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Abstract: The patient in this case is a young boy who reported intermittent urethral tingling with abnormal urination and increased frequency of urination without any cause 1 day ago, and came to the clinic. After physical examination and laboratory tests, the patient was diagnosed with urethritis and was hospitalized for 6 days after medication for urethral stinging and other uncomfortable symptoms.
Basic information】Male, 17 years old
Type of disease】Urethritis
Hospital】The First Hospital of China Medical University
Date of Consultation】June 2019
Treatment plan】Intravenous injection (sodium neproxen for injection, cefoxitin sodium for injection) + oral medication (ninjutai capsule, metronidazole tablet, cotrimoxazole tablet, inflammable tablet, cefdinir capsule)
Treatment period】6 days of hospitalization, 7 days of home medication
Treatment effect】The condition improved and the symptoms disappeared.
I. Initial consultation
The patient was 17 years old and had intermittent stabbing pain in the urethra without any cause one day before the examination, the intensity of the pain was sometimes mild and sometimes severe, the frequency of urination increased compared with usual, and gradually discharge from the urethral orifice appeared, and there was a residue of discharge in the underwear, but there was no fever, no lumbago, no visual hematuria, and no treatment. The outpatient physical examination showed that the prostate gland was slightly painful to palpate, no obvious enlargement, the central groove existed, the surface was smooth; the foreskin was too long, could be turned up, the distal foreskin was thickened, thick yellow-white discharge was visible at the outer urethral opening and the inner plate of the foreskin, and the discharge increased when the urethra was squeezed. The urine routine examination was also performed and there was an increase in leukocytes. The preliminary diagnosis was urethritis, prepuce, prostatitis and prepuce. The patient was then admitted to the hospital for further consultation and treatment.
II. Treatment history
After the patient was admitted to the hospital, MRI was completed and the findings suggested abnormal signals within the right peripheral zone of the prostate, and prostatitis was considered. The patient was given systemic supportive therapy, anti-inflammatory and analgesic treatment with injectable sodium neproxen, injectable cefoxitin sodium for urethritis, and oral ninhydrin capsules for prostatitis, and incision and drainage for abscess formation, and was discharged after 6 days of continuous inpatient treatment. The patient was given metronidazole tablets, cotrimoxazole tablets, inflammable tablets and cefdinir capsules for 7 days at home and continued to observe his condition.
III. Treatment effect
One day after the patient was admitted, the discharge from the external urethral opening and inner foreskin plate was significantly reduced; 2 days after admission, the discharge from the external urethral opening disappeared, and there was no urethral stinging and urinary frequency; 3 days after continuous treatment, a drug sensitivity test was performed, suggesting no bacterial growth, indicating that the urethritis had been initially controlled. After 6 days of hospitalization, the prostate pressure disappeared, no obvious discomfort in the perineum, and the routine blood test indicated that the white blood cell count was normal, so the patient was agreed to be discharged from the hospital for surgery and take medication at home to consolidate the treatment.
IV. Notes
The patient’s condition was controlled within 1 day of hospitalization and he was very happy. He also talked about going back to school after discharge and not missing too many classes, so I encouraged him. I also instructed the patient that he should increase the amount of water he drinks in his daily life, pay attention to personal hygiene, and keep the perineal area hygienic in addition to the recommended daily washing and changing of underwear. In addition, since the patient is relatively young, still in school and under pressure to study, psychological quality is also important and family members should not exert too much pressure on the patient to avoid affecting their own resistance leading to recurrence of UTI. Finally, during the home medication, you should also pay close attention to your own situation, if there is painful urination, urinary habits change, etc., should be timely follow-up.
V. Personal insight
Although the incidence of urethritis is higher in women, men aged 15-30 are also susceptible to the disease, like the patient in this case who was 17 years old and also suffered from urethritis. The actual Urethra is a very good place to get a good deal of time and money. However, if you are reluctant to seek medical attention because of shame and therefore delay treatment, it may lead to aggravation of the infection and even male infertility in serious cases.