Article : Utility of Urinalysis in Evaluation of Adolescent Males...

Utility of Urinalysis in Evaluation of Adolescent Males for STIs

Findings from a retrospective study support empirical treatment and testing for sexually transmitted infections in adolescent males with urinary complaints; urinalysis is unnecessary.


In a retrospective study of males aged 15–21 who presented to an urban pediatric emergency department with urinary complaints or suspected sexually transmitted infection (STI), investigators described evaluation and treatment patterns and rates of STI and assessed the usefulness of urinalysis. Patients with primary scrotal/testicular pain were excluded.

Of 216 patients who made 270 visits during 2007, urinalysis was performed in 64%, urine culture in 53%, Neisseria gonorrhoeae (GC) and Chlamydia trachomatis (CT) nucleic acid testing in 93%, and Trichomonas vaginalis (TV) culture in 5%. Overall, 91% of patients were treated empirically for GC and CT, 18% for TV, and 5% for urinary tract infection. Sixty-four percent of patients tested positive for GC alone (28%), CT alone (14%), or both (21%). The sensitivity of a positive urinalysis (greater than small leukocyte esterase result, >5–9 white blood cells per high-power field, or both) for the presence of GC, CT, or both was 86%, specificity was 82%, positive predictive value was 89%, and negative predictive value was 77%. Of 20 patients (7%) who were not treated empirically, none had any positive tests. No patient had a positive urine culture.


Citation(s):

Timm N et al. Evaluation and management of sexually transmitted infections in adolescent males presenting to a pediatric emergency department: Is the chief complaint diagnostic? Pediatr Emerg Care 2011 Nov; 27:1042.

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