Abdominal and bimanual pelvic examination may reveal mild lower quadrant discomfort, but focal tenderness, guarding, or masses should not be detected. Men with nongonococcal urethritis, particularly those who are unresponsive to antichlamydial therapy, may be infected with trichomoniasis. T vaginalis has been associated with prostatitis, balanitis, and epididymitis. It may be associated with urethral strictures and infertility. T vaginalis can cause epididymitis, prostatitis, and superficial penile ulcerations at the prepuce.
Studies focus on differentiating trichomoniasis from other causes of vaginitis.
A pH of greater than 4.5 suggests trichomoniasis or bacterial vaginosis rather than candidiasis. The test is sensitive but not specific, since this pH can be found in one third of those with normal vaginal flora or candidiasis. In the presence of trichomoniasis or bacterial vaginosis, polyamines, a product of anaerobic metabolism, results in a fishy smell. The wet prep is prepared by mixing vaginal secretions with normal saline. Due to the low number of organisms, trichomonads may not be detected in asymptomatic or chronically infected women.