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Condition/Disorder Synonym

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  • Nongonococcal urethritis

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ICD-9-CM Codes

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  • 590.9 Infection of kidney, unspecified

  • Associated ICD-9-CM PT diagnoses/treatment diagnosis that may be directly related to urogenital (UG) disorders or consequences from bed rest, surgery, or inactivity or directly related to UG disorders specifically

    • 315.4 Developmental coordination disorder

    • 718.45 Contracture of joint; pelvic region and thigh

    • 719.70 Difficulty in walking

    • 728.2 Muscular wasting and disuse atrophy

    • 728.89 Other disorders of muscle, ligament, and fascia

    • 729.9 Other and unspecified disorders of soft tissue

    • 780.7 Malaise and fatigue

    • 781.2 Abnormality of gait

    • 782.3 Edema

    • 786.0 Dyspnea and respiratory abnormalities

    • 786.05 Shortness of breath

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ICD-10-CM Code

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  • N15.9 Renal tubulointerstitial disease, unspecified

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Preferred Practice Pattern

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  • As of January 2013, the APTA Guide to Physical Therapist Practice does not include practice patterns for organ system pathology; therefore, the associated or secondary musculoskeletal, cardiovascular/pulmonary, or potential neuromuscular patterns would be indicated.

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Key Features

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Description

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  • Swelling and Inflammation of the urethra

  • Males and females frequently asymptomatic1

  • Females present with symptoms of urinary tract infection: burning with urination

  • Males present with a clear or purulent discharge1

  • If spread to kidneys, symptoms more severe and pain is located in the low back with possible tenderness to palpation of the kidneys

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Essentials of Diagnosis

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  • Difficulty urinating

  • Painful urination

  • Malodorous urine

  • Pelvic pain in women

  • Change in color of urine

  • Positive cultures

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General Considerations

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  • Most infections of the urethra are sexually transmitted

  • Most common bacterial causes in males1

    • N gonorrhoeae

    • C trachomatis

    • Coliforms in males practicing insertive anal intercourse

  • May refer pain to back, pelvic region

  • May result in secondary problems such as

    • Reiter syndrome

    • Epididymitis or Prostatitis

    • Aerobic capacity and muscle endurance impairment

    • Sarcopenia

    • Weakness/impaired muscle performance

    • Neuromuscular problems

    • Weight loss or weight gain indicating the need for PT intervention depending on severity

  • May mimic colon cancer or tumors, irritable bowel, colitis, or gynecological problems in females such as endometriosis, uterine fibroids, or ectopic pregnancies

  • There are specific UG pathologies that may be appropriate for PT, but PT usually does not have a role specifically in the treatment

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Demographics

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  • Women more susceptible to cystitis, secondary to the anatomical proximity of the urethra to the anus and the urethra to the bladder

  • Frequently associated with sexual intercourse

  • E. coli is common bacterial cause

  • Women more susceptible to urethritis because of anatomical proximity of urethra to vagina and can be caused by sexually transmitted diseases such as herpes, gonorrhea, and chlamydia

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Clinical Findings

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Signs and Symptoms

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  • Symptoms are frequently referred to the back and abdominal area; it may be more common than previously identified for patients to be inappropriately referred to PT

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