Gonorrhoea in men: clinical and diagnostic aspects

Genitourin Med. 1996 Dec;72(6):422-6. doi: 10.1136/sti.72.6.422.


Aim: To review the features of gonococcal infection in men in the 1990s.

Methods: A retrospective study of all men with gonorrhoea presenting to an inner city department of genitourinary medicine in the years 1990 to 1992.

Results: 1749 cases of gonorrhoea were seen in 1382 men. A high incidence of gonorrhoea was found in attenders of African or Caribbean extraction. In 228 men with a known date of infection, the incubation period, a mean of 8.3 days, was longer than previously described. The mean infectious period was 12.0 days. By 14 days 86.2% of men had developed symptoms. Of 1615 men with urethral infection 81.9% complained of discharge, while dysuria occurred in 52.8%. Discharge with dysuria were present in only 48.1% of patients. In 10.2% episodes of urethral infection the patients had no symptoms referable to their gonorrhoea. Urethral gonorrhoea was diagnosed by microscopy in 94.4% of symptomatic men and in only 81.1% of asymptomatic men. Microscopy of rectal samples were positive in 46.4% of cases. In this population, a dose of 2 g of ampicillin with 1 g of probenecid gave a high cure rate of gonorrhoea as long as infection was not due to penicillinase-producing organisms.

Conclusions: These data suggest that the incubation and infectious period of urethral gonorrhoea has increased compared with previous studies and that symptoms have altered. Only 48.1% of men described the classical symptoms of discharge with dysuria. Microscopy of urethral smears remains useful in symptomatic men but is less sensitive in those without symptoms.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Ampicillin / therapeutic use
  • Anti-Bacterial Agents / therapeutic use
  • Chlamydia Infections / complications
  • Chlamydia trachomatis
  • Drug Resistance, Microbial
  • Drug Therapy, Combination
  • Gonorrhea / complications
  • Gonorrhea / diagnosis*
  • Gonorrhea / drug therapy
  • Gonorrhea / ethnology
  • HIV Infections / complications
  • Humans
  • Male
  • Middle Aged
  • Probenecid / therapeutic use
  • Rectal Diseases / microbiology
  • Retrospective Studies
  • Sexual Behavior
  • Travel
  • Treatment Outcome
  • Urethral Diseases / microbiology
  • Uricosuric Agents / therapeutic use


  • Anti-Bacterial Agents
  • Uricosuric Agents
  • Ampicillin
  • Probenecid