GENITOURINARY INFECTIONS (GUI)
Of the many infections that occur in the body, Infections of the genitalia and urinary tract are most disconcerting and annoying to the body and mind, simply because of the sexual nature of the body parts involved and it's deep and evolutionary impression in the mind.
Because genitalia and urinary tract are so closely placed and related in both females and males, most infections involve both the urinary tract and the genitalia and hence I have grouped them together as Genitourinary Infections (GUI).
Though males can have genitourinary infections(GUI) as well as females, both differ qualitatively and quantitatively to each other.
In males many genitourinary infections (GUI) are likely to be sexually transmitted disease (STD) like syphilis, gonorrhea, AIDS, chancroid etc. Mostly it’s the male who transfer such infections to the female. Other genitourinary infections(GUI) in males are similar to those in females though less common and can be treated similarly.
In males, urine is expelled through the urethra, which is a narrow canal passing through the penis and collection of urine takes place in the urinary bladder and that too temporarily, except in elderly males with Benign prostatic hypertrophy (BPH), in which case urine stays in the bladder longer and hence genitourinary infections (GUI) is more common in such cases.
In females though there is no danger of of BPH but the urethra is much shorter and stays inside the vagina, and hence while micturating, the urine gets in touch with the inner walls of this vagina, and can stay there for long periods of time, and give rise to media for the growth of bacteria, which multiply fast to infect the urethra, vagina and external genitalia and can go higher to infect the cervix and uterus and even fallopian tubes causing lower abdominal pain, problems in micturition, general malaise and irritability, which can increase frequency of micturition.
This is the reason genitourinary infections (GUI) is more common in females.
Another common cause of genitourinary(GUI) infections in females is the use of tamponades during menstruation. In many cases, the females use cotton & cloth which is used in many cycles after washing. Blood, especially menstrual blood, is a very good medium for the growth of bacteria. The bacteria can infect and grow on these cloths in as less as 12 to 24 hours.
Before going into the treatment of genitourinary infections (GUI), I am going to give important preventive steps, particularly in females.
The females are advised to shave off their pubic hairs as it facilitates washing after micturition and prevents urine from getting entangled in the pubic hairs which may extend around the vagina and external genitalia.
Next comes the micturition habits. Females should go to Toilets where water is available. Also the Mesopotamian version of toilet, where one sits with bottom clear of the toilet, is preferable as it permits easy washing of vagina after micturition.
The female should take a mug or bottle of water in one hand, part apart the vaginal lips with other hand (clean or washed before micturition ) and pour water inside which will wash away all urine sticking to the inside walls of vagina and external genitalia and hopefully bacteria as well and reduce the bacterial count as well as make vagina less favorable for the growth of bacteria, by decreasing their concentration to less than the threshold necessary to cause infection.
The other very important preventive method in females is that tamponades used during menstruation should always be disposable and should be changed at least every day. Reusable cotton &/ cloth tamponades should never be used. In some susceptible females, the tamponades can even be changed twice or thrice daily.
Another preventive method, particularly when male and female are living apart is to examine each other’s genitalia before proceeding with sexual intercourse. Any abnormal discharge, smell, ulcer or lesion noticed should mean that such a person has genitourinary infection (GUI), which should be treated before commencing sexual intercourse again.
Females should prophylactically take the following treatment every 3 or 6 months and can get their male partner the same treatment.
• Injection Tetanus Toxoid 0.5ml intramuscular
• Tablet Ciprofloxacin 500 mg twice daily after food
• (in females 250mg if weight less than 45 kg)
• Tablet Metronidazole 400 mg twice daily after food
• Tablet Chlorpheniramine maleate 4mg twice daily
• (cause sedation and drowsiness, don’t drive)
• Cap Flucanazole 150 mg at bed time
In addition a parentral (intravenous or intramuscular) antibiotic like Injection Ceftriaxone 1 gram or Injection Benzathine penicillin 2.5 million units (after hypersensitivity test ) or Injection Cefuroxime 1 gram or Injection Ampicillin 1 gram should be taken.
Those not able to tolerate Ciprofloxacin can take Capsule Amoxycillin 500 mg twice daily for three days.
The same prophylactic treatment I have described can be curative in almost all genitourinary infections (GUI) and can be taken in present infections.
In present infections make sure that both sexual partners take treatment at the same time to prevent reinfection from the partner.