[Question #7503] Chlamydia and Gonorrhea Test

55 months ago

Hello Doctors

I have asked a few questions on here not too long ago but i forgot my username and password so i had to make a new one.

I have a question about chlamydia and gonorrhea urine testing.

I tested for both, and also for a UTI and Trich. I was only given one bottle to urinate in, but when i went to give it to them they said i need to urinate in a second bottle.

Since i wasn’t told about the second bottle, i didnt have any urine left and couldn’t urinate in the second one so i drank 3 full water bottles in a matter of 20 minutes and went back to urinate in the second bottle.

My question is, does the fact that i drank all that water affect the test in any way? If all that came out was water would that mean the test would be negative even if it’s actually positive? I read online that the result could come out as dilute if that was the case but i just need an expert opinion on this one.

Thank you so much

H. Hunter Handsfield, MD

55 months ago

Welcome back.

This can be answered more accurately with additional information. Are male or female? Why is testing being done: symptoms? if so, what are they? screening for general purposes? known exposore? Also, were the two specimens the initial urine stream (just an ounce or two) or larger, i.e. "midstream"; the first is best for STI testing, the latter for UTI. Also, urine misses some infections that are better detected by vaginal or urethral swab testing. Depending on this information, the timing may not matter at all.

That said, these 3 STI tests are highly sensitive, and would almost always detect infection regardless of whether these instructions are followed.

Happy to address all this in more detail with this information.

HHH, MD

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55 months ago

Hi Dr. HHH thank you for your reply

I am a female and received oral from a male that i no longer have any contact with. This happened 4 months ago. I have tested negative for HIV up to 4 months so i decided to just do a full std test.

About 2 months after it happened i was experiencing vaginal discomfort, more discharge than usual, frequent urination, irregular periods and stomach cramps. So i did the urine tests which came back negative but i’m worried it has missed any of the infections since i had drank all that water. I’m wondering if i should repeat the urine test just in case.

The first specimen was a full bottle all the way to the top and the second was just past the “20” line (the lowest number) which i had to pass in order for it to be accepted.

H. Hunter Handsfield, MD

55 months ago

Thanks for the clarifications.

Your symptoms are a mixed bag, consistent with both UTI and some STIs. However, you had an exposure that was essentially no risk. Trich is never carred in the oral cavity, so not possible to acquire by receiving oral sex. Second, chlamydia is rare in the torat; and although gonorrhea is more common, both gonorrhea and chlamydia are very rarely transmitted by cunnilingus -- so you also were at little or no risk for these. That said, if you have otherwise been sexually active and not tested recently, perhaps these make sense. But if positive, it won't be from the exposure described.

Also, trichomonas testing in women is normally done on vaginal swabs. To my knowledge, there is no experience with urine testing in femalss. As already noted, there was little point in tested based on the event 4 months ago, but if you are otherwise at risk, a negative urine test won't necessarily excludet he possibility of infection.

For STI testing, the second specimen was appropriate and the result will be reliable. Recency of voiding is less important for gonorrhea/chlamydia testing (and maybe trich?) than collecting only the first ounce or less. (My guess is the "20" mark was for mlilliliters; 20 ml is about 2/3 ounce. The first specimen would have been best for UTi testing. Do you know for sure which test(s) was/were done on the two specimens? What were the results?

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55 months ago

I’m not too sure which ones were used for which but i’m guessing the first one was the gonorrhea / clamydia/ trich - the main reason for doing the test, and then the UTI could have been the second one since it was added in at the end. All the results came back “not detected”.

So just to confirm,

based on the results, I wouldnt need to retest?

2. Can i be confident that the amount of water i drank wouldnt affect the test?

I haven’t had any exposures since then so it’s odd that i felt all those symptoms only after this event. I was expecting at least the UTI result to be positive but now i just feel like there was a mistake in these tests.

55 months ago

Hi Dr HHH,

Sorry to bother you again, I’m just following up with you about my question. I think you may have accidentally missed it. Thank you

H. Hunter Handsfield, MD

55 months ago

Apologies for the long delayed reply.

As I said above, you were at little or no risk for any STD from the exposure described, or for UTI. Negative urine culture is always conclusive, and that result means you do not have a UTI. Your vaginal symptoms almost certainly are not due to gonrrhea or chlmydia, and probably are from any infection from the sexual exposure you have described. Bu if you continue to have symptoms that concern you, you'll need to see a doctor in person. While you can be sure you have not UTI, urine or vaginal swab testing are not capable of accurately diagnosing vaginal infections. If you do, it isn't from the oral sex event.

With apology again for the delayed reply, that completes the two follow-up exchanges included with each question, and so ends this thread. I hope the discussion has been helpful -- and reassuring, as I intended!

Bes wishes and stay safe. Happy new year.

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