Polkowski's results add additional data to the growing evidence that a first-voided urine (FVU) sample is at least as sensitive as a urethral swab for culturing gonococci from men with urethritis.
The author's observation that the FVU culture method is more acceptable to male patients than urethral-inserted swabs may be of considerable importance in increasing male participation in both screen testing and post-treatment tests of cure.
The wide discrepancy Polkowski reported between the results of the Gram-stained smears and cultures of urethral discharge points up an important problem.
Dans and Judson1 carried out a novel study testing the reliability of the Gram-stain smear relative to the experience of the smear reader. These authors had two technicians. Technician 1 was long experienced in reading Gram-stained smears of urethral discharge from men; technician 2 was well qualified in other areas of microbiology but had no prior experience in reading