PATHOLOGICAL STUDIES OF RECENT MALE URETHRAL GONORRHEA TREATED WITH VARIOUS CHEMOTHERAPEUTICS

Abstract

The recent therapeutics of gonorrhea has been changed a great deal by the discoveries of new chemotherapeutic remedies such as sulfonamides, penicillin and other antibiotics and according to these new remedies rapid retardation in the pain of gonorrhea has become an easy goal to attain in treatment.
However, even with these chemotherapeutics an 100 percent complete cure of gonorrhea has not yet been proved and more over it seems to the author that recurrence, lingering of leucocyte filaments or incurable feelings after treatment with chemotherapeutics have gradually been increasing. In an attempt to clarify these above-mentioned facts noticed after the treatment the author has made studies do patients of gonorrhea who have had some complaints after chemotherapeutic treatments in order to investigate the curative mechanism and general histopathological change in urethral tissues taken by test extirpation.
In 1928, Prof. Tabayashi reported in detail concerning the pathologic histological findings and curaitve mechanisms of chronic gonorrhea under local treatment. The auther has discussed his histopathological findings in cases mentioned above while comparing with the results of Prof. Tabayashi.
For preliminary studies the author has investigated 188 patients who visited the Urological Deparrtment of the Tokyo Medical College with complaints for gonorrhea during the year of 1951 with careful and thorough clinical examinations and found that 108 cases were acceptable for this reseach studies. Concerning the outlines of chemotherapeutics in these 108 cases are given in Table I.
Table I
1. Total cases 188.
2. Cases of primary infection or reinfection. 34. (18.1%)
3. Cases not cured or cases with recurrence after chemotherapy 108. (57.5%)
4. Average doses of penicillin given 3, 150, 000.u.
a. Maximum doses given 39, 500, 000.u.
b. Minimum doses given 300, 000.u.
5. Cases treated with penicillin alone 64.
6. Cases treated with penicillin and other chemotherupeutics combined. 34.
a. Pc. and Sulfonamides combined 14.
b. Pc. and St. m. combined 9.
c. Pc. and Au. m. combined 3.
d. Pc. and Ch. m. combined 1.
e. Pc. St. m. and Sulfonamides combined 3.
f. Pc. St. m. and Au. m. combined 1.
g. Pc. Ch. m. and Te. m. combined 1.
7. Cases treated with sulfonamides alone 2.
8. Miscellaneous (Cases with complications, old cases, and cases without chemotherapeutics) 46.(24.5%)
Remarks=Pc.=Penicillin, St. m.=Streptomycin, Ch. m.=Chloromycetin,
Au. m.=Aureomycin, Te. m.=Terramycin,
Among patients who visited the same hospital from November 1951 to April 1952, 106 patients were found to be just the cases fitted for this reseach studies and were studied histopathologically. The outlines of therapeutics given in these patients are summarized briefly in Table II.
Table II
1. Cases not cured or cases with a recurrence after chemotherapy 106.
2. Average doses of penicillin given 4, 290, 000. u.
a. Maximum doses given 30, 000, 000. u.
b. Minimum doses given 100, 000, u.
3. Cases treated with penicillin alone 53.
4. Cases treated with penicillin and other chemotherapeutics combined 53.
a. Pc. and Sulfonamides combined 26.
b. Pc. and St. m. combined 14.
c. Pc. and Au. m. combined 3.
d. Pc. and Te. m. combined 2.
e. Pc. and Ch. m. combined 2.
f. Pc. Te. m., and Ch. m. combined 3.
g. Pc. Au. m., and Ch. m. combined 2.
h. Pc. St. m., and Au. m. combined 1.
Sections to be examined were extirpated from the urethra of the above mentioned 106 patients and each section was studied histopathologically. In cases in which the symptoms of inflammation were severe, the tissue was taken after a certain period after the completion of penicillin treatment. The period between the completion of chemotherapeutic treatment and extirpation of the tissue was 2 days at minimum and 208 days at maximum.