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140); acute retention occasionally develops in a primary episode of genital herpes and (rarely) in other forms of acute urethritis. Milder urethritis is more often associated with complaint of irritation, initially located at the meatus but later passing proximally to the fossa navicularis and urethra. Usually pain and irritation are exacerbated by urination but are sometimes present at other times: symptoms are often most marked after urine has been retained for some hours or overnight. Suprapubic pain indicates cystitis or upper urinary tract involvement; perineal pain on urination or after ejaculation sometimes occurs in patients with prostatitis.

In rare cases ova of Schistosoma haematobium may be found. In cases of suspected upper urinary tract infection, midstream or clean specimens of urine should be sent to the laboratory for microscopy and bacterial All patients should abnormal constituents such culture. Male patients The 'two glass' site test is a useful clinical indication in the assessment of the of infection and in examination after treatment of urethritis. The patient is two urine glasses and requested and the remainder into the second given to pass 50 to 60 ml Debris from any anterior urethral inflammation present will be voided with the first specimen and the second glass will contain urine representative of the contents of the bladder.

Cystitis from infection ascending from the urethra) is another common cause of lower abdominal pain encountered in practice; pain is usually suprapubic and intermittent and is often exacerbated by (which result urination. ) but more commonly the pain, of variable severity, is felt in one or both iliac fossae and is colicky and intermittent, but may be persistent. In patients with endometritis, pain is usually central and may be referred to the rectum or anus or to the groin: deep dyspareunia and abnormalities of menstruation are usual.

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