FIRST-VOID URINE VERSUS URETHRAL SWAB FOR MOLECULAR DETECTION OF SEXUALLY TRANSMITTED INFECTIONS IN MEN WITH MULTIPLE SEXUAL PARTNERS.

Authors

D Shishniashvili, Z Bedinashvili, K Tsomaia, L Svanadze, N Chkhikvishvili, G Durglishvili

Published in

Georgian medical news. Issue 376-377. Pages 246-252.

Abstract

Sexually transmitted infections remain a major clinical and global public health burden. Nucleic acid amplification tests are recommended for the molecular detection of urogenital sexually transmitted infections. Although physician-collected urethral swabs have traditionally been used for STI testing in men, swab collection is invasive and may cause substantial discomfort. First-void urine is a promising non-invasive alternative that can support molecular STI testing and screening in men.
To compare first-void urine with physician-collected urethral swab specimens for PCR-based detection of sexually transmitted infections in men with multiple sexual partners.
A prospective paired specimen-comparison study included 148 men aged 22-49 years. Urethral swabs were collected first by a physician, followed by the collection of the initial 20-30 mL of first-void urine. PCR testing targeted Chlamydia trachomatis, Neisseria gonorrhoeae, Mycoplasma genitalium, and Trichomonas vaginalis. Paired results were analyzed using exact McNemar tests and Cohen's kappa.
At least one STI pathogen was detected in 128 of 148 men (86.5%). First-void urine detected at least one pathogen in 128 participants, whereas the urethral swab detected at least one pathogen in 100 participants. All 28 participant-level discordant results were first-void urine-positive/urethral swab-negative (p<0.001). First-void urine yielded higher detection for C. trachomatis (43 vs 38; p=0.063), N. gonorrhoeae (55 vs 45; p=0.002), and M. genitalium (75 vs 62; p=0.0002). T. vaginalis detection was identical in both specimens (27 vs 27).
First-void urine demonstrated equal or higher molecular detection yield than urethral swab for all four STI pathogens studied, supporting its use as a practical specimen for molecular STI testing in men with multiple sexual partners.

PMID:
42830059
Bibliographic data and abstract were imported from PubMed on 05 Oct 2026.

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