Men: "What should I do before I see the doctor?"

Telephone first, to make sure that the clinic is open at a time convenient to you.

Find out whether an appointment is necessary.

Don’t wash your genital area or pass water for at least 3 hours before seeing the doctor. Otherwise you might flush away the germs and make it difficult for the clinic to find out what is causing the problem.

"What happens when I see the doctor?"

Let’s assume that you are visiting a specialist or a sexual health clinic in the UK. In other countries the circumstances may be different, but the same basic principles probably apply.

You are first likely to be shown into a waiting room.

Initially you will be seen by a nurse, health adviser or doctor and asked some questions about your general and sexual health. This will include questions about your sexual activities, whether with a man, woman or both etc. You may find these questions embarrassing, but it is important that you answer their questions honestly to help staff find out which tests you need. The person asking the questions is only interested in finding out what may be relevant to your health. They are obliged to keep the information that you provide confidential.

You will then be asked to take your trousers down so that you can be examined. The doctor could be a male or a female doctor, and it is possible that a nurse will be present. You may be embarrassed at having a detailed personal examination or worried that you may have an erection. However, specialist clinics are doing such examinations all the time. They simply want to find out if there is a problem. It is unlikely that you will have an erection.

The doctor will first examine you generally, looking for any rashes, swollen glands, etc. With your permission a small blood sample will be taken for testing for syphilis (usually routine for all patients) and possibly also for hepatitis B and C. Any tests to be performed and samples to be collected should be explained to you in order to obtain your proper consent. An HIV test, if considered necessary, should only be performed after counselling and with your specific permission.

The doctor will first feel your balls (testicles) and the fine tube going from them to make sure they are not inflamed. If you are uncircumcised, your foreskin will be retracted and the head of your penis and the region behind examined for any signs of soreness or ulcers. The doctor will see if any  discharge is present. Any discharge  will be collected for testing.  You will be asked to provide a sample of urine. A very fine cotton bud (swab) will then be inserted about 2 centimetres into your urethra (water passage). This lasts only a moment and may be momentarily uncomfortable. The whole examination usually takes from 5 to 10 minutes, after which you will be asked to wait a short while.

At a specialist clinic, there will be technicians or trained nurses available to immediately carry out some rapid tests on the specimens collected. Other tests may have to be sent to a specialist laboratory, with the results available after around a week. In some countries / regions of the world specialist tests for Chlamydia and some other STIs may not be available. In that situation the health practitioner will be relying on personal experience and local knowledge.

Once the preliminary tests have been performed, the doctor will have come to some preliminary conclusions and will tell you in private what he thinks is the matter (if anything) and what treatment is necessary. This is your opportunity to ask the doctor any questions that concern you. If the doctor believes that you have an STI and that your partner may have been at risk, you will be asked to request your partner to attend the clinic, so that you both may be treated. The clinic will usually suggest a tactful way of doing this.

If you think it is going to be too difficult to tell your partner, for example if it was a casual sex partner, many specialists  provide a "contact slip". You send or give this to the person concerned, or ask the doctor or nurse to do it for you.

The contact slip explains that the person concerned may have been exposed to sexually transmitted infection and suggests that they make an appointment with a doctor or clinic for a check-up. Your identity and infection are not disclosed.

Treatment is normally given immediately. However, it is likely you will be asked to come back in two to three weeks and meanwhile to abstain from sex.

On leaving the clinic you are likely to be glad it’s over but also glad that you went. You will probably have gained some peace of mind in addition to any expert treatment and advice.

On the second visit the results of the more detailed laboratory tests will be available and the doctor will be able to assess whether treatment has succeeded. On this second visit, a genital examination may be un-necessary, depending on what was initially found.

"Will my general practitioner or physician be told?"

"Are there alternatives to a urethral swab?"