International Journal of STD & AIDS > Volume 17, Number 5 > Pp. 289-295

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Original research articles

Quantifying leukocytes in first catch urine provides new insights into our understanding of symptomatic and asymptomatic urethritis

Rebecca C Wiggins, Christopher H Holmes, Monique Andersson, Fowzia Ibrahim, Nicola Low and Patrick J Horner

Department of Clinical Sciences at South Bristol, University of Bristol, Bristol BS2 8AE; Department of Clinical Sciences at South Bristol, University of Bristol, Bristol BS2 8AE; The Milne Centre Genito-Urinary Clinic, Bristol Royal Infirmary, Bristol BS2 8HW; Department of Social Medicine, University of Bristol, Bristol BS8 2PR; Department of Social and Preventive Medicine, University of Bern, Bern CH-3012, Switzerland; Department of Clinical Sciences at South Bristol, University of Bristol, Bristol BS2 8AE; The Milne Centre Genito-Urinary Clinic, Bristol Royal Infirmary, Bristol BS2 8HW

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.

Key Words: LEUKOCYTES • URETHRITIS • URINE • QUANTIFICATION

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