男性重复尿道炎的临床研究(附9例报告)

目的:研究男性重复尿道炎的临床特点,指导临床诊疗。方法:分析9例男性病例的重复尿道病理分型、重复尿道炎临床特点、治疗过程和随访情况。结果:9例患者Ⅰ型患者7例,ⅡA2型1例,ⅡB型1例。重复尿道炎病程2～420 d,平均77.2±141.5 d。4例病程较长的患者有多次应用多种抗生素反复治疗史;临床表现多样,以重复尿道或正常尿道内出现分泌物或脓液为主要症状;分泌物内主要检出病原体有淋病奈瑟菌、溶脲脲原体、沙眼衣原体等;性伴侣生殖道病原体与患者分泌物病原体一致率87.5%。经过足够疗程敏感抗生素治疗,症状消失;性伴侣同时治疗;随访3个月无复发者。结论:重复尿道炎临床表现多样,容易漏诊;对于保守治疗者宜采用敏感抗生素足疗程治疗;性伴侣需同时治疗。

Male urethral duplication infection: experience with 9 cases

Objective： To study the clinical characteristics of male urethral duplication infection and offer some guidelines for the diagnosis and treatment of the disease. Methods ： We analyzed the pathological types, clinical characteristics, therapeutic processes and follow-up results of 9 cases of male urethral duplication. Results ： Among the 9 cases of urethral duplication, 7 turned out to be of Type Ⅰ, 1 Type Ⅱ A2 and 1 Type ⅡB. The disease courses varied from 2 to 420 days, with an average of 77.2 ± 141.5 days. Four cases with longer disease duration were identified with a history of repeated use of various antibiotics for treatment. Their clinical manifestations varied, with the outflow of excretions or pus from the duplicate or normal urethra as the cardinal symptoms. The patho- gens detected from the secretions were mainly Neisseria gonorrhoeae, ureaplasma urealyticum, and Chlamydia trachomatis. The consistency rate of the same pathogens detected in the vaginal or cervical secretions from the sex partners of the patients was 87.5%. All the symptoms disappeared after a sufficient-course treatment with sensitive antibiotics, and the patients＇ sex partners received the same medication simultaneously. No recurrence was found during a 3-month follow-up. Conclusion ： Urethral duplication infection has various clinical manifestations, and thus is easily missed in diagnosis. Sufficient-course treatment with sensitive antibiotics is recommended for those that prefer conservative therapy, and their sex partners should be treated simultaneously.