Urethritis physical examination

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Seyedmahdi Pahlavani, M.D. [2]

Overview

The most common physical finding in urethritis is urethral discharge. The entire genital area must be examined to rule out other possible afflictions.

Physical Examination

Appearance of the patient

Patients are usually well-appearing.

Vital signs

Rarely, fever is found to be present.

Genitourinary system

In patients with symptoms suggestive of urethritis, a thorough examination of the genital area must be performed.[1][2]

  • The genitalia are best examined while the patient is supine.
  • Patients should be examined for inguinal lymphadenopathy, ulcers, or urethral discharge.
  • The skin of the entire pubic area, scrotum, groin, and penis should be examined for lesions, and the hair should be examined for lice.
  • The testes, epididymis, and spermatic cords should be palpated for masses or tenderness.
  • The urethral meatus should be inspected for secretions.
  • If no discharge is present, the urethra should be gently stripped or milked.
  • Milking frequently expels a discharge that may be collected on a swab for further examination.

Images

Milking in patients with urethrits:

References

  1. Brill JR (2010). "Diagnosis and treatment of urethritis in men". Am Fam Physician. 81 (7): 873–8. PMID 20353145.
  2. Bennett, John (2015). Mandell, Douglas, and Bennett's principles and practice of infectious diseases. Philadelphia, PA: Elsevier/Saunders. ISBN 9781455748013.

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