Is there a role for leucocyte esterase testing in non-invasive screening using nucleic acid amplification tests of asymptomatic men?

With the increasing pressure to achieve the government's 48 hour access target for departments of genitourinary (GU) medicine better utilization of resources must be part of the solution. The leucocyte esterase (LE) test has been shown to perform as well as a urethral smear in asymptomatic men in identifying chlamydia-positive individuals and is likely to perform better in detecting genitalium-positive individuals than chlamydia-positive men. The LE test, which is both inexpensive and non-invasive, offers an interim, evidence-based, solution to the issue of whether asymptomatic men attending departments of GU medicine should be screened for the presence of urethral inflammation.