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We found very little urethral LGV which fits the general picture of the recent LGV outbreaks in Europe,11 but also poses the question of how transmission is being sustained. Early reports suggested transmission through sex toys or fisting, but more recent analyses have not supported this association, and more research into modes of transmission is required.3 4 There is insufficient evidence to recommend routine screening of MSM for urethral LGV. Diagnostic tests for CT with LGV typing of CT positive specimens should be carried out on LGV contacts and men with signs of genital ulcer adenopathy syndrome or other suspected LGV disease.

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