[CLINICAL STUDY OF MALE URETHRITIS INCLUDING MYCOPLASMA GENITALIUM URETHRITIS AT OUR HOSPITAL].

(Purpose) Since June 2022, urinary PCR testing for Mycoplasma genitalium (MG) and Trichomonas vaginalis (TV) has been covered by insurance for male urethritis in Japan. This study aimed to investigate the clinical characteristics of male urethritis, with a focus on MG urethritis, at our institution. (Materials and methods) Male patients who visited our outpatient clinic with symptoms suggestive of urethritis between November 2022 and April 2025 underwent urinary PCR testing for Neisseria gonorrhoeae (NG), Chlamydia trachomatis (CT), MG, and TV. (Results) Among 56 patients, 32 (57.1%) tested positive for at least one pathogen. Single infections were observed in 27 patients (NG, n=10; CT, n=13; MG, n=4), and co-infections in 5 patients (NG+CT, n=2; NG+MG, n=2; CT+MG, n=1); 24 patients tested negative for all pathogens. Seven patients were positive for MG, with a median age of 32 years (range, 24-39 years). Clinical symptoms included dysuria and purulent discharge (n=4), residual urine sensation (n=3), and urinary frequency and hematuria (n=1 each). Pyuria (≥5 white blood cells/high-power field) was observed in four patients. Prior to MG diagnosis, patients received azithromycin (AZM), ceftriaxone (CTRX), minocycline (MINO), or levofloxacin (LVFX), without microbiological eradication. After MG diagnosis, AZM (n=2) and MINO (n=1) were administered, but all cases remained positive. Ultimately, all patients were treated with sitafloxacin (STFX). Microbiological cure was confirmed in four patients, while three were lost to follow-up after symptom improvement. The median time from onset to confirmed eradication was 62.5 days (range, 15-113 days). (Conclusion) MG urethritis is relatively common in clinical practice and often shows resistance to AZM. STFX appears to be an effective treatment option.