I received unprotected oral sex from someone with gonorrhea.  I had a NAAT urine test done 3 weeks post-exposure and was not experiencing symptoms.  Later in the day after the test, I experienced burning after urination which lasted a few days.  During this time, I developed pain in my left testicle and it feels like either they have swollen or my scrotum has shrunk.   The NAAT test was negative.  My urine sample was given about 1 hr 15 minutes after previously urinating and I urinated 4 or 5 times prior to the test around Noon.  I drink a lot of water.

A week after the NAAT test I went and had another test done.  This time it was a DNA Probe.  This too came back negative.  I was given 1000mg of Azithromycin.  A week later the pain in my testicles had not resolved.  I am now feeling pain in my left leg.  I went back to a different doctor who did a prostate & testicle exam.  He did not note swelling in either.  I was put on Levaquin 5 days ago.  Things may be getting better but it is hard to tell.  There is no pain in the morning but by afternoon, evening it is much greater.  I have not had any discharge at all at any time. I experience some discomfort post-urination for 1 hr after ejaculation.  Erections are difficult.

I have two negative urine tests of different types.  A urine culture and test was done for UTI on Monday which was positive for trace blood, trace leukocytes, and negative for nitrites.   The doctor's said he will call if the antibiotic does not match the culture.  It is now Friday and no call.  I've been a complete nervous wreck and have lost 15 lbs during this ordeal.  If there is a gonorrhea infection in my testicles or epididymis is it possible that it would not show in a urine test?  Or can I rely on these urine tests and assume there is a coincidence in timing and some other possible cause?    I am following up with a urologist next week but I need to sleep and breathe calmly again. I had a vasectomy 3 years ago and a PMH of UTI and prostatitis. 

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Thank you, Doctor.  Surely an anxiety-driven response was in the back of my mind.  I guess my biggest concern was the general lack of symptoms or fleeting symptoms in my urethra and the fear that the bacteria would not make it to the urine such that it would be detected in any test.  

Dr. Hook,

Sorry for the delayed response,.  I missed your earlier follow-up.  You characterized the response as "anxiety-driven" and I must say, I have to agree.  If you had gonorrhea( no evidence that you do), and it had spread to the testicles or epididymis, it would have been symptomatic (I have never heard of asymptomatic epididymitis) and would still be detectable with the testing you had.  You do not have gonorrhea from the events you described above.  Really.  EWH
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Dr. Hook,  thank you and your colleagues on this site for your time and courtesy answering questions and allaying fears.  I saved my final question just as a followup.   I had a followup appointment with a urologist.  He ordered ultrasounds which did not show any abnormalities.  He ordered further urine tests including for STI's.   The third and final STI test was a uroprobe (spelling?) PCR test.   That's three negative tests (NAAT, DNA Probe, and UroProbe).  Frankly, I was ready, willing, able to rest on two negative tests and was not happy that the urologist put me through extraordinary anxiety for a third.   I have not slept or eaten well in a month.   His staff was judgmental.  He thought everything was in my head. 

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