Introduction:
Genitourinary infections are divided into urinary tract infections and genital tract infections. Urinary tract infections include cystitis and pyelonephritis. Genital tract infections include vaginitis (inflammation of the vagina), urethritis (inflammation of the urethra), cervicitis (inflammation of the cervix), genital ulcerative diseases, endometritis (inflammation of the lining of the uterus), and pelvic inflammatory disease. This article describes three common genitourinary infections, mainly urinary tract infections, vaginitis, and endometritis.
What Is a Urinary Tract Infection (UTI)?
Urinary tract infections occur in any part of the urinary system (bladder, urethra, and ureter). However, most infections occur in the urethra and bladder.
What Causes Urinary Tract Infection?
UTIs are most commonly seen in women. They occur through microorganisms like bacteria, fungi, and protozoa. The organism enters the urinary tract via the urethra and spreads to the bladder, causing infection and inflammation. Some other risk factors for UTIs include:
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Inadequate water intake.
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Not keeping the genital area clean or dry.
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Sexual activity.
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Kidney stones.
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Certain types of birth control.
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Menopause (period of the end of menstrual cycles).
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A suppressed immune system(due to diabetes or other conditions).
What Are the Symptoms Seen in a Urinary Tract Infection?
Some symptoms of urinary tract infections include
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A strong urge to urinate that does not go away.
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Frequent urination but with small amounts of urine every time.
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Pain or burning sensation while urinating.
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Urine is bright pink or red and has a strong odor and cloudy appearance.
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Blood in the urine.
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Pain in the flank, center of the pelvis, and pubic bone of women.
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Pain during sexual activity.
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Fever with chills.
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Tiredness.
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Vomiting and nausea.
How Is Urinary Tract Infection Diagnosed?
Some of the tests done to diagnose urinary tract infections include:
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Urine Analysis - The urine will be examined for bacteria and pus cells in urine analysis. The bacteria and pus cells found in the urine determine the presence of an infection.
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Urine Culture - A urine culture determines the type of bacteria present in the urine and its sensitivity and resistance to certain antibiotics.
In the event of infection not responding to the treatment or is recurrent, the doctor might suggest further tests such as:
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Ultrasound - Ultrasound imaging creates a detailed image of the internal organs.
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Cystoscopy - A cystoscope (instrument with a lens and light source) is used to see the inside of the bladder from the urethral region.
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Computed Tomography (CT) Scans - CT scans are done to obtain additional detailed images of the urinary tract regions.
How Is Urinary Tract Infection Managed?
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Antibiotics are the first treatment choice for urinary tract infections. The overall health of the patient and the type of bacteria found in the urine is the deciding factor for medication.
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Medicines for simple urinary infections include Cephalexin, Ceftriaxone, and Nitrofurantoin.
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In case of a complicated UTI, the medicine of choice is Fluoroquinolone.
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The UTI infections usually resolve within a few days after starting the medications.
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The individuals are also advised to drink copious amounts of water.
What Is Vaginitis?
Vaginitis refers to vaginal infection or inflammation. Vaginitis mainly occurs during the reproductive years (late teens to early 40s).
What Are the Symptoms Seen in Vaginitis?
Some of the common symptoms seen are:
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Itching and burning sensation in the vagina.
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Vaginal discomfort and soreness.
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Vaginal bleeding and blood spots.
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Swollen, flushed, and inflamed skin around the vulva and vagina.
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Color change and change in the amount of vaginal discharge.
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Burning sensation and pain during urination.
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Pain during sexual intercourse.
What Are the Types of Vaginal Infections?
Vaginal infections are distinguished from each other by their unique symptoms. The different types of vaginal infections include:
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Bacterial Vaginosis (BV) - Bacterial vaginosis is caused when the bacteria naturally found in the vagina overgrow. It does not cause much itching but has a thin greenish, grayish-white, or yellowish-colored discharge. This discharge usually has a fish-like odor which gets stronger after penetrative sex. BV is not a sexually transmitted infection, but sexual contact increases the chances of bacterial overgrowth.
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Atrophic Vaginitis - This condition develops after menopause or when estrogen levels drop. Atrophic vaginitis is not an infection but increases the chances of developing UTIs and vaginal infections. Symptoms are burning, vaginal itching, changes in discharge, and dryness.
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Yeast Infections - Yeast infections are caused by a fungus called Candida albicans. Factors like hormonal changes, stress, and antibiotics lead to the overgrowth of yeast, causing the infection. Here, swelling occurs in the labia or the skin folds outside the vagina. Symptoms like soreness, burning, and vaginal and vulval itching are also seen in vaginal infections. Vaginal discharges are lumpy and white with a texture resembling cottage cheese.
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Trichomoniasis - The parasite Trichomonas vaginalis causes this infection. It is contracted through oral, anal, or vaginal sex without protection. It causes both fish-like odor and vaginal itching. Swelling, inflammation, and irritation occur in the vulva and vagina. Vaginal discharges are frothy and greenish-yellow in color. Other symptoms include lower abdomen pain and pain during sex and urination.
How Are Vaginal Infections Diagnosed?
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The healthcare provider will take a detailed history of vaginal infections, sexual history, and other health conditions.
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A pelvic examination to check for inflammation or irritation, depending on the symptoms.
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A sample of vaginal discharge for analysis is collected.
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A swab test will be performed in the cervix to test for (sexually transmitted infections) like chlamydia or gonorrhea.
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Urine samples will also be collected to test for other STIs.
How Are Vaginal Infections Treated?
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Bacterial infections are treated with Metronidazole (in a cream, gel, or tablet form) or Clindamycin.
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Yeast infections are treated with antifungal suppositories or creams.
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Trichomoniasis is treated with Tinidazole or Metronidazole tablets.
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Atrophic vaginitis is treated with Estrogen tablets or creams to reduce vaginal irritation and dryness.
What Is Endometritis?
Endometritis is an inflammation in the uterine lining affecting all layers of the uterus. Endometritis is the most commonly occurring infection in the postpartum period.
How Is Endometritis Caused?
Most cases of endometritis involve aerobic and anaerobic bacteria. These microbes travel from the vagina into the cervix, leading to inflammation and infection in the uterine lining. This condition is a result of the rupture of membranes during childbirth. The bacteria colonize these damaged, bleeding, or devitalized uterine tissue causing the infection.
What Are the Symptoms of Endometritis?
The first sign of infection is fever associated with abdominal pain and purulent and foul-smelling lochia (normal discharge from the uterus after childbirth). Abnormal vaginal bleeding and discharge are also noted.
How Is Endometritis Diagnosed?
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Physical examination, like pelvic and abdominal examination, is done, and tenderness will be noted in the suprapubic and uterine region.
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Abnormalities in vital signs like fever, hypertension, and tachycardia are present.
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Samples will be collected from the cervix to test for the presence of bacteria that caused the infection.
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A complete blood test and erythrocyte sedimentation rate (ESR) are done to know elevated levels of the total count or other parameters.
What Are the Treatment Options for Endometritis?
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In the case of mild disease, oral antibiotics are given. Some of the antibiotics given include Doxycycline, Amoxicillin-Clavulanate, and Levofloxacin.
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Intravenous antibiotics and hospital admission are usually recommended for patients with severe- to-moderate endometritis.
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Significant improvement will be noted in the condition within 48 to 72 hours of medicines.
Conclusion:
Female genitourinary infections include urinary tract infections, vaginitis, endometritis, urethritis, cervicitis, and genital ulcerative diseases. Some conditions are sexually transmitted, while others are not. Most infections can be prevented and cured by maintaining personal hygiene and taking appropriate preventive measures and treatment at the right time.
