A Simple Test for Chlamydia in Men

Chlamydia is the most common sexually transmitted disease (STD) in the USA; there are often no symptoms in women, but pelvic inflammation can lead to infertility. In men, there may be a penile discharge. Unfortunately, men are often untreated because they are reluctant to have a diagnostic test. (There is a long standing myth that men attending such clinics have to have the "umbrella test."  The usual story is that something like to a closed cocktail umbrella is inserted into the penis through the urethral opening, and then opened out and withdrawn. It’s only a myth.) Now there’s a report from the UK in the British Medical Journal describing a simple urine test for diagnosing chlamydia in men. This avoids the need for a swab of the urethra, which can be a little painful.

Researchers from Cambridge University studied the new test in comparison with the existing polymerase chain reaction test in 1,200 men attending 2 STD clinics in UK. Each participant provided two urine samples. The first was collected using a device designed to collect the first 4-5 mL called Firstburst – this portion contains greater numbers of bacteria. The second sample was collected in a standard urine cup.

The new Chlamydia Rapid Test provided results within one hour. It had a good level of sensitivity and specificity (83% and 98%, respectively), compared with the polymerase chain reaction test, when used with the first-void sample. The advantage of a one-hour result lies in being able to institute treatment at the same visit – important, as ‘failure to attend’ is fairly common in STD clinics. And treatment with an antibiotic (usually azithromycin or doxycycline) is simple and effective. It’s the diagnosis that’s the problem, and this new test, when it’s more widely available, should encourage earlier attendance, diagnosis, and treatment.