Diagnosis and treatment outcomes of urethritis-like symptoms in young males: a retrospective cohort study

The study evaluated the prevalence of gonorrhoea and chlamydia infections and find out other non-infectious diseases in sexually active young males with urethritis-like symptoms and their treatment outcomes. We retrospectively reviewed the young adult males (aged 20-50 years) who visited our clinic with urethritis symptoms from March 2019 to April 2022. All patients underwent urinalysis, urine culture, and urinary polymerase chain reaction (PCR) testing for gonorrhoea and chlamydia. Student's t-test and Pearson's chi-square test were used to compare the differences between the triple-negative group (i.e., negative results in urinalysis, urine culture, and urinary PCR) and the any-positive group. Logistic 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. Of the 365 participants with urethritis-like symptoms, 139 patients were diagnosed of gonococcal or chlamydia urethritis. Among the 202 patients with negative urinalysis and urine culture, 60 patients were diagnosed with gonorrhoea or chlamydia using PCR. Urethral discharge was an independent predictor. 142 patients with triple negative results were attributed to other non-infectious diseases. Empirical antibiotic treatment is recommended for patients with urethritis symptoms showing positive or negative urinalysis results but with urethral discharge.