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Urethritis is inflammation of the urethra caused by microorganisms that are most often transmitted sexually. It is the most common sexually transmitted disease in humans. The infection becomes manifest a few days or a few weeks after sexual relations with a contaminated person. Symptoms include purulent or serous urethral discharge that is rarely haemorrhagic, painful urination, pruritis in the genital area, dysuria or urinary frequency. Laboratory diagnosis of urethritis is generally based on cytological criteria, i.e. the presence of more than five polymorphonuclear leukocytes per field of view when a 100x objective lens is used to examine a stained smear and/or the presence of more than ten leukocytes per field of view when a 400x objective lens is used to examine a first voided urine sediment . The patient should preferably be examined in the morning or four hours after the last passage of urine. Urethritis is typically classified as gonococcal urethritis, caused by Neisseria gonorrhoeae, or non-gonococcal urethritis, which is much more common and refers to all cases of urethritis of known or unknown causes excepting gonococcal urethritis. Non-gonococcal urethritis is most commonly caused by three microorganisms, Chlamydia trachomatis (serovars D-K), Mycoplasma genitalium and Trichomonas vaginalis . Ureaplasma urealyticum is no longer considered to be a cause of acute urethritis. There have been reports of urethritis being caused by other bacteria such as Neisseria meningitides and Haemophilus influenza. Nonetheless, no cause can be identified in 20 to 50 % of the cases of male urethritis : these cases could be due to still unknown microorganisms or to non-infectious causes.
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