Alternative Names gonococcal urethritis, urethritis , clap disease, the clap
Definition Gonorrhoea (gon-or-ee-ah) is a bacterial infection of the urethra, the tube through which urine and semen are released from a man's body. It is caused by bacteria called Neisseria (nye-sear-ee-ah) gonorrhoea. The infection usually begins in the genital area, but may spread to the blood, bones, heart valves, and other sites.
What is going on in the body? A man gets gonorrhoea through sex with an infected partner. The risk of a man getting gonorrhoea after having sex once with an infected partner is 15% to 20%. As the number of sexual contacts increases, the risk rises. A man can also get gonorrhoea from oral or anal sex.
What are the signs and symptoms of the infection? About 50% of men with gonorrhoea have no symptoms.
Symptoms of gonorrhoea can include:
discharge of pus from the penis
painful urination
Sometimes the man will have very little discharge. Some men have no discharge at all.
What are the causes and risks of the infection? A man gets gonorrhoea from contact with an infected partner. The risk of getting gonorrhoea rises as the number of contacts with an infected partner increases.
What can be done to prevent the infection? Avoiding sexual contact or only having sex with an uninfected partner can prevent gonorrhoea. Condoms are helpful in preventing the spread of gonorrhoea.
How is the infection diagnosed? Gonorrhoea is suspected when a man has a discharge from the penis and painful urination. Samples of the discharge are taken from inside the penis with a small swab. This should be done several hours after urination. Material on the swab is sent to a laboratory to be cultured or to undergo an antigen analysis which test for chemicals produced by the bacteria. The sample can also be checked under a microscope in a doctor's office.
What are the long-term effects of the infection? Left untreated, gonorrhoea can cause a narrowing of the urethra in men.
Gonorrhoea causes serious problems for women. It is one of the most common causes of pelvic inflammatory disease (PID). PID is a severe infection of the reproductive organs in women. PID can lead to:
the inability to get pregnant
ectopic pregnancy, in which the foetus is growing in the fallopian tubes or abdomen, rather than in the uterus
abdominal pain
What are the risks to others? A man with untreated gonorrhoea can give the disease to any sexual partner. Many people with gonorrhoea also have other sexually transmitted diseases (STDs), such as chlamydia and syphilis, which they can give to sexual partners.
What are the treatments for the infection? Most cases of gonorrhoea can be treated with a single Injection of an antibiotic, such as ceftriaxone. It is also recommended that infected persons take oral antibiotics, such as penicillin, ceftriaxone or ciprofloxacin.
What are the side effects of the treatments? Side effects of treatment may include an allergic reaction to the medication. Antibiotics taken by mouth might cause stomach irritation or skin sensitivity to light.
What happens after treatment for the infection? The discharge and discomfort of gonorrhoea may take a while to stop, even with treatment. A man can quickly be reinfected if he engages in sex with a partner who has not been treated. The infection may never clear due to resistance of the infection to the antibiotics.
Some men treated for gonorrhoea really have idiopathic (id-eo-path-ic) urethritis. This means that the cause of the urethritis is unknown. Idiopathic urethritis causes 10% to 15% of cases of male urethritis. Idiopathic urethritis is not contagious. Symptoms usually go away with time.
How is the infection monitored? Follow up with a doctor or is not necessary if symptoms go away. Any sexual partners of the person should get treatment at the same time. Unprotected sexual activity should not occur until both partners have been cured.
Gonorrhoea must be reported to public health authorities by the doctor so that public health measures designed to prevent spread of this sexually transmitted disease can be initiated.
Author: Stuart Wolf, MD Reviewer: HealthAnswers Australia Medical Review Panel Editor: Dr David Taylor, Chief Medical Officer HealthAnswers Australia Last Updated: 1/10/2001 Contributors Potential conflict of interest information for reviewers available on request
