The role of urethral samples in the diagnosis of gonorrhoea in women

We studied the value of carrying out urethral samples in women to diagnose gonorrhoea. All cases of genital gonorrhoea in women were identified (between 1 October 2000 and 30 September 2001) at the Whittall Street Clinic and the genitourinary medicine department at the Coventry and Warwickshire Hospital. Two hundred and twenty-four cases of female urethral gonorrhoea were identified. In 20 cases (6.3%) the urethra was the sole site of the infection. At the Whittall Street Clinic, we had to carry out 643 urethral samples in order to treat one additional case of gonorrhoea. On the other hand, 1204 urethral samples were requested to treat one additional case of female gonorrhoea at the Coventry and Warwickshire Hospital. In both units, use of the Gram-stained urethral smear permitted early treatment in only 1.8% of cases of genital gonorrhoea. Units with low prevalence of gonorrhoea should consider abandoning urethral samples for the diagnosis of gonorrhoea in women.