Diagnostic treatment and reporting criteria for gonorrhoea in sexually transmitted disease clinics in England and Wales. 1: Diagnosis.

The current methods used in the diagnosis of gonorrhoea are reported. The sites sampled in symptomatic patients who were not gonorrhoea contacts and those sampled in symptomless contacts are described. Urethral specimens were taken routinely from all male heterosexual and active homosexual patients with a urethral discharge but in only 81% and 82% respectively of these patients if they were symptomless gonorrhoea contacts. Not all consultants would repeat investigations (smear and/or cultures) in gonorrhoea contacts if the initial ones were negative; heterosexual male and active homosexual patients were less likely to be seen again. Smears and cultures were performed routinely on women in 97% of clinics, but for men this was so in only 81% of clinics. The wider use of cultures for men, the policy with regard to the taking of urethral specimens from asymptomatic male heterosexual and active homosexual patients who are gonorrhoea contacts, and the number of diagnostic investigations required are discussed.