Treatment of trichomonal prostatitis with metronidazole.

Abstract

The treatment of trichomonal infestations of the genito-urinary tracts of both men and women has been greatly improved since the introduction of metronidazole in 1959. Cure rates in women of over 80 per cent, have been reported by several observers (Rodin, King, Nicol, and Barrow, 1960;Nicol, Barrow, and Redmond, 1960; Watt and Jennison, 1962). Even higher cure rates have been claimed in cases of trichomonal urethritis in men (Durel, Roiron, Siboulet, and Borel, 1960; Rodin and others, 1960; Sylvestre, Belanger, and Gallai, 1960).The incidence of trichomonal prostatitis is unknown. As examination of the prostatic secretion is not always carried out in the male sexual contacts of women with trichomonal vaginitis or in men with symptoms of disease of the lower genito-urinary tract, the true frequency of the condition is likely to remain undetermined. Patients and MethodThe patients in this series were all men who attended the department of venereology or were seen in private practice either because their sexual partners had been Found to have trichomonal vaginitis or because they had undiagnosed symptoms referrable to the lower genitourinary tract. Their ages ranged from 17 to 74 years.In addition to physical examination, investigation included an urethral scrape and culture, microscopical and cultural examination of the centrifuged deposit of urine, prostatic massage, and microscopical and cultural examination of the prostatic secretions, frequently on more than one occasion. ResultsTrichomonas vaginalis was demonstrated in the prostatic secretions in 34 patients. Symptoms were entirely absent in 27 patients, but six complained of vague discomfort or pain in the perineum, the penis, or both. One patient complained of frequency of micturition. A past history of urethritis was obtained from nineteen of the patients and in six of them no investigations had been performed or treatment given and the discharge had cleared up spontaneously. Trichomonal vaginitis was found in the sexual partners of ten of the men.The diagnosis was made by demonstrating Trichomonas vaginalis on microscopical examination and growing it in cultures in eighteen of the patients. The parasite was found microscopically but was not grown in cultures in nine and was grown in cultures but not demonstrated microscopically in seven patients.Treatment consisted of oral metronidazole, 200 mg. three times daily after meals for 7 days. Most of the patients were followed for 3 months and repeated tests were performed on the prostatic secretions and the urine to establish and confirm cure. Thirty of the patients (88 per cent.) were considered to have been cured by a single course of treatment and were discharged from follow-up after 3 months. In two patients (both of whom denied intercourse or the possibility of re-infection), the parasite reappeared in the prostatic secretions during the period of observation but in both cases it disappeared after a second course of metronidazole at the same dosage. In two further patients the parasite was not eliminat...

Metronidazole and tinidazole in a single large dose for treating urogenital infections with Trichomonas vaginalis in men.

“…It has been pointed out by many investigators that more men would be found to have urogenital infection with Trichomonas vaginalis than actually reported if thorough examinations were performed (Strain, 1945;Bedoya et al, 1958a, b;Schuppius, 1958;Catterall and Nicol, 1960;Ohmura, 1960;Hoffman et al, 1961;Catterall, 1965;Kimura, 1965;Perl et al, 1965;Schmor, 1974;Weidenbach and Leix, 1974). T. vaginalis is found in a little over 20% of normal male urine samples and in 8 to 110% of urine samples after prostatic massage.…”