... having a first herpes "outbreak" or episode. Clinical manifestations of genital herpes differ between the first and ... What is the link between genital herpes and HIV? Genital ulcerative disease caused by herpes makes it easier to transmit ...
Genital warts Overview By Mayo Clinic Staff Genital warts are one of the most common types of sexually transmitted ... human papillomavirus (HPV), the virus that causes genital warts, at some point during their lives. Women are ...
... who have sex with women get genital warts? Yes. It is possible to get genital warts, or any other STI, if you are a woman who ... you have signs or symptoms of genital warts. Yes. It is possible to get genital warts, or any other STI, if you are a woman who ...
... Choosing the Right Sport for You Shyness Genital Herpes KidsHealth > For Teens > Genital Herpes Print A A A What's in this article? ... How Is It Prevented? What Is It? Genital herpes is caused by a virus called herpes simplex ( ...
... who have sex with women get genital herpes? Yes. It is possible to get genital herpes, or any other STI, if you are a woman who ... sex and avoid sexual activity during an outbreak. Yes. It is possible to get genital herpes, or any other STI, if you are a woman who ...
Veliath, A J; Bansal, R; Sankaran, V; Rajaram, P; Parkash, S
Five cases of amebiasis of the genital tract involving the cervix, vulva and penis are described. All presented as an ulcerating mass and were clinically suspected to have a tumor. In two cases the amebiasis co-existed with a carcinoma, an association which is extremely rare. The spouse of a patient with penile amebiasis was found to have amebiasis of the cervix suggesting a sexually transmitted mode of infection. The need for histopathological confirmation of all suspected genital malignancies is emphasised due to the striking resemblance of genital amebiasis to a carcinoma. The co-existence of amebiasis with carcinoma is of interest and suggests a possible etiological relationship.
Yanofsky, Valerie R.; Patel, Rita V.
External genital warts, also known as condylomata acuminata, are extremely common, with between 500,000 to one million new cases diagnosed each year in the United States alone. To date, more than 120 distinct subtypes of human papillomavirus have been identified. Human papillomavirus types 6 and 11 rarely give rise to cervical cancers, but are responsible for 90 percent of the cases of genital warts. The current treatment options are largely centered upon removal of the warts rather than elimination of the underlying viral infection. A wide range of therapies are presently in use, which are highly variable and can differ dramatically with respect to cost, side-effect profiles, dosing schedules, duration of treatment, and overall effectiveness. As of yet, no definitive therapy has emerged as the ideal standard of care in the treatment of genital warts, and therapy selection generally occurs in a patient-specific manner. PMID:22768354
Garland, Suzanne M; Steben, Marc
Genital herpes is a relatively common infection caused by herpes simplex virus (HSV) type one or two (HSV-1, HSV-2) respectively. It is acquired most commonly via sexual activity. More recently there has been an increase in infections due to HSV-1. Most new cases of genital HSV are not diagnosed due to HSV infections having short-lived signs and symptoms, or in many instances are asymptomatic. Hence many people infected with HSV are unaware that they have it. The risk of transmission to a partner is highest during outbreak periods, when there are visible lesions, although genital HSV can also be transmitted during asymptomatic periods. Use of condoms and antiviral medications assist in preventing transmission. Antiviral agents are effective in controlling clinical episodes, but do not eradicate infection, which remains latent for the life of a patient. Despite the surge in vaccine research, there is unfortunately no readily available preventative or therapeutic vaccine for HSV to date.
... best way to prevent genital herpes is abstinence. Teens who do have sex must properly use a latex condom every time ... Date reviewed: February 2016 previous 1 • ... Boyfriend Has an STD Before We Have Sex? Telling Your Partner You Have an STD Contact ...
... herpes is HSV-2. HSV-1 usually causes cold sores that appear on the mouth, lips, and eyes, but it is becoming more common as a cause of genital herpes, especially in young women. How common is the herpes virus? At least 50 million people in the United ...
... types of HPV. They can also lead to vaginal or vulvar cancer, anal cancer, and throat or mouth cancer. Important ... result Make sure you are screened for cervical, vaginal, vulvar, or anal cancer if you have been diagnosed with genital warts.
Scappatura, F. Philip
The author reviews the prevalence of genital herpes, outlines the typical clinical courses of the disease in its primary and recurrent forms. He discusses the physical, psychological and social effects of this sexually transmitted disease and provides three protocols for the use of oral acyclovir in its treatment. PMID:21263803
Introduction External genital warts (EGWs) are sexually transmitted benign epidermal growths caused by the human papillomavirus (HPV), on the anogenital areas of both females and males. About 50% to 60% of sexually active women aged 18 to 49 years have been exposed to HPV infection, but only 10% to 15% will have genital warts. Methods and outcomes We conducted a systematic review and aimed to answer the following clinical questions: What are the effects of treatments for external genital warts? What are the effects of interventions to prevent transmission of external genital warts? We searched: Medline, Embase, The Cochrane Library, and other important databases up to December 2009 (Clinical Evidence reviews are updated periodically, please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA). Results We found 55 systematic reviews, RCTs, or observational studies that met our inclusion criteria. We performed a GRADE evaluation of the quality of evidence for interventions. Conclusions In this systematic review we present information relating to the effectiveness and safety of the following interventions: bi- and trichloroacetic acid; condoms; cryotherapy; electrosurgery; imiquimod; intralesional, topical, or systemic interferons; laser surgery; podophyllin; podophyllotoxin; surgical excision; and vaccines. PMID:21418685
... a sexually transmitted disease (STD) caused by a herpes simplex virus (HSV). It can cause sores on your genital or rectal area, buttocks, and thighs. You can get it from having vaginal, anal, or ... of herpes are called outbreaks. You usually get sores near ...
