Comparison of the Gram-stained Urethral Smear and First- vo ided Urin e Sediment in the Diagnosis of Nongonococcal Urethritis

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Abstract
The diagnostic sensitivity of the numbers of leukocytes in the sediment of first-voided urine and in gram-stained smears of urethral secretions was evaluated by a study of 62 men with symptoms of nongonococcal urethritis. Fifty-one patients (82.3%) had pyuria (defined as 10 or more leukocytes per high-power field) in the sediment of first-voided urine; 28 (45.2%) had > 4 leukocytes per oil-immersion field in gram-stained urethral smears. Frequencies of positive first-voided urine sediments and urethral smears were similar in Chlamydia trachomatis-positive and -negative cases. Results of cultures, urinalyses and urethral smears were not affected by recent micturition. Pyuria in the first-voided urine but not a positive urethral smear is a sensitive sign of urethritis whether or not urethral discharge is evident. Specimens of urethral secretions were subjected to different storage conditions to determine the effect on subsequent isolation of C. trachomatis. Equal rates of isolation were demonstrated for specimens that had been held at 4.degree. C for either 4 or 20-24 h or frozen to -70.degree. C for 1 wk prior to culture.

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