Urethritis and Pure Urinary Tract Infection (UTI)

To the Editor.—  Komaroff et al should be commended on their interesting and informative article in the Archives regarding the evaluation of dysuria in women with and without vaginitis (138:1069-1073, 1978). However, several problems in their analysis of their results should be noted. In Table 2, "urethritis" is listed as a subcategory of "pure UTI," whereas the authors imply that this diagnostic entity refers to patients with lower urinary tract symptoms, normal findings on pelvic examination, and insignificant bacterial growth on urine culture, a clinical situation that is often termed the "urethral syndrome." As noted in other studies,¹ the urethral syndrome accounts for approximately one third to one half (in this case 40 of 98, or 41%) of all cases of dysuria in the absence of marked vaginitis or gonorrhea. As patients with the urethral syndrome generally do not respond to antibiotics,² grouping them with bacteriuric "pure UTIs"