Clinical Manifestations of Trichomoniasis in Men

  1. John N. Krieger, MD;
  2. Carole Jenny, MD;
  3. Michael Verdon, PA;
  4. Nancy Siegel, PA;
  5. Roxanne Springwater, RN;
  6. Cathy W. Critchlow, MS; and
  7. King K. Holmes, MD, PhD
  1. From the University of Washington School of Medicine, Seattle, Washington. Requests for Reprints: John N. Krieger, MD, Department of Urology RL-10, University of Washington School of Medicine, 1959 Pacific Street NE, Seattle, WA 98195. Acknowledgment: The authors thank Charles Spiekerman for his comments and analysis of the data. Grant Support: Partially sponsored by grants RO1 DK38955 and IP30 27757 from the National Institutes of Health, Bethesda, Maryland.

    Abstract

    Objective: To determine the prevalence and clinical manifestations of trichomoniasis among sexually active men.

    Design: Survey of two groups of men attending a sexually transmitted disease clinic. Subjects had a comprehensive sexual history and clinical examination plus cultures for Trichomonas vaginalis, Neisseria gonorrhoeae, and Chlamydia trachomatis.

    Participants: The study included 147 sexual partners of women with trichomoniasis and 300 subjects selected randomly from heterosexual men coming to the same clinic for evaluation of new problems.

    Main Outcome Measures: Isolation of T. vaginalis was compared with urogenital signs and symptoms.

    Results: The prevalence of T. vaginalis was 33 of 147 (22% [95% CI, 16% to 29%]) among sexual contacts of women with trichomoniasis and 17 of 300 (6% [CI, 3% to 9%]) among heterosexual men attending the same clinic. Men with trichomoniasis alone were more likely to complain of urethral discharge (P < 0.01), to have discharge on examination (P < 0.03), and to have inflammatory cells in their urethral secretions (P < 0.01) than were men who did not have T. vaginalis, N. gonorrhoeae, or C. trachomatis. Trichomonas vaginalis remained associated with nongonococcal nonchlamydial urethritis (adjusted odds ratio 3.8; CI, 1.1 to 11.2) after adjustment for race, age, number of sex partners in the previous 6 months, exposure to a partner with trichomoniasis, and history of trichomoniasis, urethritis, or gonorrhea.

    Conclusions: Trichomoniasis was common among men at risk for sexually transmitted diseases and was associated with symptoms and signs of urethritis.

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    1. Ann Intern Med June 1, 1993 vol. 118 no. 11 844-849
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