Shelve routine use of costly silver wound dressings, says DTB

Apr 15, 2010

Urologists are failing to pick up and treat Chlamydia infection in young men, say UK researchers in a letter published ahead of print in the journal Sexually Transmitted Infections.

Yet is the most commonly reported sexually transmitted infection in Europe and the commonest cause of of the testicle and the epididymis (involved in sperm manufacture), a condition known as epididymo-orchitis.

If chlamdyial infection goes untreated, it can cause .

Many cases of epididymo-orchitis are referred to urologists because the symptoms mimic testicular torsion, in which the spermatic cord is twisted, cutting off the to the testicle, say the authors.

But once correctly diagnosed, many young men still remain under the care of an urologist.

Yet despite clear guidelines on how to manage this condition to ensure that the infection is promptly treated, many urologists are simply ignoring the recommendations, which have been in existence for more than a decade, say the authors.

They base their findings on a survey of urology departments in five teaching hospitals in different regions of the UK, where young men with epididymo-orchitis were treated over a period of 18 months.

During this time, 204 cases were diagnosed in men under the age of 35, but in only 7% of cases (15) were first morning (void) urine or urethral samples sent for testing, as recommended. Most of these (11) tested positive for Chlamydia.

Mid-stream urine samples, which are less conclusive, were sent in 103 cases, but only 11 requests were made to test for Chlamydia, none of which tested positive.

In all, the source of the infection was picked up in only one in 10 cases.

When it came to treatment, the guidance was also largely ignored. was prescribed in 44% of cases, despite increasing evidence of chlamydial resistance to this antibiotic.

And in almost one in three cases the course was for less than the two weeks recommended in the clinical guidelines.

A follow up appointment was made for only just over half of patients, and fewer than one in four men were instructed to attend a sexual health (GUM) clinic, as recommended.

Despite informal education updates, when the audit was repeated in two of the five centres, there was little sign of any improvement, say the authors.

"We feel this confirmed that urologists remain poor at managing epididymo-orchitis in sexually active young men, and are therefore almost certainly failing to diagnose many cases of and other in exactly the group both most at risk and most likely to have multiple partners," conclude the authors.

Explore further: WHO: More Ebola cases in past week than any other

add to favorites email to friend print save as pdf

Related Stories

New chlamydia test offers rapid, pain-free test for men

Jul 28, 2009

A new urine test developed with funding from the Wellcome Trust will allow doctors to diagnose Chlamydia infection in men within the hour, improving the ability to successfully treat the infection on the spot ...

Taking the sex out of sexual health screening

May 09, 2008

Young women would accept age-based screening for the sexually transmitted infection chlamydia, but would want this test to be offered to everyone, rather than to people ‘singled out’ according to their sexual history.

San Diego battles rising STD cases

Feb 15, 2008

Health officials in San Diego have begun a media campaign to try to cut the rising rate of syphilis and other sexually-transmitted diseases.

Recommended for you

WHO: More Ebola cases in past week than any other

42 minutes ago

The past week has seen the highest increase of Ebola cases since the outbreak in West Africa began, the World Health Organization said Friday, offering more evidence that the crisis is worsening.

Guidelines presented for diagnosing focal liver lesions

15 hours ago

(HealthDay)—Focal liver lesions (FLLs) are mostly benign, and can be diagnosed based on knowledge of their presentation, associated clinical and laboratory features, and natural history, according to clinical ...

User comments : 0