1. Diseases of the Urinary and Reproductive System Warning: Some images may be disturbing

2. Urinary System

3. Female Reproductive Organs

4. Male Reproductive System

5. 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

6. Diseases of the Urinary System Urethritis – inflammation of the urethra Cystitis – bladder infection Ureteritis – infection of the ureters Pyelonephritis – kidney infection

7. 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

8. 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

9. 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

10. 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

11. Infection rates by age

12. 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!

14. 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

15. Cervix infection from gonorrhea

16. Infection rates by state

17. 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

18. Salpingitis

19. 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

20. 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

21. 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

22. 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

23. 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

24. Treatment Penicillin is still used with good results for primary and secondary stage disease

26. Vaginosis

27. 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

28. Genital herpes

29. Incidence of genital herpes

30. 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

31. Genital warts