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untreated gonorrhea

Dear Doc,

Iam 31 had protected oral and vaginal sex with a high risk female for approximately 30 seconds both ways.  About a month later i noticed some discharge after ejaculation from masturbation.  I will note that theejaculation came out very slow which was somewhat abnormal for me.  the discharge last appr. 30 minutes.  I had no pain when urinating and no other discharge that i recall.It was not yellow or green.  so i assumed it was left over ejaculate.  At 8 weeks I had all std testing done including chlam,gon,hiv,herpes 1&2,syph, with local GP. all results negative.  Now at 3 months past exposure I am experiencing problems with my ejaculate coming out slow if at all.  I have never had this problem in the past and my ejaculate stream was always comes out with force.  Also periodically I have had frequent urination but my stream doesn't seem to be slowed at all.
I am concerned with the following:

1. Was 8 weeks after exposure too long to have a gon test done.  It was NAAT with urine.
2. How long will discharge last.  Is it continuos for days or can it be a one time discharge.
3. If the test was negative, and the infection had cleared on its own, could it have caused a urethral stricture due to the ejaculation problems that im having.
4. should i retest in case of a false negative due to performing the urine test in the afternoon as opposed to first urination of the morning?
5. how prominent are urethral strictures in mild untreated gonorrhea cases?

6 Responses
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300980 tn?1194929400
MEDICAL PROFESSIONAL
If you had the infection and it cleared on its own your test would not be positve but you would not be infected either.  The possibility that you had an infection from the low risk encounter you described, that it caused your ejaculatory difficultires and then cleared itself is zero.  No change in my assessment or advice.  EWH
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Avatar universal
OK.. will do.. so if infected and left untreated, the test would be positive for a long standing time regardless if it had cleared on its own or not?

That's the last question.

Thanks again Doc!
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300980 tn?1194929400
MEDICAL PROFESSIONAL
No, other than having taken antibiotics which might have cured an infection, there really are no recognized causes for false negative NAATs for gonorrhea or for chlamydial infection.  As I said before, you should beleive these test results and look for another cause.  EWH
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Avatar universal
sorry doc I meant false negative not false positive
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Avatar universal
Thanks doc,

Im relying on my test results and will visit a urologist.  however, would there be anything that would make the test false positive? Like time of urination between the voiding of urine before the specimin sample? Also, could it have cleared within the 8 weeks thus causing a negative result? as I had stated before I have never experienced these ejaculation difficulties before and am currently not on any medication.  
Helpful - 0
300980 tn?1194929400
MEDICAL PROFESSIONAL
Welcome to the Forum.  I'll try to help.  The exposures you describe are unlikely to have given you gonorrhea or other STD.  High risk or not, condom protected sex is safe sex, making infection most unlikely.  Further, as far as ejaculation is concerned, the situation you describe does not bring to mind any STD, particularly with negative tests.  Your 8 week test results provide virtually definitive evidence that you do not have gonorrhea or other STDs as the cause of your discharge.  Problems with delayed or failure of ejaculation can be due to many causes including medications.  My sense is that these problems have been present a while and may even be progressing.  If so, I would suggest that you seek evaluation by a urologist.

With regard to your specific questions:
1. Was 8 weeks after exposure too long to have a gon test done.  It was NAAT with urine.
No, if you had gonorrhea, the test would be positive.  The NAATs are the most reliable tests for gonorrhea ever,

2. How long will discharge last.  Is it continuos for days or can it be a one time discharge.
The discharge of gonorrhea can be continuous.  It would be quite unusual for gonorrhea to cause a discharge at a single time than then not more.

3. If the test was negative, and the infection had cleared on its own, could it have caused a urethral stricture due to the ejaculation problems that im having.
Urethral strictures are quite unusual and when they occur it is typically because of prolonged inflammation which you have not experienced.

4. should i retest in case of a false negative due to performing the urine test in the afternoon as opposed to first urination of the morning?
No, I would have confidence in your test results.

5. how prominent are urethral strictures in mild untreated gonorrhea cases?
In this day urethral strictures are a most uncommon complication of gonorrhea.  I suspect your ejaculatory difficulties are not due to gonorrhea that went unnoticed.

I hope my comments are helpful.  EWH
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