Urethritis Common in Men With No Symptoms

Major Finding: Among 236 men without urethral symptoms or concerns, 16% had microscopic evidence of inflammation and nearly half of those men (7% of the total group) had discharge that was visible upon examination.

Data Source: An observational study.

Disclosures: None reported.

ATLANTA — Asymptomatic urethritis is relatively common even in men reporting no urethral concerns, according to study findings suggesting that routine genital examination may help diagnose unsuspected sexually transmitted diseases.

Of 236 men, aged 16–63, recruited from a Seattle emergency department waiting room who reported having no urethral symptoms or concerns, 16% had microscopic evidence of inflammation and nearly half of those men (7% of the total group) had discharge that was visible upon examination by the study clinician. Another 2% of men had visible discharge without microscopic evidence of inflammation, according to Catherine M. Wetmore, whose results were presented at a conference on STD prevention sponsored by the Centers for Disease Control and Prevention.

“Conventional wisdom suggests that women frequently experience asymptomatic reproductive tract infections but that men are generally more aware of potential signs/symptoms of infection,” Ms. Wetmore explained in a written statement. However, urethral discharge was visibly detectable in nearly 10% of these men reporting no urethral signs or symptoms.

Moreover, 80% of men with visible discharge had microscopic evidence of urethral inflammation, defined as having at least five polymorphonuclear neutrophils (PMNs) per high-power field over at least three fields on a urethral gram-stain.

Ms. Wetmore, of the University of Washington, Seattle, and her colleagues also evaluated the incidence of sexually transmitted infections (STIs) in these men. Nearly one in five men (18%) with asymptomatic urethritis, and 4% of men without urethritis, had detectable STIs, including Mycoplasma genitalium (9% and 2%, respectively), Chlamydia trachomatis (8% and 2%, respectively) and Trichomonas vaginalis (3% and 1%, respectively). No cases of gonorrhea were detected.

Participants were an average of 37–39 years old; 52% were African American, 33% were white, 2% were Asian/Pacific Islander, and the remainder were other races.

In a multivariate analysis, factors that were independently associated with an increased risk of asymptomatic urethritis included having a detected STI, older age, race (African American vs. white), having a greater number of recent sex partners, being uncircumcised, having had recent anal sex, and having voided at least 2 hours before the exam.

Although Ms. Wetmore was hesitant to make clinical recommendations, she noted that her findings suggest that a genital examination may provide an opportunity for diagnosing and treating unsuspected sexually transmitted infections.

She reported having no conflicts of interest.

Major Finding: Among 236 men without urethral symptoms or concerns, 16% had microscopic evidence of inflammation and nearly half of those men (7% of the total group) had discharge that was visible upon examination.

Data Source: An observational study.

Disclosures: None reported.

ATLANTA — Asymptomatic urethritis is relatively common even in men reporting no urethral concerns, according to study findings suggesting that routine genital examination may help diagnose unsuspected sexually transmitted diseases.

Of 236 men, aged 16–63, recruited from a Seattle emergency department waiting room who reported having no urethral symptoms or concerns, 16% had microscopic evidence of inflammation and nearly half of those men (7% of the total group) had discharge that was visible upon examination by the study clinician. Another 2% of men had visible discharge without microscopic evidence of inflammation, according to Catherine M. Wetmore, whose results were presented at a conference on STD prevention sponsored by the Centers for Disease Control and Prevention.

“Conventional wisdom suggests that women frequently experience asymptomatic reproductive tract infections but that men are generally more aware of potential signs/symptoms of infection,” Ms. Wetmore explained in a written statement. However, urethral discharge was visibly detectable in nearly 10% of these men reporting no urethral signs or symptoms.

Moreover, 80% of men with visible discharge had microscopic evidence of urethral inflammation, defined as having at least five polymorphonuclear neutrophils (PMNs) per high-power field over at least three fields on a urethral gram-stain.

Ms. Wetmore, of the University of Washington, Seattle, and her colleagues also evaluated the incidence of sexually transmitted infections (STIs) in these men. Nearly one in five men (18%) with asymptomatic urethritis, and 4% of men without urethritis, had detectable STIs, including Mycoplasma genitalium (9% and 2%, respectively), Chlamydia trachomatis (8% and 2%, respectively) and Trichomonas vaginalis (3% and 1%, respectively). No cases of gonorrhea were detected.

Participants were an average of 37–39 years old; 52% were African American, 33% were white, 2% were Asian/Pacific Islander, and the remainder were other races.

In a multivariate analysis, factors that were independently associated with an increased risk of asymptomatic urethritis included having a detected STI, older age, race (African American vs. white), having a greater number of recent sex partners, being uncircumcised, having had recent anal sex, and having voided at least 2 hours before the exam.

Although Ms. Wetmore was hesitant to make clinical recommendations, she noted that her findings suggest that a genital examination may provide an opportunity for diagnosing and treating unsuspected sexually transmitted infections.

She reported having no conflicts of interest.

Major Finding: Among 236 men without urethral symptoms or concerns, 16% had microscopic evidence of inflammation and nearly half of those men (7% of the total group) had discharge that was visible upon examination.

Data Source: An observational study.

Disclosures: None reported.

ATLANTA — Asymptomatic urethritis is relatively common even in men reporting no urethral concerns, according to study findings suggesting that routine genital examination may help diagnose unsuspected sexually transmitted diseases.

Of 236 men, aged 16–63, recruited from a Seattle emergency department waiting room who reported having no urethral symptoms or concerns, 16% had microscopic evidence of inflammation and nearly half of those men (7% of the total group) had discharge that was visible upon examination by the study clinician. Another 2% of men had visible discharge without microscopic evidence of inflammation, according to Catherine M. Wetmore, whose results were presented at a conference on STD prevention sponsored by the Centers for Disease Control and Prevention.

“Conventional wisdom suggests that women frequently experience asymptomatic reproductive tract infections but that men are generally more aware of potential signs/symptoms of infection,” Ms. Wetmore explained in a written statement. However, urethral discharge was visibly detectable in nearly 10% of these men reporting no urethral signs or symptoms.

Moreover, 80% of men with visible discharge had microscopic evidence of urethral inflammation, defined as having at least five polymorphonuclear neutrophils (PMNs) per high-power field over at least three fields on a urethral gram-stain.

Ms. Wetmore, of the University of Washington, Seattle, and her colleagues also evaluated the incidence of sexually transmitted infections (STIs) in these men. Nearly one in five men (18%) with asymptomatic urethritis, and 4% of men without urethritis, had detectable STIs, including Mycoplasma genitalium (9% and 2%, respectively), Chlamydia trachomatis (8% and 2%, respectively) and Trichomonas vaginalis (3% and 1%, respectively). No cases of gonorrhea were detected.

Participants were an average of 37–39 years old; 52% were African American, 33% were white, 2% were Asian/Pacific Islander, and the remainder were other races.

In a multivariate analysis, factors that were independently associated with an increased risk of asymptomatic urethritis included having a detected STI, older age, race (African American vs. white), having a greater number of recent sex partners, being uncircumcised, having had recent anal sex, and having voided at least 2 hours before the exam.

Although Ms. Wetmore was hesitant to make clinical recommendations, she noted that her findings suggest that a genital examination may provide an opportunity for diagnosing and treating unsuspected sexually transmitted infections.

She reported having no conflicts of interest.