HOW ARE MEN WITH URETHRAL DISCHARGE MANAGED IN GENERAL-PRACTICE

Chlamydia and gonorrhoea remain major causes of morbidity despite the availability of effective therapy. Because of the asymptomatic nature of many infections, particularly in women, active case finding is nece ssary to trace and offer screening and treatment to sexual contacts of those infected. Genitourinary medicine (GUM) clinics provide investig ation and treatment for a variety of sexual health problems but the pr oportion of infections treated outside these clinics is unknown. A que stionnaire survey of general practitioners (GPs) was used to examine t he prevalence and management of male urethritis in Scotland. Responses were received from 277/347 (80%) of GPs. A median of one case/year of male urethritis was seen and screening for gonorrhoea and chlamydia w as undertaken in 82% and 63% of cases not referred to a GUM clinic res pectively. Six per cent of GPs attempted to trace sexual contacts. Twe nty-nine per cent (60) of patients were not referred to a GUM clinic a nd increasing distance to the clinic was associated with non-referral. Eleven per cent (18) of patients objected to referral to a GUM clinic . There is scope to improve the management of male urethritis by provi ding greater support for GPs, encouraging clinic referral where possib le and appropriate investigations and treatment when not.