Establishing the cause of genitourinary symptoms in women in a family practice. Comparison of clinical examination and comprehensive microbiology

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Abstract
A prospective study comparing the diagnostic yield of standard clinical examinations and of comprehensive microbiological studies in establishing the etiology of genitourinary (GU) symptoms and the prevalence of GU tract infections in 204 women seen in a university-based family practice was conducted; 2/3 were initially seen with GU symptoms and 1/3 for routine examinations. In each case demographic and historical information was obtained; a physical examination and a variety of laboratory tests, including research procedures not commonly available, were performed. Diagnoses considered were urinary tract infection and sterile pyuria, trichomonal, yeast and nonspecific vaginitis; and GU tract infection with Neisseria gonorrhoeae, Chlamydia trachomatis or herpes simplex virus. Using strategies commonly employed in practice, a diagnosis was reached in only 34% of symptomatic women, a figure rising to 66% when selected, nonroutine laboratory examinations were added.