A)Wondering if you feel that is not as accurate or is it more off a standard since it is done by the government

B)Lastly how does Chlamydia/gonorrehea spread is it common through oral sex exposure in my case reciept of oral sex

Thanks doctor

Welcome back to the Forum.  I'll be glad to continue our exchange and hope that I can put your continuing concerns to rest with the information I have provided.  NAATs tests for gonorrhea and chlamydia are amongst the most sensitive tests for gonorrhea and chlamydia ever developed and your results should be believed.  For purposes of standardization, the FDA requires that manufacturers specify a sample volume and while I supposed very large volumes of urine might dilute things and affect results, volumes of up to 100 ml have been studied and the performance does not change.  Your results are valid and should be believed.  There is no need for further testing or for continuing concern that you might be infected.

Gonorrhea is occasionally acquired through receipt of insertive oral sex with an infected partner.  This mechanism of transmission has not been well studied as to the frequency with which it occurs but most experts agree that receipt of oral sex is less likely to result in acquisition of infection than unprotected vaginal sex with an infected partner.  Acquisition of chlamydial infection from receipt of oral sex is decidedly unusual- for reasons that are not clear, Chlamydia does not "like" the oro-pharynx.  EWH

I am in Canada (Toronto to be exact) - would you say that in North America or I presume in General - that seeing different tests results is not common if being carried out using NAAT. For example in my situation going from a negative to a Positive is rare due to he volume of urine produced.

Thank you kindly, 

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC254310/ 

i found the above link and while i do not expect you to read that study -  i just had a question about the chart below from it - with reference to 51 to 90 (ml) would that say that chances of Gono or Chlymadia being detected are very low? The only reason i am worried Doctor is due to my wife's pain in her lower abs which i seen on this website relates to symptoms of PID . Thank you for being so patient in dealing with this questions. I finding it hard to understand what pain she is going through can be aside from PID - she said she is ovulating as well but never had this discomfort before. Thank you 

You asked for expert opinion and got it.  This 12 year old paper was written by friend/colleagues.  If you look at the references, I am an author on 2 of the 5 cited references.  The authors note that, in particular, LOWER urine volumes seem to be a problem and that any possible problem with larger volumes is less prominent than for small volume.  They state that the subject needs more study but now, more than 12 years later there are no more data.  Your guilt wants this to PID as some sort of divine retribution for your misstep.  IT IS NOT.  If you continue to search the internet, you will only find more conflicting data.  My suggestion is that you re-test, this time providing the recommended specimen volume. I am confident that you will then find that your test is still negative.  That will effectively rule out your concern that your partner has PID from an infection you acquired form the VERY low risk misstep that you are fixated on.  At that point, if you cannot move forward, you need counseling and perhaps disclosure to your partner, not more testing or therapy.  

I will keep this thread open so you can post your results of you are tested.  There will be no further comments unless you provide test results.  EWH

my nerves had taken over - the results came back negative.

Did a second round of urine work and came back negative as well - thank you and apologies again looking back at how my posts turned out.

Have a great week.

Thank you for the follow-up and sharing your results.  I hope that they will allow you to now move forward without continuing concerns.  

As you know, this thread will be closed shortly.  Again, thanks and take care. EWH