CONTENTS
Chapters
- The Toll of STDs
- Reducing the Toll of STDs
- Managing STDs
- Diagnostic and Treatment Tips
- Getting Services to the People
- Getting People to Services
- Promoting Prevention—Condoms and Monogamy
HIGHLIGHTS
Population Reports is published by the Population Information Program, Center for Communication Programs, The
Johns Hopkins School of Public Health, 111 Market Place, Suite 310, Baltimore, Maryland
21202-4012, USA
Volume XXI, Number 1
June, 1993 |
Urethral Discharge
Diagnostic Tips
- Identify the origin of the discharge. Urethritis causes
discharge from the meatus (the opening of the penis).
In uncircumcized men discharge from the glans or
foreskin may appear to come from the meatus (185).
- If no discharge is visible, consider applying gentle
pressure to the penis. It may be possible to observe
discharge by holding the head of the penis between the
thumbs and gently rolling the thumbs up and down. It
may be necessary to milk the urethra: Start at the base
of the penis. Place one finger or the palm of the hand
beneath the penis and one or two fingers on top at the
base. Applying gentle pressure, move the hands outward
towards the tip of the penis. Repeat if necessary. If
patients are reluctant or afraid, they may milk the
penis themselves.
- If the patient urinated shortly before the examination,
thus rinsing discharge from the urethra, the discharge
may not reappear for several hours.
Treatment Tips
- If the recommended drugs are not available but
penicillin is available, use it only if the prevalence
of gonorrhea resistant to penicillin is less than 5% in
the area.
- If a patient and his sexual partner have been treated
twice for gonorrhea and still have symptoms, they may
be infected with a resistant strain. Refer them to an
STD clinic.
- Cefixime and ceftriaxone cure incubating syphilis (a
recent infection that has not produced symptoms);
ciprofloxacin, spectinomycin, and kanamycin do not.
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