Urine Tests and Concerns About STDs

Q: Urine Tests and Concerns About STDs

Hello： 1) Not necessarily, but was your gonorrhea last year transmitted through unsafe sexual practices? What was the process for confirming the gonorrhea diagnosis? 2) Such tests can only serve as a reference; regardless of whether the result is positive or negative, multiple te

Urinalysis and Questions about Sexually Transmitted Infections (STIs)

Hello, doctor.
I visited the urology department on March 17 due to chronic prostatitis.
Later, I checked my test results on the National Health Insurance app, and while my white blood cell count was normal, the bacteria count was 19.8.
I provided a midstream urine sample, and the doctor informed me that there was no significant infection, and I was prescribed anti-inflammatory and pain relief medication.
During a previous follow-up, I asked my attending physician if my condition could be due to an unresolved gonorrhea infection from January of last year, but the doctor assured me that I had been effectively treated with a single dose of ceftriaxone (1g) and did not require another injection.

1.
Could this be chronic gonorrhea?
2.
I had a retest for chlamydia and gonorrhea DNA in December of last year, and both results were negative.
If it were indeed chronic gonorrhea, would it still be detectable?

Xiao Ming, 10~19 year old female. Ask Date: 2021/03/25

Dr. Du Shixi reply Urology

Hello: 1) Not necessarily, but was your gonorrhea last year transmitted through unsafe sexual practices? What was the process for confirming the gonorrhea diagnosis? 2) Such tests can only serve as a reference; regardless of whether the result is positive or negative, multiple tests should be conducted.
If there are any concerns, it may be necessary to visit a specialized clinic or a large hospital for further examination.
Wishing you good health.

Reply Date: 2021/03/25

More Info

When interpreting urine tests and addressing concerns about sexually transmitted diseases (STDs), it's essential to understand the context of your symptoms and the results of your tests. Based on your inquiry, you have been experiencing chronic prostatitis and have had a urine test that showed a high bacterial count, yet your doctor indicated that there was no clear infection. Let's break down your questions and provide some clarity.

1. Could this be chronic gonorrhea?
Chronic gonorrhea is a rare condition, especially if you have been treated effectively with ceftriaxone, which is a potent antibiotic for gonorrhea. The fact that your doctor has assessed your symptoms and test results and concluded that there is no significant infection suggests that the bacteria detected might not be causing an active infection. It's important to note that some bacteria can be present in the urine without causing an infection, especially if they are part of the normal flora or if there is a low-grade infection that does not produce significant symptoms. Chronic prostatitis can sometimes mimic the symptoms of an STD, but it is often due to non-infectious causes or other types of infections that are not sexually transmitted.

2. If it were chronic gonorrhea, would it still be detectable?
If you had chronic gonorrhea, it would typically be detectable through specific tests, including urine tests for gonorrhea DNA or culture tests. Since you mentioned that you had negative results for both chlamydia and gonorrhea DNA tests in December, it is unlikely that you have a chronic infection. Gonorrhea can sometimes be difficult to detect if the infection is very low-grade or if the bacteria are not actively replicating, but given your recent negative tests, it is more plausible that you do not have an ongoing gonococcal infection.

Additional Considerations:
- Chronic Prostatitis: This condition can be caused by various factors, including inflammation, pelvic floor dysfunction, or non-bacterial causes. It’s essential to follow up with your urologist for further evaluation and management, especially if your symptoms persist.

- Urine Test Interpretation: A bacterial count of 19.8 in the context of normal white blood cell counts may suggest contamination or the presence of non-pathogenic bacteria. It’s crucial to interpret these results in conjunction with clinical symptoms and other diagnostic findings.

- Follow-Up Testing: If you have ongoing concerns about STDs, it may be worthwhile to discuss with your healthcare provider the possibility of retesting or exploring additional tests that can provide more definitive answers regarding your sexual health.

Recommendations:
- Consult Your Urologist: Given your history and current symptoms, it’s advisable to have a thorough discussion with your urologist about your concerns regarding chronic prostatitis and the possibility of any underlying infections.

- Monitor Symptoms: Keep track of any changes in your symptoms, including pain, urinary frequency, or any new symptoms that may arise. This information can be helpful for your healthcare provider in determining the next steps.

- Lifestyle Considerations: Maintaining a healthy lifestyle, including hydration, a balanced diet, and avoiding irritants (like caffeine and alcohol), can help manage prostatitis symptoms.

In conclusion, while your concerns about chronic gonorrhea are understandable, the evidence from your tests and the clinical assessment by your doctor suggests that you may not have an active infection. Continuing to work closely with your healthcare provider will be key to managing your symptoms and ensuring your overall health.

Similar Q&A

Understanding STD Risks and Testing After Safe Sex Practices

Hello, Doctor! I engaged in sexual activity on April 11, using a condom throughout (which did not break). However, I only had oral sex with a condom and touched the other person's genitals (my hands had no visible wounds). I have been feeling anxious after researching online...

Dr. Xu Weikai reply Urology
Anonymous: Hello, sexually transmitted infections (STIs) are generally transmitted through bodily fluids or direct physical contact. Most STIs, such as gonorrhea and urethritis, have specific symptoms; however, some, like HIV, have less obvious symptoms and require blood tests fo...

Understanding STD Testing and Diagnosis: Key Questions Answered

Hello, Doctor: I visited a urology clinic today for a sexually transmitted infection (STI) screening, which included blood tests and a urine test. The results are not yet available. I also had a consultation with the clinic's physician, who examined my genital area and noted...

Dr. Sun Hongshun reply Urology
Hello, your questions are generally addressed as follows: 1. Without a personal examination, a diagnosis cannot be made. Please respect the professionalism of all qualified physicians. 2. In addition to urine and blood tests, bacterial and microbial cultures may also be necessary...

Understanding Urinary Issues: Symptoms and Testing Recommendations

Hello, Doctor. 1. Last Friday afternoon, I suddenly felt an itch and a strong urge to urinate, but I didn't have much urine. However, I haven't experienced these symptoms in the past few days. What could this be? 2. It has been two years since my last sexual encounte...

Dr. Li Xinyi reply Urology
The symptoms you described could potentially be a urinary tract infection, neuropathic pain, or the passage of small stones. Based on your description, it seems you are particularly concerned about persistent urethritis, which is certainly a possibility. However, it is advisable ...

Are Lab Test Results Reliable for Urological Issues?

Hello, doctor. I have a question I would like to ask you. Twenty years ago, I had urethritis. After taking medication, I improved, but occasionally I experience itching under the foreskin, which resolves after I rub it a bit. At that time, I underwent testing, and the results wer...

Dr. Li Yilun reply Urology
The physician's diagnosis of a condition must rely on the patient's presentation, physical examination, and clinical experience. With advancements in technology, diagnostic tests such as blood tests, urine tests, semen analysis, or specialized imaging studies can assist...