Determination of iron status in women attending genitourinary clinics with pruritus vulvae.

OBJECTIVE: To compare iron status in women with pruritus vulvae and in asymptomatic controls. METHODS: 42 women with pruritus vulvae and 42 asymptomatic broadly age-matched controls were enrolled in this prospective study. The outcome measures assessed were serum iron, serum ferritin, total iron-binding capacity, haemoglobin and transferrin saturation. RESULTS: 12 (29%) participants and 10 (24%) controls were iron deficient; 1 (2%) participant and 1 (2%) control had laboratory-defined iron deficiency anaemia. Participants generally had lower levels of iron markers than controls, with differences (95% confidence interval (CI)) of -3.5 microg/l (-9.89 to 6.99) for serum ferritin (p = 0.73), -4.9 mmol/l (-8.12 to 0.12) for serum iron (p = 0.06) and -5.5 mmol/l (-5.75 to 1.46) for total iron-binding capacity (p = 0.24). No significant difference in haemoglobin or mean cell volume was shown between the two groups (haemoglobin: p = 0.17, 95% CI -0.83 to 0.15; mean cell volume: p = 0.15, 95% CI -4.59 to 0.73). CONCLUSION: This study does not provide evidence to support the routine determination of iron status in patients presenting to genitourinary medicine clinics with pruritus vulvae from all causes.

Management of sexually transmitted disease by surgeons.

The management of 63 patients diagnosed by surgeons as having sexually transmitted disease (STD) was audited. A diagnosis of STD was made in 51 (81%) of patients without taking a sexual history. Only 2 (3%) patients were referred to genitourinary medicine (GUM). Appropriate microbiological specimens were obtained from only two of 52 (4%) patients diagnosed with either pelvic inflammatory disease (PID) or epididymo-orchitis. Reliance was placed on inappropriate specimens in 22 (42%). There was widespread use of inappropriate antibiotics. The management of sexually transmitted disease by surgeons was very poor. These patients should all be referred to genito-urinary medicine.