y Chapter 4.2: Urethral Discharge, Population Reports, Series L, Number 9

CONTENTS

         Chapters
  1. The Toll of STDs
  2. Reducing the Toll of STDs
  3. Managing STDs
  4. Diagnostic and Treatment Tips
  5. Getting Services to the People
  6. Getting People to Services
  7. 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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