Evaluating dysuria in adolescent females.

Adolescent females presenting with acute dysuria in primary care settings are often assumed to have urinary tract infections and are evaluated accordingly. Dysuria, with or without a change in vaginal discharge, is also often associated with sexually transmitted infections, usually urethritis, even when the patient does not report a history of sexual activity. An adolescent female with dysuria, an abnormal urinalysis, and a negative urine culture has a high probability of having a sexually transmitted infection. Although providers who treat adolescents should not assume all of their patients are sexually active, it is essential that they ask questions about their patients' past and present sexual activity and consider the possibility of sexually transmitted diseases in young women presenting with this symptom.

Pelvic inflammatory disease in adolescents: high incidence and recurrence rates in an urban teen clinic.

STUDY OBJECTIVE: To determine pelvic inflammatory disease (PID) incidence and recurrence rates in an urban teen clinic. DESIGN/SETTING: A retrospective chart review of female patients seen as outpatients over an 18-month period at an urban teen clinic. 192 patients were diagnosed with PID, and the charts of these patients were reviewed in depth. MAIN OUTCOME MEASURES: PID incidence and recurrence rates. RESULTS: A PID incidence of 9.7% was identified. Of the adolescent females diagnosed with PID, 47% had recurrent PID. Of the females with recurrent PID, 27% had three or more episodes. Only 36% of adolescent females diagnosed with PID ever reported that their partners had been treated. CONCLUSIONS: This study suggests a higher incidence of PID as well as PID recurrence in the present clinic-based adolescent population than previously reported. More accurate monitoring of incidence and recurrence rates in well-defined populations of adolescents should be conducted with the hope of identifying effective avenues of intervention.