Fluid from the urethra is collected on a cotton swab. A sample from this swab is applied in a very thin layer to a microscope slide. A series of stains called a Gram stain is applied to the specimen.

The stained smear is then examined under the microscope for the presence of bacteria. The color, size, and shape of the cells help identify the type of bacteria causing the infection.

This test is often performed in the health care provider's office.

You may feel pressure or burning when the cotton swab touches the urethra.

The test is performed when an abnormal urethral discharge is present. It may be performed if a sexually transmitted infection is suspected.

Normal value ranges may vary slightly among different laboratories. Some labs use different measurements or test different samples. Talk to your provider about the meaning of your specific test results.

Abnormal results may indicate gonorrhea or other infections.

There are no risks.

A culture of the specimen (urethral discharge culture) should be performed in addition to the Gram stain. More advanced tests (such as polymerase chain reaction [PCR] tests) may also be done.

Urethral discharge Gram stain; Urethritis - Gram stain

Babu TM, Urban MA, Augenbraun MH. Urethritis. In: Bennett JE, Dolin R, Blaser MJ, eds. Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases. 9th ed. Philadelphia, PA: Elsevier; 2020:chap 107.

Swygard H, Cohen MS. Approach to the patient with a sexually transmitted infection. In: Goldman L, Cooney KA, eds. Goldman-Cecil Medicine. 27th ed. Philadelphia, PA: Elsevier; 2024:chap 264. 

Updated by: Linda J. Vorvick, MD, Clinical Professor, Department of Family Medicine, UW Medicine, School of Medicine, University of Washington, Seattle, WA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.