Urine leukocyte esterase as a screening tool for sexually transmissible diseases and vulvovaginitis in adolescent females

Abstract

Study Objective: To determine the predictive value of leukocyte esterase as a means of screening for sexually transmissible disease or vulvovaginitis in adolescent females.Design: A prospective study was performed comparing the results of urine leukocyte esterase and the finding of sexually transmissible diseases or vulvovaginitis.Participants: Seventy-four females (mean age = 17.4 years) from a Chicago suburban adolescent family planning clinic who were requesting birth control services were enrolled in the study.Interventions: Patients submitted an initial 10–20 cc of a voided urine specimen for leukocyte esterase testing prior to undergoing a pelvic examination for Neisseria gonorrhoeae culture, Chlamydia trachomatis microtrak, vaginal wet mount preparation, and a Pap smear. Urine leukocyte esterase was recorded as positive (trace, +1, + 2) or negative and compared with the results of other laboratory tests for sexually transmissible diseases or vulvovaginitis.Results: Thirty-eight leukocyte esterase-negative subjects had no detectable infections. Thirty-six subjects were leukocyte-esterase positive: 2 had urinary tract infection, 9 had a sexually transmissible disease or vulvovaginitis, and 25 had no detectable infections.Conclusion: Urine leukocyte esterase was found to have a statistically significant predictive value for sexually transmissible disease and vulvovaginitis (p = 0.003).