Top

Archives of Gynecology and Obstetrics

Published in:

01-04-2012 | General Gynecology

Accuracy of urethral swab and urine analysis for the detection of Mycoplasma hominis and Ureaplasma urealyticum in women with lower urinary tract symptoms

Authors: Joerg Humburg, Reno Frei, Edward Wight, Carolyn Troeger

Published in: Archives of Gynecology and Obstetrics | Issue 4/2012

Abstract

Objectives

Our objective was to evaluate and compare the accuracy of urethral swabs and urine specimens in the detection of Mycoplasmas in women with lower urinary tract symptoms (LUTS).

Methods

During a urogynecological work-up, including cystometry, we obtained first-void urine, urethral and vaginal swabs in 207 consecutive women at our urogynecological division. Mycoplasma hominis and Ureaplasma urealyticum as well as other microorganisms were detected by standard culture methods.

Results

131 of 207 women reported LUTS. The other 76 formed the controls. Of 207 women 50 (24.2%) had positive cultures for Mycoplasmas. The prevalence of Mycoplasmas in women with LUTS (30.3%) was statistically significant and higher in the group without LUTS (14.5%) (p = 0.011). The detection of M. hominis was most accurate using urethral swab (Specificity 99.9%, PPV 99.6%) compared to the urine specimen (96%, 75%) and vaginal swab (95.1%, 67%). Similar results could be achieved for U. urealyticum (urethral swab: specificity 98.7%, PPV 96.3%; urine specimen: 86.8%, 72%; vaginal swab: 80.5%, 65.2%).

Conclusion

In the subgroup of women less than 50 years an (detectable) infection due to Mycoplasma or Ureaplasma leads typically to LUTS with normal filling cystometry, whereas no such findings were relevant for the elderly women.

Wennberg AL, Molander U, Fall M et al (2009) Lower urinary tract symptoms: lack of change in prevalence and help-seeking behaviour in two population-based surveys of women in 1991 and 2007. BJU Int 104:954–959PubMedCrossRef

Abrams P, Cardozo L, Fall M, Griffiths D, Rosier P, Ulmsten U, van Kerrebroeck P, Victor A, Wein A (2002) The standardisation of terminology of lower urinary tract function: report from the Standardisation Sub-committee of the International Continence Society. Neurourol Urodyn 21:167–178PubMedCrossRef

Haylen BT (2009) Female voiding dysfunction: prevalence and common associations. Curr Urol Rep 10:421–427PubMedCrossRef

Stamm WE, Running K, Hale J et al (1993) The etiologic role of Mycoplasma hominis and Ureaplasma urealyticum in women with acute urethral syndrome. Sex Transmis Dis 10:318–322

Haarala M, Kiilholma P, Lethonen OP (1999) Urinary bacterial flora in women with urethral syndrome and interstitial cystitis. Gynecol Obstet Invest 47:42–44PubMedCrossRef

Potts JM, Sharma R, Pasqualatto F et al (2000) Association of ureaplasma urealyticum with abnormal oxygen species levels and absence of leucocytospermia. J Urol 163:1775–1778PubMedCrossRef

Burkhard FC, Blick N, Hochreiter WW et al (2004) Urinary urgency and frequency and chronic pelvic pain in females. Can doxycycline help? J Urol 172:232–235PubMedCrossRef

Totten PA, Schwarts MA, Sjöström KE et al (2001) Association of Mycoplasma genitalium with nongonococcal urethritis in heterosexual men. J Infect Dis 183:269–276PubMedCrossRef

Gittes RF, Nakamura RM (1996) Female urethral syndrome. A female prostatitis? West J Med 164:435–438PubMed

10.

Casin I, Vexiau-Robert D, De la Salmonière P et al (2002) High prevalence of Mycoplasma genitalium in the lower genitourinary tract of women attending a sexually transmitted disease clinic in Paris, France. Sex Transm Dis 29:353–359PubMedCrossRef

11.

Anagrius C, Loré B, Jensen JS (2005) Mycoplasma genitalium: prevalence, clinical significance, and transmission. Sex Transm Infect 81:458–462PubMedCrossRef

12.

