Are Genitourinary infections all sexually transmitted?
Posted by admin on September 11, 2015
1. Primary infections, which due to pathogenic sexually transmitted microorganism. Sexually transmitted pathogens include parasites (Trichomonas vaginalis), bacteria (Treponema pallidum, Neisseria gonorrhoeae, Chlamydia trachomatis, Haemophilus ducreyi), and viruses (Herpes simplex virus, human papillomavirus, human immunodeficiency virus).
2. Infections due to members of the resident flora which overgrow to lead to an infection due to the fungus Candida albicans or to members of the endogenous bacterial flora (Bacteroides fragilis and members of the family Enterobacteriaceae) are no Bacterial vaginosis occurs when the balance of vaginal flora is upset.
Urinary Track infections:
Urinary track infections are most common in women than men. Every woman will have at least one urinary track infection in their life.
Cystitis is an infection of the urethra, which causes a bladder inflammation. Most of them are due to bacteria coming from the local flora like E. Coli responsible for 85% of them, or Staphylococcus responsible for 5-10%, and only in a few cases to Chlamydia and Gonorrhoeae, which are sexually transmitted. The urinary tract and urine are normally sterile. Numerous mechanical and biologic processes ensure that microorganisms do not enter the urinary tract. Women are more susceptible to urinary infections because the female urethra is short and because the area around the urethral opening is colonized with potential pathogens. Most of the time the infection is caused by normal flora bacteria: the bacteria come from the digestive system and spread to the urinary track, where they become pathogen.
The main symptom is dysuria with pain, urgency and frequency to urinate, and sometimes pyuria (shallow urines) or hematuria (blood in the urines). Children often don't have urinary track symptoms with only a high fever. Cystitis can cause unexplained fever among young girls. Eldery people also lack urinary track symptoms and can present incontinence, fever, and sometimes a change of behavior and/or confusion.
Diagnostic will be made with urine testing showing a large amount of pathogen bacteria in the urines.
If the infection is not treated on time it can deteriorate with complications, including pyelonephritis, an infection that ascends to kidneys involving renal damage, fever, chills, vomiting, nausea, diarrhea, deep abdominal pain, leukocytosis, and may lead to chronic kidney infection with scarring and fibrosis.
If cystitis is not generally due to sexually transmitted microorganism, sexually active people are at higher risk. Menopause increases the risk too, due to a decrease of the protective vagina flora. Among men a chronic prostatitis increase the risk of developing cystitis. Urinary catheters also increase the risk of urinary track infection.
Oral antibiotics treat urinary track infections. During pregnancy the presence of a urinary track infections should be treated even without presenting symptoms as there is a high risk of kidneys infection. The pyelonephritis is treated more aggressively than the cystitis with intravenous antibiotics, with sometimes hospitalisation. Prevention will include mainly to avoid urethral contamination, urethral flushing, lowering urine PH.
In the vagina there are different types of bacteria. Some are "good bacteria" which help prevent the growth of "bad" bacteria. Sometimes the balance between "good" and "bad" bacteria is broken and can lead to an infection: the vaginosis. Candida and Gardnerella are the most common bacteria responsible for these infections, but it can be due to other bacteria. Bacteria vaginosis is not dangerous but can cause very disturbing symptoms.
The symptoms are:
- Increased vaginal discharge that look thin and grayish white
- Vaginal odor (unpleasant fishy odor)
- Sometimes: Itchiness, Pain, Burning sensations
In front of these symptoms, the doctors may perform a "whiff test" to make the diagnostic. A drop of potassium hydroxide (KOH) is put in contact with the woman's discharge liberating a fishy odor in case of vaginosis.
Bacterial vaginosis is not considered contagious, but an increase of the number of sexual partners increase the risk of infection. However, bacterial vaginosis also occurs among single women. It is not possible to contract bacterial vaginosis from toilet seats, swimming pools, or hot tubs, or touching contaminated objects.
A third of vaginosis will resolve on its own. Treatment will include metronidazole taken orally or vaginally, vaginal Clindamycin cream or Tinidazole.
Prevention includes mainly personal hygiene for prevention of Candida and Gardnerella infections.
Prostatitis is an inflammation of the prostate gland. The prostate is a small gland that lies between the penis and the bladder, which produces a thick white fluid, which, mixed with sperm create the semen. Unlike prostate enlargement and cancer, which mainly occur among old men, prostatitis can affect men of all ages.
- Pain in the pelvis, genitals.
- Pain when urinating,
- A frequent need to pee
- Difficulty urinating with problem to start peeing or problem to "stop-start" peeing.
- Pain when ejaculating, which can lead to erectile dysfunction and decrease of libido.
- In some cases, aching and fever
There are two main types of prostatitis:
Acute Prostatitis: symptoms are severe and sudden. Acute prostatitis is rare and need an immediate treatment. It is usually due to an infection of the urinary track, spreading to the prostate.
Chronic Prostatitis: symptoms come and go over a long period of time. Causes of chronic prostatitis are not clear, and usually no infections can be found.
Diagnostic is made by urine sample analysis and prostate examination by your health practitioner. Sometimes more complicated tests are performed to precise the diagnostic.
Chronic prostatitis is usually treated with painkillers like Ibuprophen. Beta-blockers or antibiotics can also be prescribed in some cases.
Acute prostatitis will be treated with painkillers and two to four weeks of antibiotics. Treatment can be done at a hospital if the pain is too high.
Although Epididymitis is mostly due to Chlamydias or Gonorrhoeae, which are sexually transmitted bacteria, some of them are due to E. Coli or other bacteria responsible for urinary track infection, especially among men over 35 years old in whom Epididymitis is due to urinary track infection.
Epididymitis are classified as acute, sub acute or chronic depending on the duration of the symptoms. It can include:
- Redness, warmth and swelling of the scrotum
- Tenderness behind the testicle
- Sometimes fever.
It can be difficult to distinguish testicular torsion and Epididymitis. The main differentiation is made by the cremastueric reflex, which remains normal in case of Epididymitis.
Diagnostic is usually made with a doppler ultrasound showing area of blood flow and help distinguish testicle torsion and Epididymitis. Other tests will be performed to find the cause underlying the Epididymitis.
Treatment of both acute and chronic forms will include antibiotics ( Azithromycine and Cefixime in case of Chlamydia or Gonorrhoeae, or fluoroquinolones or penicilin if an Enteric organisms is suspected). Complications are abscess formation and testicular infarction. Chronic epididymitis can lead to a permanent destruction of the epididymite and the testicle.
Genitourinary infections are in some cases due to organisms, which are not sexually transmitted. Even if no transmission can be spread to the partner in all these cases, treatment usually involves to avoid any sexual intercourse during the duration of the treatment. This protects both partners from an eventual contact with pathogens, and the patient, as sexual activity is often a risk factor for all these infections.
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