[Question #2606] Dr H question: STI Chlamydia/Gonorrhea

42 months ago
I had a short unprotected oral situation about 8 months ago. A csw put my penis in her mouth for about 10/15 seconds and I was upset and made it stop. I am pretty much a hypochondriac.  I have always peed often. Well, now 8 months later I got the full std panel and everything came back clean, however, I was unaware of the 2 hour urination window. I had actually urinated 15-20 minutes (and prob five times total before the test) prior to the test. Is my negative test still valid? If so, what could cause me to constantly urinate ( I do drink a ton of water and caffeine) or have the urge to urinate and sometimes it's uncomfortable to pee? I've never had discharge, to my knowledge.  Can I be confident in my test? Thank you very much for your help. 
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
42 months ago
Welcome to the forum. Thanks for your question.

You really needn't be worried about having either gonorrhea or chlamydia. First, it is unlikely you acquired either gonorrhea or chlamydia from the exposure described. It was very brief, reducing any transmission risk. Chlamydia is rarely transmitted mouth to penis, and gonorrhea almost always causes obvious symptoms you would have noticed within a few days (discharge of pus, painful urination). Second, if you had been infected, the chances are the infection would be long gone:  the immune system usually clears gonorrhea within a few weeks, without treatment; and although chlamydia can persist longer, it's generally gone within a few months. Finally, don't be worried about time since last urinating and test accuracy. In busy STD clinics, we never require a 2 hour wait. The test probably is fully accurate even after a few minutes.

So considering all those factors, you can be confident you don't have either gonorrhea or chlamydia. Don't give it another thought!

I hope this information has been helpful. Let me know if anything isn't clear.

HHH, MD

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42 months ago
Thank you for your response and reassurance.  It may be guilt or shame or something of the sort that has it in my head.  Scared of punishment from the big guy I suppose.  But my last couple of questions are, while I 100% trust your expertise, I'm curious as to why people use the scare tactic of if you pee so close to a test then the bacteria will be flushed out and you could have a false negative... Is there science behind that? Also, I pee a lot but I drink a lot of water.  But I tend to have the urge to pee.  Feels like pee is actually stuck in my urethra, then I do use the restroom and it feels uncomfortable sometimes (I wouldn't ever say painful--I just feel something sometimes) and sometimes I dribble after I am done.  Is this any symptom of an sti?  I will say that since your response, I do physically feel better and symptoms have decreased. Thanks again for your help and providing expertise to this forum.  It's a great thing that you do and I appreciate it.
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
42 months ago
Urine doesn't flush out infecting bacteria very efficiently. The organisms tightly adhere to infected cells, and DNA testing by PCR and related technologies is little affected by time since voiding. However, when manufacturers developed the current tests, they were sill worried about it (conservatively but unnecessarily) and limited studies to people who hadn't voided for 2 hours, and so FDA regs require that to be stated as a test limitation. It doesn't mean the tests aren't accurate earlier, only that it hasn't been stuided. STD clinics and others with lots of testing experience have long known that it seems to make no difference in test performance, and most STD clinics ignore the time limitation.

The main symptom of urethral STDs is discharge, with voiding pain or discomfort secondary and rarely the only symptom. Also, neither test performance nor your symptoms are the only reasons I'm confident you don't have gonorrhea or chlamydia; also note my comments about low risk plus spontaneous resolution within 8 months.

Thanks very much for your kind words about our service. I'm glad to have helped; that's why we're here.
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42 months ago
Thanks, Dr. H.  I guess my last question is, with the symptoms described, does it make sense to have a UTI test or is it somewhat normal?  Thanks again (and it really is my last question). 
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
42 months ago
This sounds to me like someone with a somewhat more reactive lower urinary tract than average, and/or greater perception of normal variations in detrusor (bladder muscle) tone -- i.e. overactive bladder. But if you remain concerned and want further reassurance, mention it to your doctor and/or have a routine urinalysis one of these days.

See http://www.emedicinehealth.com/overactive_bladder/page2_em.htm and/or search "detrusor overactivity".

Best wishes and stay safe.


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