Horner P, Thomas B, Gilroy CB et al (2001) Role of Mycoplasma genitalium and Uraplasma urealyticum in acute and chronic nongonococcal urethritis. CID 32:995–1003CrossRef

13.

Jensen JS, Björnelius E, Dohn B et al (2004) Comparison of firs void volume and urogenital swab specimens for detection of Mycoplasma genitalium and Chlamydia trachomatis by polymerase chain reaction in patients attending a sexually transmitted disease clinic. Sex Transm Dis 31:499–507PubMedCrossRef

14.

Keane FE, Thomas BJ, Gilroy CB et al (2000) The association of Mycoplasma hominis, Ureaplasma urealyticum and Mycoplasma genitalium with bacterial vaginosis: observations on heterosexual women and their male partners. Int J STD AIDS 11:356–360PubMedCrossRef

15.

Rosemond A, Lanotte P, Watts S et al (2006) Systematic screening tests for Chlamydia trachomatis, Mycoplasma hominis and Ureaplasma urealyticum in urogenital specimens of infertile couples. Pathol Biol (Paris) 54:125–129CrossRef

16.

Daxboeck F, Zitta S, Stadler M et al (2005) Mycoplasma hominis and Ureaplasma urealyticum in patients with sterile pyuria. Int J Microbiol 295:279–285CrossRef

17.

Bradshaw CS, Morton AN, Hocking J et al (2006) High recurrence rates of bacterial vaginosis over the course of 12 months after oral metronidazol therapy and factors associated with recurrence. J Infect Dis 111:1478–1486CrossRef

18.

Baka S, Kouskouni E, Antonopoulou S et al (2009) Prevalence of Ureaplasma urealyticum and Mycoplasma hominis in women with chronic urinary symptoms. Urology 74:62–66PubMedCrossRef

19.

Latthe PM, Toozs-Hobson P, Gray J (2008) Mycoplasma and ureaplasma colonisation in women with lower urinary tract symptoms. J Obstet Gynaecol 28:519–521PubMedCrossRef

20.

Bump RC, Copeland WE jr (1985) Urethral isolation of the genital mycoplasmas and chlamydia trachomatis in women with chronic urologic complaints. Am J Obstet Gynecol 1:38–41

21.

Tibaldi C, Capello N, Latino MA et al (2009) Vaginal and endocervical microorganisms in symptomatic and asymptomatic non-pregnant females: risk factors and rates of occurence. Clin Microbiol Infect 15:670–679PubMedCrossRef

Title: Accuracy of urethral swab and urine analysis for the detection of Mycoplasma hominis and Ureaplasma urealyticum in women with lower urinary tract symptoms
Authors: Joerg Humburg
Reno Frei
Edward Wight
Carolyn Troeger
Publication date: 01-04-2012
Publisher: Springer-Verlag
Published in: Archives of Gynecology and Obstetrics / Issue 4/2012
Print ISSN: 0932-0067
Electronic ISSN: 1432-0711
DOI: https://doi.org/10.1007/s00404-011-2109-1

At a glance: The STEP trials

Springer Medicine

Accuracy of urethral swab and urine analysis for the detection of Mycoplasma hominis and Ureaplasma urealyticum in women with lower urinary tract symptoms

Abstract

Objectives

Methods

Results

Conclusion

At a glance: The STEP trials

Springer Medicine

Abstract

Objectives

Methods

Results

Conclusion

Please log in to get access to this content

Other articles of this Issue 4/2012

Submental lymph node metastasis from invasive ductal breast carcinoma

Placental alpha microglobulin-1 (AmniSure® test) for detection of premature rupture of fetal membranes

Stimulation of the endometrium with high-grade blastocyst culture supernatant (SEHB) can improve pregnancy outcome for couples undergoing intracytoplasmic sperm injection (ICSI): a randomized clinical trial

Leak-proof extracorporeal drainage for management of large ovarian tumors

Mature cystic teratomas in our series with review of the literature and retrospective analysis

Cellular blue nevus of the vulva mimicking Bartholin’s gland abscess in a 15-year-old girl: a case report