Rectal microscopy in men – expensive, time consuming and inappropriate

Waters, Laura; Worthen, Elaine; O'Mahony, Colm

doi:10.1258/095646206780071054

Cited by 1 publication

(3 citation statements)

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“…6 Second, in the time and motion analysis, six hours and 45 minutes were consumed for every positive rectal GC result obtained. Waters and et al 7 also commented on the fact that rectal microscopy in asymptomatic patients can yield case rate of only 1%. An informal survey concluded that up to 20 weeks of staff time could be consumed in carrying out microscopy often yielding a negative result.…”

Section: Discussionmentioning

confidence: 99%

“…Using rectal microscopy for all MSM irrespective of symptom presentation is however outside current national guidelines 4 and regarded by some as time consuming, demoralizing and cost-ineffective. 7 We present a retrospective analysis of GU medicine attendees with a view to establish the sensitivity of rectal microscopy in asymptomatic men, thereby strengthening the evidence base for the BASHH recommendation of abandoning microscopy as a diagnostic tool in the management of asymptomatic rectal GC. In addition, we aimed to establish the time required to produce a positive microscopy result sufficient for a presumptive diagnosis of rectal GC.…”

Section: Introductionmentioning

confidence: 87%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Microscopy detection of rectal gonorrhoea in asymptomatic men

2009

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This audit aimed to determine the usefulness of microscopy to detect presumptive rectal gonorrhoea (GC) infection in asymptomatic men. We retrospectively audited more than 400 male patients attending a London genitourinary medicine clinic from January 2005 to March 2007 who tested rectal culture positive for Neisseria gonorrhoeae and compared this with the microscopy detection rate. In total, 123/423 (29%) of culture positive samples were microscopy positive. Of those that tested microscopy negative (300/423), 64 (21%) were symptomatic and 236 (79%) asymptomatic. In addition, a time and motion study examined 81 rectal slides over a two-week period to identify microscopy reading time required to make a presumptive diagnosis of GC. Three slides were positive, resulting in six hours and 45 minutes to detect one positive sample. Given the low sensitivity for rectal microscopy coupled with the length of time required to obtain a presumptive positive rectal GC result, we believe rectal microscopy is no longer a cost-effective tool screening for asymptomatic men, and this report supports the BASHH guideline that it is not recommended in the management of asymptomatic rectal infection.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 87%