Genital piercing in association with gonorrhoea, chlamydia and warts

A 26-year-old heterosexual man presented with urethral discharge and penile oedema, two days after having a Reverse Prince Albert penile ring replaced. Clinically, he also had genital warts at the piercing tract openings. Investigations revealed positive chlamydial and gonococcal infection of the urethra. The gonococcal isolate was found to be highly resistant to antibiotics and the genotype matched an isolate only once previously recorded in the international database. We discuss how the genital piercing might have affected this patient's multiple infections, the possible contribution of genital piercing to the penile oedema, as well as potential anatomical spread of warts associated with a genital piercing.