Introduction Men are not routinely tested for Trichomonas vaginalis (Tv) and Mycoplasma genitalium (Mg) in the Netherlands and, therefore, their prevalence and/or role in urogenital complaints in the Dutch male population is unknown. Our aim was to describe the age-specific prevalence of Tv and Mg and the possible association of Tv and Mg infections with male urogenital complaints, ethnicity, high-risk sexual behaviour and co-infections with Chlamydia trachomatis (Ct), in men attending the Sexually Transmitted Infection (STI) clinic in Amsterdam, the Netherlands.

Methods Urine samples and clinical data were collected from 526 heterosexual men and 678 men who had sex with men (MSM) attending the STI clinic. To investigate age as a risk factor, we oversampled older men. Urine samples were tested for Tv and Mg using TMA (Hologic) and in-house PCR.

Results TV infection was rare in heterosexual men (1.1%) and non-existent in MSM attending the STI clinic, whereas Mg infection was equally common in both groups (3.1%). Most Tv cases were older than 40, of non-Dutch ethnicity and associated with low-risk sexual behaviour. No age or ethnic trends were observed for Mg infection; however, high-risk sexual behaviour in MSM did correlate with Mg infection. Co-infections of Tv or Mg with Ct were very rare (< 0.5%). Of the patients with Mg infection 21.6% reported urogenital symptoms.

Conclusion Tv infection is rare and asymptomatic among men attending the STI clinic in Amsterdam. Our results support previous findings that Tv prevalence increases with age. Mg is quite common in men, but also remains mostly asymptomatic. While the outcome of this study does not encourage general testing for Tv in men, it does, however, suggest that some male urogenital symptoms – not caused by gonorrhoea or Ct - could be explained by Mg infection.

Disclosure of interest statement This work was funded by the Public Health Laboratory in Amsterdam, the Netherlands. The authors declare no conflicts of interest.