Should we still be testing for asymptomatic non-specific urethritis in departments of genitourinary medicine?
It has recently been advocated that non-invasive testing with first-catch urine specimens using nucleic acid amplification techniques, to detect Chlamydia trachomatis and Neisseria gonorrhoeae, should replace routine microscopy on asymptomatic men. Although it is assumed that this strategy will be cost effective, the available evidence suggests that this will result in fewer sexually transmitted infections being averted than continuing the current practice of screening for urethritis and testing for both microorganisms in asymptomatic men. This review article summarizes the available evidence and argues that research is urgently needed in order to properly evaluate the cost-effectiveness of detecting urethritis in asymptomatic men.
Horner
P J
PJ
Milne Sexual Health Centre, Bristol Royal Infirmary, Lower Maudlin Street, Bristol BS2 8HW, UK. paddy.horner@bristol.ac.uk
D002690:Chlamydia Infections / Q000175:diagnosis / Q000652:urine; D002692:Chlamydia trachomatis / Q000302:isolation & purification; D042241:Early Diagnosis; D006069:Gonorrhea / Q000175:diagnosis / Q000652:urine; D006801:Humans; D008297:Male; D008403:Mass Screening; D009175:Mycoplasma Infections / Q000175:diagnosis / Q000652:urine; D045704:Mycoplasma genitalium / Q000302:isolation & purification; D009344:Neisseria gonorrhoeae / Q000302:isolation & purification; D021141:Nucleic Acid Amplification Techniques; D012747:Sexual Partners; D006113:United Kingdom; D014526:Urethritis / Q000175:diagnosis* / Q000382:microbiology*