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Uretrite

Última revisão: 21 Aug 2025
Última atualização: 02 Jan 2025

Resumo

Definição

Анамнез и осмотр

Ключевые диагностические факторы

  • presença de fatores de risco
  • secreção uretral
  • irritação ou prurido uretral
  • disúria
Полная информация

Другие диагностические факторы

  • orquialgia
  • ausência de sensibilidade e/ou inchaço do epidídimo
  • ausência de dor na pelve (mulheres)
  • ausência de erupção cutânea pustular ou petequial
  • ausência de artrite
  • ausência de inflamação ocular
Полная информация

Факторы риска

  • idade entre 15 e 24 anos
  • sexo feminino
  • homens que fazem sexo com homens
  • novos ou vários parceiros sexuais
  • IST prévia ou atual
  • uso inconsistente de preservativo
  • circuncisão
Полная информация

Диагностические исследования

Исследования, которые показаны в первую очередь

  • coloração de Gram de secreção uretral e/ou sedimento da urina
  • testes de amplificação de ácido nucleico (NAATs)
  • cultura de secreção uretral
  • preparação com hidróxido de potássio da secreção uretral
  • teste de HIV
  • Teste de sífilis
Полная информация

Исследования, проведение которых нужно рассмотреть

  • urinálise e cultura
  • câmara úmida de secreção uretral (mulheres)
  • NAAT e cultura de urina ou swab uretral/vaginal para Trichomonas vaginalis
  • NAAT para outros organismos
Полная информация

Алгоритм лечения

Острый

Coloração de Gram inicial sugestiva de gonorreia: não gestante

coloração de Gram inicial sugestiva de gonorreia: gestante

coloração de Gram inicial não sugestiva de gonorreia: não gestante

coloração de Gram inicial não sugestiva de gonorreia: gestante

ПРОДОЛЖЕНИЕ

uretrite recorrente ou resistente

Составители

Авторы

Sheldon Morris, MD, MPH

Assistant Professor

Division of Infectious Diseases

Department of Medicine

UCSD Antiviral Research Center

Division of Family Medicine

Department of Family and Preventive Medicine

UCSD La Jolla Family and Sports Medicine

San Diego

CA

Раскрытие информации

SM has received funding from NIH, CHRP, CIRM, NASA, and Visby Medical. SM owns stock in Bristol Myers Squib and is the founder of Aspera Biomedicines. SM is an author of a number of references cited in this topic.

Выражение благодарностей

Dr Sheldon Morris would like to gratefully acknowledge Dr Christina Bailey, a previous contributor to this topic.

Раскрытие информации

CB declares that she has no competing interests.

Рецензенты

Vani Dandolu, MD, MPH

Associate Professor

Ob/Gyn and Urology

Director

Division of Urogynecology

Associate Residency Program Director

Temple University Hospital

Philadelphia

PA

Раскрытие информации

VD declares that he has no competing interests.

Khalil Ghanem, MD, PhD

Assistant Professor of Medicine

Associate Fellowship Program Director

Division of Infectious Diseases

Johns Hopkins University School of Medicine

Baltimore

MD

Раскрытие информации

KG declares that he has no competing interests.

Christopher Fairley, PhD

Professor of Sexual Health

University of Melbourne

Director

Melbourne Sexual Health Centre

Carlton

Victoria

Australia

Раскрытие информации

CF is an author of a number of references cited in this topic. CF has received programme grants of 6 figures US$.

Peer reviewer acknowledgements

BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.

Disclosures

Peer reviewer affiliations and disclosures pertain to the time of the review.

Список литературы

Our in-house evidence and editorial teams collaborate with international expert contributors and peer reviewers to ensure that we provide access to the most clinically relevant information possible.

Основные статьи

Centers for Disease Control and Prevention. Sexually transmitted infections treatment guidelines, 2021. Jul 2021 [internet publication].Полный текст

Centers for Disease Control and Prevention. National overview of STIs in 2023. Nov 2024 [internet publication].Полный текст

European Association of Urology. Guidelines on urological infections. 2023 [internet publication].Полный текст

Horner PJ, Blee K, Falk L, et al; International Union against Sexually Transmitted Infections. 2016 European guideline on the management of non-gonococcal urethritis. Int J STD AIDS. 2016 Oct;27(11):928-37.Полный текст

British Association for Sexual Health and HIV. Urethritis and cervicitis. May 2023 [internet publication].Полный текст

Статьи, указанные как источники

A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.

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