AN EVALUATION OF THE URETHRAL SMEAR AS AN INDEX OF ANDROGENIC DEFICIENCY IN THE MALE

IN a communication to this Journal Andrews (1) suggested the use of urethral smears as an index of androgen deficiency in males. He reported that smears of the distal cells of the male urethra showed characteristic staining reactions with the Shorr stain (2) indicating the presence or absence of an androgen deficiency. The urethral cells of normal individuals were said to appear as masses of cuboidal cells with rather pink staining cytoplasm and with very distinct brown nuclei. On the other hand, where an androgen deficiency was present the cytoplasm stained blue and the nuclei red. Where androgen therapy was given to correct a deficiency of this hormone, the staining reaction of the urethral smear was found to change, eventually becoming characteristic of the normal individual. Such findings, if confirmed, would indeed have much clinical diagnostic significance. We have undertaken a study of this technic with results which do not support the observations reported by Andrews. A urethral smear is taken by spreading open the meatus and applying a dry slide to the inner moist surface. The slide is fixed immediately in a solution of equal parts of ether and 95% alcohol and then stained with the Shorr stain. We have found that if more than one to two seconds elapse between the taking of the urethral smear and its fixation, a “dry smear” results in which most cells will take a diffuse orange-red stain. This distortion of the staining reaction by the drying of the smear before fixation can obviously lead to an erroneous interpretation of its cytology.