Male urethral gonorrhoea -- 5,700 pounds per positive test?

We audited all male urethral gonorrhoea cases from 2003 to determine the additional yield of culture following negative microscopy. Sixty-one episodes were reviewed, of which six were diagnosed by culture alone. In all, 475 cultures were performed to diagnose each case of microscopy-negative infection. As resources in sexual health clinics are limited, it may be appropriate to reconsider our policy of universal male urethral gonococcal culture.