Gonorrhea Testing and Persistent Urethral Symptoms

Q: Gonorrhea Testing and Persistent Urethral Symptoms

Hello： If multiple tests are normal, it may not be due to an infection. <br>It is recommended to consult a medical center for further evaluation, as there may also be issues with urinary function. <br>Wishing you good health.

Gonorrhea testing

Hello doctor, I was infected with gonorrhea at the beginning of the year.
After two weeks of injection and medication treatment, most of the symptoms have disappeared, but there is still a patch of alopecia on the inner wall of the urethral opening, causing mild pain and discomfort.
It has been almost six months without worsening, but there has been slight improvement in the area.
During this period, I have visited multiple hospitals for urine tests, and there were no significant inflammatory responses.
In May, I had urine and blood tests for gonorrhea DNA and Chlamydia RNA, both of which were negative, as were other related sexually transmitted infections.
Can I conclude that urinary tract inflammation and other sexually transmitted infections can be ruled out? Additionally, could there be other factors causing the redness and swelling at the urethral opening? It is quite bothersome, as there is a mild stinging sensation, and I also experience a frequent urge to urinate due to bladder irritation.

Alex LO, 40~49 year old female. Ask Date: 2022/06/12

Dr. Du Shixi reply Urology

Hello: If multiple tests are normal, it may not be due to an infection.
It is recommended to consult a medical center for further evaluation, as there may also be issues with urinary function.
Wishing you good health.

Reply Date: 2022/06/12

More Info

Gonorrhea, caused by the bacterium Neisseria gonorrhoeae, is a sexually transmitted infection (STI) that can lead to various symptoms, particularly in the urogenital tract. After undergoing treatment for gonorrhea, it is not uncommon for some individuals to experience lingering symptoms, such as discomfort or changes in the urethra, even after the infection has been cleared. In your case, it appears that you have received appropriate treatment, and follow-up tests for gonorrhea and other STIs have returned negative results. This is a positive indication that the initial infection has been resolved.

The presence of a patch of redness or irritation at the urethral opening, along with mild pain and discomfort, can be attributed to several factors, even after the resolution of the gonorrhea infection. Here are some potential causes to consider:
1. Post-Infectious Inflammation: After an infection, it is possible for the tissues to remain inflamed for some time. This post-infectious inflammation can lead to discomfort and changes in the urethral lining, which may take weeks or even months to fully resolve.

2. Irritation or Trauma: The urethra is sensitive, and any form of irritation—whether from sexual activity, vigorous cleaning, or the use of irritating soaps or hygiene products—can lead to localized inflammation. If you have been experiencing frequent urination, this could also contribute to irritation.

3. Urethral Stricture: Although less common, a narrowing of the urethra (urethral stricture) can occur after an infection or injury, leading to symptoms such as pain, difficulty urinating, or a feeling of urgency. This condition would typically require further evaluation by a urologist.

4. Non-Infectious Urethritis: This condition can occur due to various non-infectious factors, such as chemical irritants, allergies, or even autoimmune conditions. It can present with similar symptoms to those caused by infections.

5. Psychological Factors: Anxiety and stress related to past infections or sexual health can sometimes manifest as physical symptoms, including discomfort in the genital area.
Given that you have had multiple tests that returned negative results for infections, it is reasonable to consider these other factors. However, if the symptoms persist or worsen, it is advisable to seek further evaluation from a healthcare provider, preferably a urologist. They may recommend additional diagnostic tests, such as a cystoscopy, to visually inspect the urethra and bladder for any abnormalities.

In the meantime, consider the following self-care measures:
- Avoid Irritants: Steer clear of harsh soaps, lotions, or other products that may irritate the genital area.

- Stay Hydrated: Drinking plenty of water can help dilute urine and reduce irritation during urination.

- Warm Compresses: Applying a warm compress to the area may help alleviate discomfort.

- Monitor Symptoms: Keep track of any changes in symptoms, including the frequency of urination, pain levels, and any new developments.

In conclusion, while it is reassuring that your tests for gonorrhea and other STIs have returned negative, the symptoms you are experiencing may be due to post-infectious inflammation or other non-infectious causes. Continued monitoring and consultation with a healthcare provider will be essential in addressing your concerns and ensuring your overall urogenital health.

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