Non-gonococcal urethritis (NGU) is an infection of the urethra caused by pathogens other than gonococcus, also known as non-specific urethritis, and is also called non-specific genital tract infection (NSGI) because women with the disease have not only inflammation of the urethra but also inflammation of the genital tract, such as cervicitis. Etiology and pathogenesis Chlamydia trachomatis is the most common pathogenic microorganism in NSGI, followed by Mycoplasma genitalium and Mycoplasma urealyticum, occasionally caused by Trichomonas vaginalis, Herpes simplex virus, etc. The main route of transmission is sexual intercourse. Some people report that men with chlamydial urethritis, their female sexual partners of cervical chlamydia infection up to 60%-70%; others report that women with chlamydial cervicitis, their male sexual partners of chlamydial urethritis up to 42%. 2. Obstetrical infection. Pregnant women with non-gonococcal urethritis can be transmitted to the fetus through the birth canal, causing conjunctivitis and even pneumonia in the newborn. 3, indirect infection. Swimming, sharing unclean bath towels and horse stabbing, and the use of incompletely disinfected or unsterilized medical devices in some small clinics for urogenital system examination and treatment may all lead to indirect infection. Clinical manifestations Non-gonococcal urethritis mostly occurs in sexually active people, mainly through sexual contact infection, can occur in both men and women, newborns can be infected during delivery through the birth canal, incubation period of 1 to 3 weeks. The symptoms of non-gonococcal urethritis are somewhat similar to those of gonococcal urethritis, but the patient’s urethral secretion smear and culture cannot find gonococcus, and its typical symptoms are: stinging urethra, accompanied by light or heavy urinary urgency, painful urination and difficulty in urination. 1. Male manifestations Clinical manifestations are similar to gonorrhea but to a lesser extent. The common symptoms are itching, stinging or burning sensation in the urethra, a few have frequent urination and painful urination; physical examination shows mild redness and swelling of the urethral orifice, urethral discharge is mostly plasma, the amount is small, some patients will find a small amount of discharge in the morning, the pus film sealing the urethral orifice “paste” phenomenon, or underwear is contaminated; some patients may not have any symptoms Nearly half of the patients are easily overlooked or misdiagnosed at the time of initial diagnosis, and 10% to 20% of the patients have a combination of gonococcal infection. (1) Epididymitis: mostly acute, unilateral, often coexisting with urethritis; (2) Prostatitis: mostly subacute, chronic, asymptomatic or with dull perineal pain or penile pain; (3) Reiter’s syndrome: manifests as a triad of urethritis, conjunctivitis and arthritis; (4) Others: such as proctitis, ophthalmoplegia, ankylosing syndrome; (5) Urethritis, iritis, and ankylosing syndrome. (4) Others: such as proctitis, ocular iritis, ankylosing spondylitis, etc. (2) Female manifestations Mainly involving the cervix; nearly half of the patients are asymptomatic, and those with symptoms lack specificity, showing only increased leucorrhea and cervical edema and erosion on physical examination. Chlamydia trachomatis can cause pharyngeal infection from oral-genital contact; it can also cause vestibular adenitis, tubal infection, endometritis, ectopic pregnancy, infertility, and even perihepatitis. 3. Neonatal infections Newborns delivered through the mother’s birth canal can be infected with Chlamydia trachomatis or Mycoplasma solium, causing conjunctivitis or pneumonia. Laboratory tests 1, urethra, cervical secretion smear and Linococcus culture negative; 2, urethra, cervical scraping for chlamydia antigen test or chlamydia culture positive, or urethra scraping for Mycoplasma solium culture positive. The diagnosis of non-gonococcal urethritis is mainly based on the history of sexual contact, history of spousal infection, etc., typical clinical manifestations are mainly urethritis in men and cervicitis in women, and laboratory test results. How to treat In principle, early diagnosis, early treatment, regular medication, and individualized treatment plans should be achieved. Treatment should pay attention to the selection of drugs with strong effects on mycoplasma and chlamydia commonly used are tetracyclines, macrolides, quinolones, etc. Commonly used drugs are: doxycycline, azithromycin, memantin, erythromycin, clarithromycin, sparfloxacin, etc. Tetracyclines are contraindicated in pregnancy. The combination of more than two types of drugs with different effects should be used according to the severity of the disease. This can overcome the shortcomings of using a drug with insufficient effects and reduce mixed infections and incomplete treatment. In addition to systemic medication, local intravaginal medication can improve the efficacy. The Chinese medicine can reduce the resistance of the body to western medicine and increase the dose of western medicine and prolong the course of treatment to achieve better results. Warm tips: 1, Chlamydia trachomatis and Mycoplasma urealyticum on penicillin, cephalosporin antibiotics and other drugs that act on the cell wall have resistance, so treatment with such drugs is not effective; 2, the patient’s sexual partner or spouse, even if there are no symptoms, should also be examined at the same time. If the same pathogens as the patient are detected, they should be treated at the same time. During the treatment period, sexual intercourse should be prohibited or condom should be worn; 3. Alcohol should be avoided during the treatment period and for 3 months after the cure; 4. Since the symptoms of non-gonorrhea are mild, the symptoms are even less obvious after the treatment, and some patients think they are cured. This is wrong. It is necessary to complete a course of adequate treatment and follow up and review 2 weeks after the end of treatment. 5. Clinically, some patients still have urethral discomfort after one or several courses of treatment, but the signs and laboratory tests are normal. This is the “STD cure syndrome”, which may be related to the psychological effect and slight stimulation of the urethra, and does not constitute a sufficient basis for re-treatment. Patients should participate in more cultural and sports activities to divert their attention; take hot water baths, physical therapy, etc.; 6. Most non-gonorrhea can be cured. If it is not treated for a long time or repeatedly infected, complications such as acute epiglottitis and prostatitis may occur, but the incidence is not high.