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

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Diseases of the urinary and reproductive system

Diseases of the Urinary and Reproductive System

Warning: Some images may be disturbing


Urinary system

Urinary System


Female reproductive organs

Female Reproductive Organs


Male reproductive system

Male Reproductive System


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


Infection rates by age

Infection rates by age


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


Cervix infection from gonorrhea

Cervix infection from gonorrhea


Infection rates by state

Infection rates by state


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


Salpingitis

Salpingitis


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


Vaginosis

Vaginosis


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 herpes1

Genital herpes


Incidence of genital herpes

Incidence of genital herpes


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


Genital warts1

Genital warts


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