title: Quantifying leukocytes in first catch urine provides new insights into our understanding of symptomatic and asymptomatic urethritis.
abstract: We quantitatively investigated inflammatory cells in the male urethra. Leukocytes in the first catch urine (FCU) from 87 men with and without urethritis were quantitated using haemocytometer counts and stained with an anti-CD45 pan-leukocyte antibody. An increased number of leukocytes in FCU specimens was associated with urethritis (P > 0.002), the presence of discharge and/or dysuria (P < 0.001), and detection of Chlamydia trachomatis (P < 0.001) and Neisseria gonorrhoeae (P < 0.001). In men with urethritis, higher leukocyte counts were also observed in the above groups (P = 0.07, 0.03 and P < 0.0001, respectively). As leukocyte number increased, the likelihood of detecting either pathogen increased. This study suggests that symptoms and signs are a surrogate marker for the degree of inflammation present, and that as urethral inflammation increases, the likelihood of detecting a sexually transmitted pathogen also increases. This would explain why men with asymptomatic urethritis are less likely to have a sexually transmitted infection detected than those with discharge and/or dysuria.
authors.affiliation: Department of Clinical Sciences at South Bristol, University of Bristol, Bristol BS2 8AE, UK.
authors.forename: Rebecca C
authors.initials: RC
authors.lastname: Wiggins
authors.forename: Christopher H
authors.initials: CH
authors.lastname: Holmes
authors.forename: Monique
authors.initials: M
authors.lastname: Andersson
authors.forename: Fowzia
authors.initials: F
authors.lastname: Ibrahim
authors.forename: Nicola
authors.initials: N
authors.lastname: Low
authors.forename: Patrick J
authors.initials: PJ
authors.lastname: Horner
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002690:Chlamydia Infections / Q000175:diagnosis* / Q000473:pathology; D002692:Chlamydia trachomatis / Q000302:isolation & purification; D005122:Exudates and Transudates / Q000382:microbiology*; D006069:Gonorrhea / Q000175:diagnosis* / Q000473:pathology; D006801:Humans; D007958:Leukocyte Count; D008297:Male; D008875:Middle Aged; D009344:Neisseria gonorrhoeae / Q000302:isolation & purification; D014526:Urethritis / Q000652:urine*