Sexually transmitted diseases
Many bacteria, viruses, fungi, parasites cause sexually transmitted diseases. The prevalence of these diseases is increasing rapidly all over the world. The World Health Organization (WHO) reports that more than 1 million new cases occur around the world every day. It is known that more than 25 microorganisms defined for today are sexually transmitted and cause diseases.
Urethra is an inflammatory disease of the tubular organ that carries urine out of the bladder.
Factors: Neisseria Gonorrhoeae (Gonorrhea / Gonorrhea), Chlamydia Trachomatis (Chlamydia), Ureaplasma Urealyticum, Trichomanas Vaginalis, Herpes Simplex Virus, Mycoplasma Genitalium
Symptoms: Discharge from the penis / vagina, burning while urinating, frequent urination, itching in the urethra
Diagnosis: Urethritis is diagnosed by observing inflammatory cells (x1000 ≥ 5 leukocytes / hpf in microscopic examination) in the discharge sample examination. Gram staining is done first for differential diagnosis. If gram negative diplococci are seen in gram staining, the agent is Gonorrhea (Gonorrhea). If not seen, it is considered non-gonococcal urethritis. Trichomanas, a parasite, can be viewed directly under a microscope. Active agent separation can be made by methods such as flow culture, antibody tests and PCR.
Treatment: Sensitive antibiotic treatment is initiated for the detected agent. Cephalosporin, azithromycin and quinolone group antibiotics in the treatment of gonorrhea; doxycycline, azithromycin, erythromycin group in non-gonococcal urethritis; Metranidazole treatment is preferred in trichomonas infections. Co-treatment should also be done. However, the main purpose of treatment should be “protection, ie safe sexual intercourse”.
Complications: If left untreated, it may cause complications such as urinary tract strictures, infertility, prostatitis, testicular inflammation (epididymorchitis), meningitis, and endocarditis.
GENITAL HERPES (COLD SORE)
Genital Herpes (Herpes) is a sexually transmitted infection caused by the herpes simplex virus (HSV). Both types of HSV, most often HSV-2, can cause genital herpes (HSV-2: 85-90%, HSV-1: 10-15%).
Symptoms: It takes 1-26 days (average 4 days) for the symptoms to appear after the infection. The virus causes no symptoms in 75% of the cases. The symptoms of the virus in the first infection are different from the symptoms of the virus in recurrent attacks in the future.
- Painful blisters (vesicles) in and around the genital area or around the anus
- Painful swelling in the groin area (lymphadenopathy)
- Flu-like complaints, fever, headache, joint pain
Recurrent Attack: Ulcerated lesions in the genital or anal area
How it is Transmitted: Genital herpes can be transmitted through vaginal, oral (oral) or anal (rectal) intercourse with a person with this disease. Male-to-female transmission is more likely than female-to-male transmission. While this infection is observed in 1 out of every 5 women between the ages of 15-50 worldwide, it is observed in 1 out of 9 people in men. Although the use of condoms for protection reduces the risk, it is not necessarily protective.
Diagnosis: The diagnosis is made by physical examination and laboratory tests (viral culture, PCR test, antibody testing in the blood).
Treatment: Antiviral drugs (acyclovir, valaciclovir) are used for this purpose. These drugs provide faster disappearance of lesions and decrease the number and severity of attacks.
GENITAL WART (CONDILOMA)
- The agent is HPV (Human Papilloma Virus)
- More than thirty types infect the genital system.
- Visible genital warts are typically caused by HPV Types 6 and 11.
- For HPV-related cancers (cervix, penis, and anal), asymptomatic strains such as Types 16 and 18 are mainly responsible.
- It is most commonly transmitted through sexual contact (vaginal, oral, and anal), but it can be transmitted without sexual contact (hand contact,use of common razor or underwear, from mother to baby, etc.)
- Most of them are asymptomatic (70%).
- Incubation period is between 3 weeks and 8 months.
- The diagnosis is made by the appearance of papilledematous (cauliflower-like) brown or reddish lesions.
- Condulomas are observed as white areas with the application of 3% to 5% acetic acid to the genital area in patients with no lesions (not routinely recommended)
- Subtyping with HPV-DNA can be done, but not widely used
- Should we do a biopsy?
- Routine biopsy is not recommended
- However, atypical-looking, pigmented, hard or ulcerated warts,
- Biopsy is recommended for immunocompromised lesions that do not improve after treatment.
- HPV Vaccine
- For protection purposes, it is applied to women between the ages of 9–26 (can also be applied to men).
- Contains eight types of HPV viruses
- It is administered in 3 doses within 6 months.
- There is no treatment method to remove or remove HPV infection from the body, but 90% of viruses disappear from the body within two years.
- Even if the virus cannot be destroyed, genital warts can be destroyed by various methods.
- Electrocauterization: the area is anesthetized with local anesthesia and the lesion is burned by electric current.
- Cryotherapy: freeze the wart with liquid nitrogen
- Creams: chemically burn the wart tissue
- Women with genital warts should be screened for cervical canal.
- Similarly, patients at risk with anal conduloma (HIV, transplant, etc.) should be screened regularly with anal cytology.
- Those who have lesions in the urinary hole in the penis should be taken into cystoscopic examination in terms of urethra or bladder involvement.
OTHER SEXUALLY TRANSMITTED DISEASES:
- AIDS (HIV)
- HEPATITIS (HBV & HCV)
- GRANULOMA INGUINALE
- PUBIC LICE (PEDICULOSIS PUBIS)
Note: The page content is for informational purposes only, please consult your doctor for diagnosis and treatment.