AN ASSOCIATION BETWEEN NONGONOCOCCAL URETHRITIS AND BACTERIAL VAGINOSIS AND THE IMPLICATIONS FOR PATIENTS AND THEIR SEXUAL PARTNERS

Objectives: The aetiology of non-gonococcal urethritis (NGU) in a cons iderable proportion of men remains unaccounted for. We wished to inves tigate the possible aetiological role of bacterial vaginosis (BV), the commonest cause of abnormal discharge in women, in this condition. Me thods: We carried out two studies. In the first, case-control, study, we recruited men with and without NGU and examined their female partne rs for evidence of BV. The second, cohort design, study which ran conc urrently with the first study involved recruiting women with and witho ut BV and examining their male partners for evidence of NGU. The diagn oses of both NGU and BV were made microscopically to include symptomat ic and asymptomatic individuals in both disease categories. Results: I n the case-control study 51 couples were recruited. Of these 39 men ha d NGU and 12 (31%) of their female contacts had BV. In contrast, of 12 men without NGU, only one (8%) of the female partners had BV (odds ra tio 4.89, 95% CI: 0.51-42.27). When only Chlamydia trachomatis negativ e patients were considered, the odds ratio for an association between BV and NGU was increased to 6.77, 95% CI: 0.73-62.68). Thirty eight co uples were recruited to the cohort design study. Of 17 women with BV, 12 (71%) of their male partners had NGU. In contrast, of 21 women with out BV, seven (33%) of their male partners had NGU (p = 0.049, odds ra tio 4.8). When only C trachomatis negative patients were considered, t he significance of the association was increased (p = 0.037; odds rati o 5.42). Conclusions: An association exists between NGU and BV, and vi ce versa. If BV arises de novo the findings could help to explain the development of urethritis in stable sexual relationships.