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60: URETHRITIS

Debra F. Stern, DPT, DBA, MSM, PT; Eric Shamus, PhD, DPT, PT, CSCS; Wendy Song, DO

CONDITION/DISORDER SYNONYM

  • Nongonococcal urethritis

ICD-9-CM CODES

  • 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

ICD-10-CM CODE

  • N15.9 Renal tubulo-interstitial disease, unspecified

FIGURE 60-1

Gonorrhea in men and women. The majority of cases in women are asymptomatic. Local extension up the fallopian tubes causes salpingitis. The majority of men have acute urethritis, and only a small percentage have local extension the epididymitis. A very small part of either spectrum results in bacteremia and disseminated gonococcal infection. (From Ryan KJ, Ray CG. Sherris Medical Microbiology. 5th ed. www.accessmedicine.com. Copyright © The McGraw-Hill Companies, Inc. All rights reserved.)

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FIGURE 60-2

Structures of the kidney. A. Landmarks of the normal kidney. B. Glomerulus and glomerular capillary. C. Detailed structure of the glomerulus and the glomerular filtration membrane composed of endothelial cell, basement membrane, and podocyte. Note that for clarity the distal tubule is separated from the glomerulus in A; however, its true anatomic relationship, which is essential for physiologic function, is illustrated in B. (Redrawn with permission from Chandrasoma P, Taylor CE. Concise Pathology. 3rd ed. Originally published by Appleton & Lange. Copyright © 1998 by the McGraw-Hill Companies, Inc.)

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PREFERRED PRACTICE PATTERN

  • As of June, 2014, 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.

PATIENT PRESENTATION

A 45-year-old male presents to the clinic with groin and low back pain. After questioning he is having increased urinary urgency, burning, and pain in his penis during urination for 5 days. He also noticed a small amount of penile discharge. He denies sexual intercourse in the past 2 years. Vitals are: Temperature: 98.9; Pulse: 76; Respiration: 18; Blood pressure: 126/83; and SpO2% of 99%. Physical exam reveals a scant amount of clear penile discharge and inflammation of the urethral meatus. The patient was referred to the urologist.

KEY FEATURES

Description

  • Swelling and Inflammation of the urethra

  • Males and females frequently asymptomatic1

  • Females present with symptoms of urinary tract infection: Burning with ...

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