Contact allergic urethritis in man caused by the use of contraceptives.

This article describes several cases of contact allergic nongonococcal (nonspecific) urethritis in male patients caused by the use of contraceptives; to date no other reports on this subject have appeared in the Soviet journals. Detailed examination of the patients has excluded the bacteriogenic and mycotic causes as well as the presence of Trichomonas vaginalis in the male urethra. The disease was communicated through intercourse. Upon discontinuance of the use of contraceptives no relapses have been observed. Two complete clinical cases are given. Nine male patients aged 22 to 29 were under observation all of whom had no prior VD history. All nine were affected by acute urethritis viz. hyperemia and edema of the spongy portion of the urethra and abundant mucous and mucopurulent discharges from the urethral canal; the urine was cloudy in the first portion whereas in the second portion it was transparent and contained threadlike and flocculent bodies. When urinating the patients complained of painful and burning sensations of various intensity. Five patients out of nine in addition to urethritis were also affected by dematitis of the outer genital area namely by acute inflammatory erythema of penis scrotum and the adjacent hip area. In the remaining four patient urethritis was accompanied by balanitis. In seven cases out of nine urethritis was accompanied by eosinophilia. In all cases urethritis developed only after repeated contact with contraceptive drugs (contraceptin lutenurin and alkaceptin) or the condom. Four men developed urethritis as a result of contact with the agent contraceptin which their female partners inserted into vagina some 10-15 minutes before intercourse. Three of them developed dermatitis one of them balanitis. Urethritis developed some 12-24 hours after intercourse. Two patients developed urethritis following a contact with the agent lutenurin. The spermicide lutenurin is employed either in form of vaginal globules or foamy tablets; it contains .003 gram of the preparation Globules or tablets are inserted into the vagina 5-10 minutes before intercourse. One patient developed acute urethritis coupled with balanitis following a contact with alkoceptin paste which was used by his wife for 20 days. Every consecutive test with alkoceptin was positive; yet as soon as his wife discontinued the use of alkoceptin there were no relapses. Two patients developed contact allergic urethritis from the use of a condom. As an illustration a case history is given but there are no details as to etiology. As a rule allergic urethritis in man caused by a contact with contraceptives has not been observed very frequently. It is possible however that its frequency is much higher but that the etiology is not always correctly established. In casual sexual connections the man may not always be aware that his partner uses a contraceptive agent; hence if urethritis develops the inflammation is treated as if of usual bacterial (or abacterial) etiology. It is concluded that repeated use of contraceptive agents may lead to contact allergic urethritis in man. Careful anamneses with subsequent clinical tests should ensure the correct diagnosis. It was also proven that discontinued use of contraceptives prevents relapses.