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The British Association for Sexual Health and HIV1 does not advocate testing for asymptomatic nonspecific urethritis (NSU). The importance of asymptomatic NSU is contentious, and recent work questions these guidelines further. A systematic review in 2011 found insufficient evidence to determine whether asymptomatic NSU was associated with significant clinical consequences and concluded that current screening guidelines for NSU were based on limited evidence.2 Further studies indicate that asymptomatic NSU can, in fact, cause considerable morbidity and complications for patients and their female partners.3-5
The Gram-stained urethral smear is currently the only accepted way of diagnosing asymptomatic NSU. As this procedure is labour-intensive and usually uncomfortable, some studies have attempted to identify alternative diagnostic methods.6-10
The aim of this pilot study was to determine if testing for threads, LE or both in first-void urine (FVU) in asymptomatic men would be useful in identifying patients who do not require microscopy to check for NSU.
Methods
Asymptomatic male patients attending a genitourinary medicine (GUM) clinic between January and April 2011 were identified. Patients were questioned regarding symptoms consistent with urethritis (discharge, urethral irritation or dysuria) or suggestive of epididymitis (testicular pain and discomfort), and examined for the presence of a urethral discharge, any coexisting sexually transmissible infection (STI) and other genital conditions. Those who had micturated within 2 hours were excluded.