Gonorrhea Test in Kathmandu — NAAT on Site-Matched Specimens ~85–90% of Extragenital Infection Is Off What Urine Can See

Gonorrhea — the Infection Urine Testing Mostly Misses

Gonorrhea testing has a specific accuracy problem: urine NAAT — commonest offered test — covers only urethral infection; ~85–90% of extragenital (throat and rectal) gonorrhea is outside what urine can see. A patient whose exposure included oral or anal sex gets a urine "negative" that does not address infection that may be present.

The correct test is site-matched NAAT: first-catch urine for urethral exposure, throat swab for oral-sex exposure, rectal swab for anal-sex exposure — each specimen covering its site at ~95% sensitivity.

The infection is curable with ceftriaxone-based therapy — drug choice matters for resistance landscape — and untreated it produces the PID and fertility consequences that make correct testing worth doing.

The Specimens — Matched to the Exposure

The specimen determines coverage: first-catch urine detects urethral gonorrhea; a throat swab detects pharyngeal; a rectal swab detects rectal. ~85–90% of extragenital infections are at throat or rectum — sites urine test cannot see.

The commonest testing error is urine-only where exposure included oral or anal sex — a "negative" covering only urethra while infection sits at another site. The consultation selects specimens to match exposure.

The ~1–2 Week Window

Gonorrhea NAAT is reliable from ~1–2 weeks post-exposure — earlier, organism may not have reached detectable levels and negative is inconclusive. For a specific recent exposure, timing is discussed rather than reflexively testing too early.

Symptoms where present appear ~1–2 weeks after — urethral discharge and burning in men (more often symptomatic than chlamydia), abnormal discharge and bleeding in women, proctitis at rectal site, mostly silent pharyngitis at throat.

Treatment — Curable, Resistance-Aware

Gonorrhea is curable — ceftriaxone-based therapy, chosen for resistance landscape ( organism has developed resistance to most prior first-line drugs; ceftriaxone remains correct choice, with dose adjusted) — treatment at same visit where positive.

Partner management is essential — partners tested site-matched and treated; untreated partner is commonest reinfection source. Pharyngeal gonorrhea gets a test-of-cure at ~1–2 weeks because clearance at that site is less certain.

Broader Screening Alongside

A gonorrhea test in a patient with a relevant exposure is a prompt for broader screen: chlamydia is co-tested (usually a combined NAAT — organisms travel together), HIV 4th-gen and syphilis serology are added where exposure warrants, and hepatitis where indicated.

The exposure that produced gonorrhea exposure may have carried others — complete screen is honest response to a single-infection question.

Gonorrhea Testing & Costs

Transparent pricing; confirm when booking.

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