Non-gonococcal Urethritis

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Abstract
Non-gonococcal urethritis in the male remains a serious medical problem both because of the large number of patients with this condition and the fact that the etiology remains unknown in most cases. It is considered to be transmitted venereally. In Great Britain since 1951 incidence figures have shown a steady rise, even more marked than for gonorrhea. In both diseases there is an increase in incidence in the summer and decrease in winter. Non-gonococcal urethritis is more than twice as common among white men as among colored immigrants, while the reverse is true of gonorrhea. Csonka discusses the possible role of Pleuropneumonia-like Organisms, of T-forms of PPLO and of L-forms of bacteria. The statement is quoted that more than half of patients with non-gonococcal urethritis need psychotherapy and that the common disturbance in chronic cases is depression. Because of its tendency to spontaneous remissions and recurrences evaluation of treatment is difficult. Controlled clinical trials, using the double blind method, are essential to permit critical conclusions and comparisons. The tetracycline group of drugs is most effective. The author suggests that early evaluation, after only one or two weeks of treatment, is preferable because in patients in whom treatment is successful the response is immediate, and during the shorter period fewer patients fail to return for observation. In addition it is less often necessary to differentiate between failure and reinfection. Summarizing a number of investigations, in the first weeks after treatment there is a highly significant difference between the response rate to placebo and to antibiotic. This difference is less marked following 8 to 12 weeks of treatment. The cure rate after broad-spectrum antibiotics is similar for observation periods of 1 to 2 weeks and of 8 to 12 weeks. In patients receiving a placebo progressive improvement is noted as the observation period increases. This is a reflection of spontaneous remission.