and urine culture results in young male patients with gonorrhoea- and chlamydia-related urethritis and indicated the importance of a history of urethral discharge as an indicator for antibiotic treatment of gonorrhoea and chlamydia in these patients. The findings of this study will be valuable for urologists treating young males with urethritis symptoms, and the insights provided here will facilitate appropriate management and patient satisfaction in such cases.