Onset of infection symptoms in urethra

Patient

Q: Can Chlamydia, Gonorrhea, or other bacterial infection symptoms start to show in the urethra within a few hours of infection? 6 weeks ago I was treated for urethritis (Chlamydia and Gonorrhea tested negative via a NAAT before and after treatment, so cause unknown). I refrained from having sex for about 6 weeks and recently had sexual intercourse for the first time since my treatment began. My urethra started to feel a bit tingly soon after the sex and now that it has been over 24 hours, I still have the same feeling. I am afraid that this might be the onset of infection again. Could symptoms start to show this quickly after sex or could this just be a sign of my urethra being strained and sore from the previous infection?

Symptoms:  Tingling at urethra tip
Doctor

A:   Hello,
Thanks for contacting askthedoctor.com for an opinion.

Chlamydia and gonorrhea are transmitted through vaginal, anal or oral sexual contact. Though oral sex is otherwise considered safe with respect to transmission of sexually transmitted diseases but if a person who is not infective gives an oral sex to a person harboring chlamydia infection and then after contracting the infection has oral sex with another partner , then he/ she can transmit these STIs to the third person. The incidence is around 25-30% in the world and have been an accepted route of transfer.

Specifically, oral gonorrhea (also termed pharyngeal gonorrhea) is defined as an STD infection of the pharynx with Gram-negative coccal-shaped (round) bacteria named Neisseria gonorrhoeae. Infection is acquired from direct contact with white/yellowish pus-like fluid containing N. gonorrhoeae (also termed discharge or exudates) in one sex partner. This discharge is caused by N. gonorrhoeae. It mixes with a person's vaginal fluids, seminal fluids, or mucus membranes near the anus and rectum that come in contact with another person's oral mucus membranes. The bacterial infection then establishes itself in the pharynx and may be asymptomatic (cause no symptoms), but can cause symptoms of sore throat and discomfort when swallowing food. The affected throat resembles a strep throat with redness and occasionally may have some white spots or whitish/yellow discharge.

Men may have mild burning with urination and may notice a yellow to gray penile discharge with or without testicular pain. Symptoms may resolve without treatment even though the infection is still present. Examination is recommended for symptoms of discharge or pain and burning with urination even if the symptoms have spontaneously resolved. Gonorrhea symptoms may develop within 2-10 days, but symptoms may take up to 30 days before they appear, while chlamydia symptoms may occur 7-21 days after exposure.

So, considering that you have all the symptoms of a urinary tract infection with burning micturition , cloudy urine and weak flow and a possible lower abdominal and lower back pain as well, it would be wise to get a urine culture and a urethral swab culture be done to isolate the possible causative organisms which may be chlamydia with concomitant gonorrheal infection, though other organisms like e.coli, mycoplasma and ureoplasma can also cause UTI.Hence depending on the culture report and isolation, your physician may place you on antibiotics for a week . It is important that you complete the course of treatment and avoid any sexual activity till you complete your course and rendered free from infection.
I hope i have answered your query in detail,
wishing you good health,
regards

Comments / Follow Ups

Patient: Yes thank you. However, my main concern is the onset of the tingling feeling I am having at the urethra tip. I am not having burning urination or discharge. Can symptoms start to show within a few hours of infection?
Patient: Or can my urethra still be a bit sore from a previous infection weeks ago?
Doctor: it starts within 24 hrs in cases of recurrent infections which it seems to be now.
regards
Patient: Does recurrent refer to not being treated fully with antibiotics or being exposed to the same bacteria and being re-infected?
Doctor: Recurrence means repeat infection after the course on antibiotics have treated it fully once.
regards

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