page 13

Student Health

[unclear: e] A to Z on NGU.

NGU, NSU, PGU, VD, STD. Pardon the al[unclear: oetical] jargon. This article will attempt to [unclear: vel] the semantic and medical mysteries of [unclear: U]. why NGU? What ever happened to NSU? [unclear: o] wants to know about PGU?

Frist of all, back to basics with tome [unclear: defini- s].

• U — Non-gonococcal urethritis
• J. — Non-specific urethritis
• J — Post-gonococcal urethritis
• [unclear: —] Venereal diseases
• [unclear: O] — Sexually Trensmitted Diseases

Diposing of the last two first, the venereal [unclear: ases] or VD are those diseases, five in [unclear: num-] which are classified in the Venereal Di[unclear: e] Regulztions. Three of them are tropical don't normally occur in New Zealand and [unclear: rise], surprise, NGU isn't one of them. Now, [unclear: e's] a quaint piece of medico-legal nonsense, commonest sexually transmitted disease is classified as a venereal disease according to regulations. The preferred name for this [unclear: ple] group of diseases is not classified at a [unclear: veal] disease according to the regulations. The [unclear: ferred] name for this whole group of [unclear: diseais] now the Sexually Transmitted Disease STD for short (not to be confused with [unclear: subber] toll dialling). We thus have a broad and [unclear: ful] category called STD and a small [unclear: statuy] group of venereal diseases.

Now back to NGU. What's in the name? [unclear: urethrilis] it Simply an inflammation of the [unclear: thra] and the non-gonococcal prefix is pretty [unclear: ious]. Why has the term NSU gone out of [unclear: lion]? When it was designated "non-specific" [unclear: distinguish] it from gonotthoea it was true [unclear: t] no specific cause had been identified but that it no longer true. Specific causes for nonspecific urethritis have now been identified, if you get what it meant. Research had identified at least two organisms which are generally regarded at the main culprits.

Top contender and responsible for over 50% of cases of NGU it a tiny microorganism known at Chlamydia trachomatis. Chlamydia for short. It is an obligate intracellular parasite which is why it cannot be cultured in your friendly neighbourhood microbiological laboratory, It is technically a bacterium and related to the organism which causes the tropical eye disease Trachoma, hence the name.

Second in the running it a peculiar organism rather like a bacterium but lacking a cell wall and sometimes knows as a mycoplasma. This culprit used to be referred to as a T-strain Mycoplasma but the preferred terminology is now the lyrical Ureoplasma ureolyticum.

Enough of semantics. Now for some medical facts. NGU is now the commonest form of sexually transmitted disease in New Zealand and considering it wasn't even diagnosed decades ago that's no mean achievement. In the male, symptoms are similar to gonorrhoea, ie, a urethral discharge and pain on urination. It is so similar that laboratory tests are essential to distinguish the two. And just to complicate things there it no reason why they cannot be contracted together — in other words, a double dose. It it important to make the distinction because the treatment is quite different Pencillin for gonorrhoea and Tetracycline for NGU. And that's where Post-gonococcal urethritis or PGU comes in. If the gonorrhoea is treated but the discharge persists, one of the likely explanations it an untreated concurrent dose of NGU.

What about females? It used to be though I that NGU was specifically a male complaint but if is now realised that women may carry the infection, sometimes with mild symptoms but more commonly without any symptoms whatsoever. Should women then be treated? Doctors are still inclined to argue about this but in the case of a steady relationship the trend is more and more to treat the female. Recurrent infection in a male may be due to reinfection from an untreated female. During the birth process a baby's eyes may become infected from organisms in the female tract.

NGU lends to be characterised by remissions and this can be frustrating for the sufferer especially when there does not appear to be any explanation for the relapse. Excecssive alcohol consumption may be responsible. Follow up is important. A rare complication in 1% of cases of NGU is a joint disease known as Reiter's Disease.

There is still a lot to be learned about NGU but the importance of both partners attending for a check is being increasingly recognised.