Diseases of the urinary and reproductive system
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Diseases of the Urinary and Reproductive System. Warning: Some images may be disturbing. Urinary System. Female Reproductive Organs. Male Reproductive System. Normal Flora of the Urinary and Reproductive Systems. Normal urine is STERILE – external skin contamination possible

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Diseases of the urinary and reproductive system

Diseases of the Urinary and Reproductive System

Warning: Some images may be disturbing





Normal flora of the urinary and reproductive systems
Normal Flora of the Urinary and Reproductive Systems

  • Normal urine is STERILE – external skin contamination possible

  • Most common bacterial in the vagina is lactobacillus

  • Acid production keeps pH low and prevents other bacteria from growing

  • Candida albicans normal flora of the vagina

  • Male urethra is usually sterile


Diseases of the urinary system
Diseases of the Urinary System

  • Urethritis – inflammation of the urethra

  • Cystitis – bladder infection

  • Ureteritis – infection of the ureters

  • Pyelonephritis – kidney infection


Cystitis
Cystitis

  • Inflammation of bladder

  • Symptoms are often difficult, painful, urgent urination

  • Female urethra is only 2 inches long and close to anal opening – E. coli is most common infective agent

  • Rate of bladder infection is 8 times higher in women than men

  • 100 CFU’s or more in urine sample is over the limit

  • Treatment – trimethoprin-sulfamethoxazole


Pyelonephritis
Pyelonephritis

  • Untreated cystitis can lead to inflammation of the kidneys

  • Fever and back pain

  • Causative agent is usually E. coli

  • Potentially life threatening condition

  • IV antibiotics


Bacterial diseases of the reproductive system
Bacterial Diseases of the Reproductive System

  • New terminology STD or STI?

  • STI – Sexually transmitted infections is now the preferred terminology

  • More than 30 bacterial, viral or parasitic infections that are identified as STI’s

  • In US 15,000,000 new cases of STI’s per year


Gonorrhea
Gonorrhea

  • Neisseria gonorrhoeae Gram – diplococcus

  • 700,000 cases reported each year in the US

  • 60% of the patients are ages 15-24

  • It’s easy to get

    • Men – single unprotected exposure results in infection 20-35% of the time

    • Women – single unprotected exposure results in infection 60-90% of the time



Gonorrhea in men
Gonorrhea in men

  • Painful urination

  • Pus containing discharge from the penis

  • Symptoms appear in a few days

  • Treatment with cephalosporin antibiotics

  • REMEMBER it’s now a superbug!


Gonorrhea in women
Gonorrhea in women

  • Difficult to diagnose

  • Only the cervix is infected

  • Few women know that they are infected

  • Abdominal pain from complications of PID may be present




Chlamydia trachomatis
Chlamydia trachomatis

  • Common cause of PID in women

  • Five times as many cases in women than men

  • Most are unaware of the infection because symptoms are mild in men and asymptomatic in women

  • Complications of Chlamydia associated PID in women can be:

    • Infection of cervix

    • Uterine tubes – SALPINGITIS and tubal pregnancy

    • Ovaries and uterus



Syphilis
Syphilis

Treponema pallidum

Gram negative spirochete

Produces inflammatory immune response to damage host tissue

Treponema probably evolved from a tropical skin disease called yaws and was imported into the new world by European explorers

Three stages to the disease


Primary stage syphilis
Primary Stage Syphilis

  • Initial sign is a small sore called a CHANCRE

  • Usually painless but exudes a very infective fluid

  • Women may not know they are infected because the cervix is the site of the chancre

  • Sore disappears in a few weeks

  • Bacteria enter the bloodstream and lymphatic system


Secondary stage syphilis
Secondary stage syphilis

  • Several weeks after the primary stages skin rashes appear that are characteristic of secondary syphilis

  • Palms and soles of feet

  • Lesions from the rash are very infective

  • Difficult to diagnose at this stage

  • Symptoms usually resolve in 3 months


Latent period
Latent period

  • After secondary stage the disease enters the latent phase

  • No symptoms present

  • After 2-4 years the disease is no longer infectious

  • Most cases treated or not do not progress past this stage


Tertiary stage syphilis
Tertiary stage syphilis

  • Up to 25% of untreated case enter this phase

  • Skin lesions called gummas are this in this stage

  • Neurologic symptoms may also appear

  • This stage is very rare today


Treatment
Treatment

  • Penicillin is still used with good results for primary and secondary stage disease



Genital herpes
Genital Herpes

  • Caused by HSV-2

  • HSV-1 causes cold sores can can cause genital herpes

  • IN THE UNITED STATES ONE IN FOUR PERSON OVER THE AGES OF 30 IS INFECTED WITH HSV-2!!!!!!!

  • Most are unaware they are infected

  • Remember Herpes is forever

  • No cure only management of the condition




Genital warts
Genital warts

  • Caused by papillomaviruses

  • Million new cases in the US each year

  • Common infection 25% of women ages 14-59 may be infected

  • Papillomavirus types 16 and 18 cause cervical cancer, types 6 and 11 genital warts

  • HPV vaccine – Gardasil



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