Ross J D, Champion J
Department of Genitourinary Medicine, Whittall Street Clinic, Birmingham, UK.
Int J STD AIDS. 1998 Apr;9(4):192-5. doi: 10.1258/0956462981922025.
Chlamydia and gonorrhoea remain major causes of morbidity despite the availability of effective therapy. Because of the asymptomatic nature of many infections, particularly in women, active case finding is necessary to trace and offer screening and treatment to sexual contacts of those infected. Genitourinary medicine (GUM) clinics provide investigation and treatment for a variety of sexual health problems but the proportion of infections treated outside these clinics is unknown. A questionnaire survey of general practitioners (GPs) was used to examine the prevalence and management of male urethritis in Scotland. Responses were received from 277/347 (80%) of GPs. A median of one case/year of male urethritis was seen and screening for gonorrhoea and chlamydia was undertaken in 82% and 63% of cases not referred to a GUM clinic respectively. Six per cent of GPs attempted to trace sexual contacts. Twenty-nine per cent (60) of patients were not referred to a GUM clinic and increasing distance to the clinic was associated with non-referral. Eleven per cent (18) of patients objected to referral to a GUM clinic. There is scope to improve the management of male urethritis by providing greater support for GPs, encouraging clinic referral where possible and appropriate investigations and treatment when not.
尽管有有效的治疗方法，但衣原体感染和淋病仍然是发病的主要原因。由于许多感染具有无症状性，尤其是在女性中，因此需要积极地发现病例，以便追踪并为感染者的性接触者提供筛查和治疗。性健康诊所为各种性健康问题提供检查和治疗，但在这些诊所之外接受治疗的感染比例尚不清楚。一项针对全科医生（GP）的问卷调查被用于调查苏格兰男性尿道炎的患病率和治疗情况。347名全科医生中有277名（80%）回复了问卷。全科医生每年平均接诊1例男性尿道炎病例，在未转诊至性健康诊所的病例中，分别有82%和63%的病例进行了淋病和衣原体筛查。6%的全科医生试图追踪性接触者。29%（60例）的患者未被转诊至性健康诊所，距离诊所越远与未转诊相关。11%（18例）的患者反对转诊至性健康诊所。通过为全科医生提供更多支持、在可能且合适的情况下鼓励转诊至诊所，并在无法转诊时进行适当的检查和治疗，改善男性尿道炎治疗的空间很大。
