Theodore R. Fetter

Trichomonas vaginalis in urethritis of the male.

The effectiveness of penicillin in the rapid elimination of the gonococcus has served to focus attention on a group of diseases under the name of nonspecific or non-gonococcal urethritis. It is a not infrequent diagnosis: published reports give the incidence of this group as varying from 12 4 per cent. to a maximum of 70 per cent. of urethritides (Bull. U.S. Army med. Dep., 1947; Crouch, Reese, and Boudreau, 1953; Parrino, 1954; Babione and Graham, 1952; Durel and Siboulet, 1954; Harkness, 1950). The causes of the condition are not clearly defined. For many years speculation has centred in the possibilities of bacterial infection. Evidence has been based on the culturing of a predominant bacterium. In more recent times a virus and organisms of the pleuro-pneumonia group have been incriminated. But these same organisms have been reported in the urogenital tracts of men who gave no history of infection and were clinically well (Garvin, 1950; Wagner, Morse, and Kuhns, 1953; Ambrose and Taylor, 1953; Willcox, Howard, and Findlay, 1954; Willcox, 1955; Day and Arm, 1955; Feo, Fetter, Peoples, and Morton, 1956; Nicol and Edward, 1953; Shepard, 1954). Although Trichomonas vaginalis has been found in such cases, the idea that this organism might be responsible has stimulated little interest. This lack of interest is the more remarkable because of the incidence of this parasite in the general male population and in male patients with non-gonococcal urethritis in particular (Bauer, 1942; Feo, 1944; Seneca and Ides, 1953; Leca, 1951; Kozlowski, 1951; Sorel, 1952; Lanceley, 1953; Jira, Rossler, and Svejcar, 1955). Notwithstanding the fact that many men harbouring the flagellate are symptom-free, there are cases that attract attention. It is the purpose of this paper to emphasize the role of Trichomonas vaginalis as an aetiologic agent in cases of non-gonococcal urethritis.