Risk Factors associated with Paraurethral Duct Dilatation following Gonococcal Paraurethral Duct Infection in Men

Gonococcal Infection of the Glans Skin, a Rare Local Complication of Gonorrhea: A Clinical Study of 13 Cases

The study aimed to understand the incidence, site, skin lesion manifestations, and treatment of gonococcal infection of the glans skin. We enrolled men with gonococcal infection of the glans skin and men with gonococcal urethritis from January 2014 to February 2020. Demographic data, site of onset, and skin lesion manifestations were recorded for all patients. Ceftriaxone (1 g) was injected intramuscularly once daily for 5 days in patients with lesions comprising abscesses or nodules. A single dose of ceftriaxone (1 g) was injected intramuscularly in patients with pustules. Incision and drainage were performed in patients with nonruptured abscesses. Thirteen patients had gonococcal infection of the glans skin (0.65%; 95% confidence interval = [0.30, 1.01]) among 1,989 patients with gonococcal urethritis. Mean age was 35.48 ± 2.37 (range = 26-45) years. Nonmarital sexual behavior patterns were genital-genital in eight patients (61.54%) and genital-oral in five patients (38.46%). All skin lesions occurred on the ventral side of the glans. Eleven patients (84.62%) had a single lesion and two (15.38%) had multiple lesions. The lesions manifested as abscesses in five patients (38.46%), nodules in five patients (38.46%), and pustules in three patients (23.08%). All lesions exhibited tenderness. All 13 patients were cured after treatment. The study shows that gonococcal infection of the glans skin is a rare local complication of gonorrhea. Lesions often occur on the ventral side of the glans, presenting as abscesses, nodules, and pustules. Ceftriaxone treatment was effective for gonococcal infection of the glans skin.

Gonococcal tysonitis, a rare local complication of gonorrhea: a clinical study of 15 cases

To investigate the incidence, clinical manifestations, and treatments of gonococcal tysonitis in men. We enrolled men with gonococcal tysonitis and men with gonococcal urethritis from January 2000 to December 2020. Demographic data, interval from non-marital sexual contact to the onset of symptoms of gonococcal tysonitis, occurrence sites, and manifestations were recorded for all patients. Ceftriaxone (1 g) was injected intramuscularly once daily for 5 days in patients with lesions comprising abscesses or nodules. A single dose of ceftriaxone (1 g) was injected intramuscularly in patients with sinus-like lesions. Incision and drainage were performed in patients with non-ruptured abscesses. Fifteen patients with gonococcal tysonitis (0.29%; 95% confidence interval: 0.15-0.44%) were observed among 5087 patients with gonococcal urethritis. The mean age was 38.64 years (range, 17-74 years). The mean gonococcal tysonitis incubation period was 6.02 ± 1.37 days (range, 2-11 days). Lesions were present in the right side of the preputial frenulum in seven patients (46.67%), in the left side of the preputial frenulum in six patients (40%), and in both sides of preputial frenulum in two patients (13.33%). The lesions manifested as abscesses in 7 patients (46.67%), nodules in six patients (40%), and sinus-like lesions in two patients (13.33%); all lesions exhibited tenderness. All 15 patients were cured after treatment. Gonococcal tysonitis is a rare local complication of gonorrhea. Gonococcal urethritis with concurrent gonococcal tysonitis was less common than gonococcal urethritis with concurrent paraurethral gonococcal infection or gonococcal urethritis with concurrent gonococcal epididymitis. Gonococcal tysonitis lesions manifest as abscesses, nodules, and sinus-like lesions. Treatment with ceftriaxone is effective for gonococcal tysonitis.

Prevalence and Clinical Manifestations of Penile Gonococcal Cutaneous and Accessory Gland Infections in Men With Gonorrhea

BACKGROUND

No studies have focused on the prevalence and clinical manifestations of penile gonococcal cutaneous and accessory gland infections in men with gonorrhea.

METHODS

We enrolled patients with penile gonococcal cutaneous and accessory gland infections and patients with urethral gonorrhea from January 2014 to February 2020. Demographic data, occurrence sites, and manifestations of all patients were recorded.

RESULTS

Fifty-one patients with penile gonococcal cutaneous and accessory gland infections were observed among 1994 (2.6%; 95% confidence interval, 1.9%-3.4%) patients with urethral or penile gonorrhea. Lesions were present at the external urethral orifice in 22 (43%) patients, at the glans in 11 (21%), in the side of the frenulum of the prepuce in 7 (14%), in the penile raphe in 5 (10%), in the inner plate of the prepuce in 1 (2%), in the external urethral orifice and side of the frenulum of the prepuce in 3 (6%), and in the glans and side of the frenulum of the prepuce in 2 (4%). The lesions manifested as sinus-like lesions in 22 (43%) patients, abscesses in 14 (27%), nodules in 10 (20%), pustules in 3 (6%), nodules with sinus tracts in 1 (2%), and ulcers in 1 (2%).

CONCLUSIONS

Penile gonococcal cutaneous and accessory gland infections in men probably are more common than previously understood. They mainly involve the paraurethral duct, glans, Tyson's gland, and penile raphe. Lesions mainly present as sinus-like lesions, abscesses, and nodules.

High-Frequency Ultrasound Imaging-Guided Wedge Resection: An Effective Treatment for Paraurethral Duct Dilatation Following Gonococcal Paraurethral Duct Infection in Men

This study was performed to evaluate the therapeutic effects of wedge resection on male paraurethral duct dilatation following gonococcal paraurethral duct infection. Twenty-six men with paraurethral duct dilatation following gonococcal paraurethral duct infection were enrolled. Their lesions underwent wedge resection after examination using an ACUSON X300 ultrasound system. The anesthetic method, surgical duration, intraoperative blood loss, wound healing time, complications, sequelae, and curative effect were assessed. All 26 men received local infiltration anesthesia. The mean surgical duration was 18.65 ± 2.50 min (range, 14-23 min), the mean intraoperative blood loss was 10.50 ± 1.68 ml (range, 8-14 ml), and the mean wound healing time was 14.73 ± 1.31 days (range, 13-17 days). The lesions were cured in all patients (100%). The postoperative wounds healed in all patients. No complications or glans defects were observed in any patients. The study identifies that high-frequency ultrasound imaging-guided wedge resection is an effective and safe therapy for paraurethral duct dilatation following gonococcal paraurethral duct infection in men.