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Genitourinary diseases

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Genitourinary diseases

Written by Dr Angela Robinson, consultant in sexual health

What are 'genitourinary' diseases?

These are conditions usually caused by infections that can affect the genital area and urinary system.

Some infections are caught from another person, usually during sex.

Other cases are caused when organisms (bacteria or yeast), which are usually present in small numbers, overgrow and cause symptoms.

Some genitourinary (GU) diseases are caused by bacteria that do not cause problems in their usual home in the body, but do if they get into another place.

These diseases are often managed best at a genitourinary medicine (GUM) or sexual health clinic.

Who is at risk of sexually transmitted infections?

Young people are at greatest risk of sexually transmitted infections.

They are very unlikely to have been exposed to any sexually transmitted infections before they start having sex, so they have no chance to build up immunity (when the body can fight off an infection by itself).

In young women, the cervix (neck of the womb) is immature and is easier to infect. In general, women are more likely to be infected by a man than vice versa.

Younger people may have more partners or change partners more frequently than older generations. Sexual behaviour is the most important influence on whether you get a sexually transmitted infection. If you have sex with someone who is infected then you are likely to get the infection yourself. The more partners you have the more likely you are to have sex with someone who is infected.

How do I know if I've got an infection?

Some infections, particularly those that are sexually transmitted, can produce no symptoms at all. But they might lead to complications that cause symptoms that prompt you to seek help. Even if sexually transmitted infections do not cause symptoms, they can still be transmitted to sexual partners.

Some infections cause very similar symptoms. For example, vaginal discharge in a woman can be due to non-sexually transmitted infections such as thrush, but can also be due to sexually transmitted infections. Non-specific symptoms of change in vaginal discharge and pain on passing urine cannot tell you the type of infection. To make a diagnosis, tests usually need to be taken. Similarly in men, urethral discharge (from the tube in the penis) can be caused by more than one infection.

Sometimes symptoms occur but disappear rapidly. This does not necessarily mean that the infection has gone away. Often the infection remains hidden in the body and, if it is sexually transmitted, the infection can be passed on to a sexual partner.

What are the commonest GU diseases?

Below is a list of the commonest diseases encountered in the United Kingdom:

chlamydia trachomatis

gonorrhoea

genital herpes

non-gonococcal (or non-specific) urethritis

pubic lice ('crabs')

pelvic inflammatory disease

trichomoniasis

genital warts

bacterial vaginosis *

cystitis *

scabies (passed on through close contact, not necessarily sexual) *

thrush (candida). *

* Note: These diseases are not usually sexually transmitted, but sex can make the symptoms worse, or sometimes even initiate symptoms.

Less common GU diseases

The conditions listed below are sexually transmitted and can be very common in some parts of the world. Therefore, if you have sex without a condom abroad you are at risk of getting infected. Some of these diseases are increasing in the UK, particularly HIV and syphilis.

Chancroid.

HIV.

Syphilis.

Other causes of genital ulcers: donovanosis, lymphogranuloma venereum.

Common genitourinary diseases

Bacterial vaginosis (BV)

BV is caused by an overgrowth of bacteria that normally live in the vagina in small numbers. Although this condition is not strictly speaking sexually transmitted, BV is uncommon in virgins. The more sexual partners you have had, the more likely you are to get it. Sexual intercourse may produce symptoms or worsen the symptoms. Products that affect bacteria in the vagina can cause the condition or encourage recurrences, including products added to baths (bubble baths, antiseptics), douches, or forgetting to remove tampons.

What are the symptoms?

Sometimes women do not have any symptoms, and the condition is found only when they have a check for sexually transmitted diseases or a smear test. If symptoms are present they are usually:

a greyish white discharge with an offensive fishy smell.

a burning sensation or soreness is more common than itching although this can also occur.

there is usually no redness of the genital skin.

Often the diagnosis is missed by a GP, either because thrush is presumed to be the cause and the woman is not examined, or because the correct tests are not taken. Make sure you tell the doctor all your symptoms when you attend surgery and don't presume that you have a condition such as thrush. At least you can then discuss with your doctor the likely causes of your symptoms.

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