Gonorrhea in men

Overview

Gonorrhea is a sexually transmitted bacterial infection of the mucus membranes due to Neisseria gonorrhea. The bacteria are spread via sexual contacts with asymptomatic carriers/ill individuals. Incubation period lasts for 2-7 days. Typically, an infected man develops urethritis that manifests with dysuria and purulent discharge from the penis, although in many cases the disease remains asymptomatic and men continue to infect the others by continuing their sexually active lifestyle. If untreated, a person may eventually develop infection complications or infertility.

Bacterium

Neisseria gonorrhea are kidney-shaped aerobic bacteria which appear as Diplococcus – as they group in pairs with the adjacent sites concave.   

Risk factors                                  

  • Having unprotected vaginal, anal, or oral sexual intercourse;
  • Having multiple sexual partners;

Symptoms

Diagnosis Gonorrhea.

Usually gonorrhea in men manifests as acute urethritis (inflammation of the urethra).

  • Yellow, white or green (purulent) urethral discharge from the tip of the penis. In the beginning there is only a small amount of white/transparent discharge, although later within 1 or 2 days;
  • Pain or burning feeling while voiding (dysuria);
  • Swelling of the foreskin or the testicle (usually only one testicle is involved);

Chronic urethritis leads to the stricture formation – narrowing of the urethra which is characterized by the abnormal/decreased urine stream.  

Unprotected anal sex may lead to rectal gonorrhea characterized by:

  • Pain;
  • Itching;
  • Purulent discharge;
  • Sometimes rectal bleeding;
  • Tenesmus;

A lot of men with gonorrhea remain asymptomatic and, respectively, do not get the appropriate treatment, furthermore, they continue spreading infection further by infecting their sexual partners.

Sometimes Neisseria gonorrhea can affect the pharynx and cause pharyngitis (the disease is associated with unprotected oral sexual intercourse). Redness, itching and discharge of the eyes is suggestive of the gonorrhea in the eyes.

Complications

  • Epididymitis is a common complication of the gonococcal infection, usually inflammation of the epididymis is observed only one side;
  • Prostatits nowadays occurs rarely;
  • Penile edema occasionally develops;
  • Periurthral abscesses, abscesses of Cowper’s gland;
  • Seminal vesiculitis;
  • Balanitis may occur in uncircumcised men;

Diagnosis

Nowadays making a diagnosis of gonorrhea is not so difficult, the following tests may be used to obtain the diagnosis:

  • Samples of the urine or the swabs from the site of infection (penis, rectum, throat) to examine the bacterial cultures;
  • Detection of the antigens in the urethral swabs;
  • DNA testing (PCR) to detect bacterial DNA;

Treatment

Gonococcal infection should be treated with antibiotics. Single-dose of 2 antibiotics is usually enough for uncomplicated disease. The earlier the treatment is initiated, the better outcomes are.

Applicable medicines

  • Ceftriaxone 250 mg single intramuscular injection plus
  • Azythromycin 1 g taken by mouth;

Prevention

  • Having one healthy sexual partner who was tested for sexually-transmitted diseases;
  • The latex condoms should be used the right way as the wrong technique increases risk of infection;
  • As there are also asymptomatic cases of infection, it is recommended for every sexually active person to get tested for sexually transmitted infections and if necessary initiate treatment as soon as possible;
  • To prevent further spreading of the disease an infected person should abstain from sex for at least a week after the end of treatment;