Which Sexually Transmitted Diseases (STDs) require a urethral sample?

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From the Guidelines

Gonorrhea and Chlamydia are the two Sexually Transmitted Diseases (STDs) that require a urethral sample for diagnosis.

Urethral Sample Collection

  • A urethral swab or smear can be used to collect a sample for diagnosis of gonorrhea and chlamydia 1.
  • Nucleic acid amplification tests (NAATs) are the recommended diagnostic tests for gonorrhea and chlamydia, and can be performed on urethral swab or urine samples 1.
  • For gonorrhea, a urethral swab culture can be performed to assess the antimicrobial resistance profile of the infective strain 1.

Important Considerations

  • The use of NAATs for diagnosis of gonorrhea and chlamydia has several advantages, including high sensitivity and specificity, and the ability to use urine samples, which can reduce the need for invasive urethral swabbing 1.
  • However, the use of NAATs also has some limitations, including the potential for false-positive results, and the need for confirmatory testing in some cases 1.
  • The collection of urethral samples should be performed in accordance with established guidelines and protocols, and should take into account the patient's symptoms, medical history, and other relevant factors 1.

From the Research

Sexually Transmitted Diseases Requiring a Urethral Sample

The following STDs require a urethral sample for diagnosis:

  • Chlamydia trachomatis 2, 3, 4, 5, 6
  • Neisseria gonorrhoeae 2, 3, 5
  • Human papillomavirus (HPV) 3
  • Herpes simplex virus infection 3
  • Candidiasis 3
  • Trichomoniasis 3

Alternative Specimens for STD Diagnosis

In some cases, alternative specimens can be used for STD diagnosis, including:

  • Urine samples for Chlamydia trachomatis and Neisseria gonorrhoeae detection 2, 4, 5
  • Seminal fluid for Chlamydia trachomatis detection 6
  • Expressed prostatic secretion for Chlamydia trachomatis detection 6

Urethral Sample Collection Methods

Urethral samples can be collected using various methods, including:

  • Urethral swabbing 2, 3, 4, 5
  • Urethral cytology 3
  • First-catch urine sediment culture 5

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

Urine as a specimen for diagnosis of sexually transmitted diseases.

The American journal of medicine, 1983

Research

Comparison of urine with urethral swabs for the detection of Chlamydia trachomatis in men attending an STD clinic.

South African medical journal = Suid-Afrikaanse tydskrif vir geneeskunde, 1995

Research

First catch urine sediment for Chlamydia trachomatis and Neisseria gonorrhoeae culture in adolescent males with pyuria.

The Journal of adolescent health : official publication of the Society for Adolescent Medicine, 1991

Research

Is seminal fluid a suitable specimen for detecting chlamydial infection in men?

Acta microbiologica et immunologica Hungarica, 1995

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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