[Question #8701] Ghonnoreah Test

41 months ago

Hi Doctors,

My wife and i have had some problems recently and i have reveived unprotected fellatio from two CSWs recently - One about a week ago and one three days ago.

i know the risk is low for STIs but this morning i had a burning sensation when peeing (not too bad).

i haven’t had any other burning sensation throughout the day when peeing and no obvious puss so i think this may just be down to being dehydrated / having not drunk much water yetserday.

Questions

1. Would i be right that the burning sensation described as a ghonnoreah symptom would be persistent and wouldnt just be a ‘one off’? (i.e. it would be something you would notice a lot when peeing throughout the day).

2. would there be obvious discharge as well as burning when peeing?

3. i plan to get my urine tested just to put my mind at rest. If i do this on tuesday it will be just over 4 days post exposure - is this enough time for an accurate test result for ghonnoreah?

Thank you

H. Hunter Handsfield, MD

41 months ago

Welcome back to the forum. Thank you for your confidence in our services. I logged in a few minutes after you posted this question: most users should not expect nearly real-time replies!

You correctly understand that oral sex is relatively low risk for all STIs, but that gonorrhea is one possibility. However, I doubt you have it.

1) Once dysuria (painful urination) due to gonorrhea starts, it is continuous; a one-off episode is very unlikely to be gonorrhea. Your judgment of slight dehydration, with urine more concentrated than usual, makes sense to me.

2) Yes: urethral gonorrhea almost always causes obvious urethral discharge.

3) Given the low risk and the symptoms described, testing for gonorrhea is optional. But if you go ahead with your plan to be tested, 4 days is plenty of time for a reliable result. You can expect it to be negative.

I hope these comments are helpful. Let me know if anything isn't clear.

HHH, MD

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40 months ago

Thanks for the response Dr that’s great. Given this i’ve chose to save the NHS time and money and not test. Its day 5 post exposure and no obvious ghonnoreah symptoms. I need to take antibiotics for a non-sti related issue (Bursitis) which would aradictae ghonnoreah i assume.

Given the low risk of transmission in the first place, overlaid with the fact i have no symptoms at day 5, do you think i’m safe to assume there is no ghonnoreah infection and so okay to resume unprotected sex with my wife?

Thanks Doctor

H. Hunter Handsfield, MD

40 months ago

With respect to gonorrhea, you can safely resume sex with your wife. But of course there is no guarantee about other STIs like herpes and syphilis, for example -- low risk from oral sex but not zero risk. That said, gonorrhea definitely is the main risk and you can be sure you don't have it.

For future reference, some but not all antibiotics are active against gonorrhea. The treatment for your bursitis isn't necessarily effective. What antibiotic will you be taking?

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40 months ago

thanks Doctor - i had assumed the risk of syphillis would be tiny given the heterosexual nature of this encounter.

is testing for this and herpes something you’d reccomend given oral is widely thought to be ‘safe sex’ with only a low risk of transmission? I am moving to Singapore shortly so arranging testing in the nornal window will be difficult.

Not sure of antibiotics as pick them up tomorrow.

thanks for this helpful advice.

H. Hunter Handsfield, MD

40 months ago

Indeed heterosexually transmitted syphilis is uncommon in the UK. Syphilis testing is so routine, however, that if you had gone to the trouble to come to an STI clinic in the US -- and probably most NHS GUM clinics in the UK -- syphilis testing would be done. However, it is definitely optional. As for herpes testing, no knowledgeable expert would recommend it in the absence of symptoms to suggest a new HSV infection. The tests aren't good enough to be reliable in this situation.

That completes the two follow-up exchanges included with each question and so ends this thread. I hope the discussion has been helpful. Best wishes and stay safe.

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