Role of the rectal sample


In 1929, Hayes, a proctologist at Houston, Texas, wrote 'Gonorrhoea of the anus and rectum is not at all a rare disease, yet I think it is a disease that has been too much overlooked in the past'. Reviewing 1,218 cases, he found rectal gonorrhoea in 75 patients. He concluded that gonorrhoeal proctitis was much more frequent in women than in men and that autoinoculation was the chief mode of infection. Martin (1935), quoting Jullien (1886), stated that rectal gonorrhoea 'is a disease one sees only if one looks for it'. In Martin's own series of 111 women with urogenital gonorrhoea, 30 per cent. also suffered from rectal gonorrhoea. Clements and Hughes (1935), working at St. Thomas's Hospital, London, found that, of the 128 female cases with evidence of gonorrhoea by microscopy and/or culture, 69 were found by the same methods of examiination to be suffering from gonorrhoeal proctitis. In eight of their patients who were under observation after treatment of genitourinary gonorrhoea, rectal gonnorrhoea was found in follow-up tests at which urethral and cervical specimens revealed no gonococci. These patients would have been discharged as cured but for the rectal examination. Furthermore, in seven (5 4 per cent.) of their cases, gonococci were never found at any time other than in the rectum. Nicol (1948) demonstrated gonococci in rectal samplings of 26 of 74 consorts of men with proven gonorrhoea. In this series, five (6-7 per cent. of the total) gave positive results only in the rectum. He suggested that rectal testing should be a part of the routine examination and should always be included in the tests for cure. Jensen (1953) found positive rectal cultures in 63 of a total of 205 patients infected with gonorrhoea, an incidence of 31 per cent. In his series, four cases (2 per cent.) were found to be positive only in the rectum. He also was of the opinion that the great majority, perhaps all, of these cases of rectal gonorrhoea in women originated through peno-anal contact.

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@inproceedings{BhattacharyyaRoleOT, title={Role of the rectal sample}, author={M. N. Bhattacharyya} }