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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 tubulointerstitial disease, unspecified

Preferred Practice Pattern

  • 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.

Key Features

Description

  • 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

Essentials of Diagnosis

  • Difficulty urinating

  • Painful urination

  • Malodorous urine

  • Pelvic pain in women

  • Change in color of urine

  • Positive cultures

General Considerations

  • 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

Demographics

  • 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

Clinical Findings

Signs and Symptoms

  • 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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