... Know STDs Questions and Answers About Sex Genital Warts (HPV) Can You Get Genital Herpes From a ... Sexually Transmitted Diseases (STDs) About Birth Control Genital Warts (HPV) Telling Your Partner You Have an STD ...
Ono, Fumitake; Yasumoto, Shinichiro
Genital candidiasis occurs mainly in women referred as vulvovaginal candidiasis (VVC), and occasionally occurs in men as to be called balanitis. VVC is one of the most common causes of infectious vaginitis. Approximately three-quarters of women will experience an episode of VVC at least once in their life and 5-8% of them will have more than four attacks within a year; this condition has been designated as recurrent VVC (RVVC). Causative agent in majority of VVC is Candida albicans, but occasionally VVC is caused by other Candida spp. VVC is not traditionally considered a sexually transmitted disease. On occasion sexual transmission of Candida can occur during vaginal intercourse. Particularly Candida transmission and sexual behaviors are linked to RVVC. Epidemiological evidence suggests that anogenital and, especially, orogenital contact transmits Candida.
... within a day of its appearance) Syphilis (small, painless open sore or ulcer [called a chancre] on ... genitals or around the anus) Lymphogranuloma venereum (small painless sore on the male genitals) Other types of ...
... painless sores. Less common infections such as chancroid , granuloma inguinale , molluscum contagiosum , and syphilis may also cause ... Elsevier; 2016:chap 16. Read More Chancroid Donovanosis (granuloma inguinale) Genital herpes Genital warts Melanoma Molluscum contagiosum ...
... genital warts, it could be a sign of sexual abuse , and parents should be aware of that possibility. However, HPV also can spread through nonsexual contact between a child and a ... genital warts are spread through sexual contact, the best way to prevent them is ...
Tummon, I. S.; Dudley, D. K.; Walters, J. H.
Genital herpes is a sexually transmitted disease caused by the herpes simplex virus. Following the initial infection the virus becomes latent in the sacral ganglia. Approximately 80% of patients are then subject to milder but unpredictable recurrences and may shed the virus even when they are asymptomatic. The disorder causes concern because genital herpes in the mother can result in rare but catastrophic neonatal infection and because of a possible association between genital herpes and cancer of the cervix. No effective treatment is as yet available. Weekly monitoring for virus by cervical culture from 32 weeks' gestation is recommended for women with a history of genital herpes and for those whose sexual partner has such a history. Images FIG. 1 FIG. 4 FIG. 5 PMID:7020907
The examination of the rape victim should focus on the therapeutic, forensic and psychological needs of the individual patient. One aspect will be an examination for ano-genital injuries. From a medical perspective, they tend to be minor and require little in the way of treatment. They must be considered when assessing the risk of blood-borne viruses and the need for prophylaxis. From a forensic perspective, an understanding of genital injury rates, type of injury, site and healing may assist the clinician to interpret the findings in the context of the allegations that have been made. There are many myths and misunderstandings about ano-genital injuries and rape. The clinician has a duty to dispel these.
Berkowitz, Carol D.
Child sexual abuse as well as accidental trauma may cause acute injuries in the anogenital area. Most data on residual findings following genital trauma come from longitudinal studies of children who have been sexually assaulted, undergone surgical procedures, or experienced accidental trauma. Like injuries in other part parts of the body, such…
Berkowitz, Carol D.
Child sexual abuse as well as accidental trauma may cause acute injuries in the anogenital area. Most data on residual findings following genital trauma come from longitudinal studies of children who have been sexually assaulted, undergone surgical procedures, or experienced accidental trauma. Like injuries in other part parts of the body, such…
... 15. FGM is a violation of the human rights of girls and women. Female genital mutilation (FGM) comprises all procedures that ... recognized internationally as a violation of the human rights of girls and women. It reflects deep-rooted inequality between the sexes, ...
Lowy, D R; Kirnbauer, R; Schiller, J T
Genital human papillomavirus (HPV) infection is a common sexually transmitted disease that at the present time is not effectively controlled or treated. Many infections are inapparent and transient. However, some HPV infections result in persistent lesions that in some cases undergo carcinogenic progression. A subset of genital HPVs, designated high-risk types, are preferentially associated with high-grade dysplasias and carcinomas. About 90% of cervical cancers contain high-risk HPV DNA, most often HPV16. Development of a subunit vaccine against high-risk genital HPVs is a desirable and, it appears, an increasingly feasible long-term goal. The viral E6 and E7 oncoproteins are selectively maintained and expressed in progressed HPV tumors and could potentially be targets for therapeutic vaccines. The L1 major virion structural proteins have recently been shown to self-assemble into virus-like particles when expressed in insect cells. These particles might serve as the basis for a prophylactic vaccine to prevent genital HPV infection. Images PMID:8146136
Ladjali, M; Rattray, T W; Walder, R J
Female genital mutilation, also misleadingly known as female circumcision, is usually performed on girls ranging in from 1 week to puberty. Immediate physical complications include severe pain, shock, infection, bleeding, acute urinary infection, tetanus, and death. Longterm problems include chronic pain, difficulties with micturition and menstruation, pelvic infection leading to infertility, and prolonged and obstructed labor during childbirth. An estimated 80 million girls and women have undergone female genital mutilation. In Britain alone an estimated 10,000 girls are currently at risk. Religious, cultural, medical, and moral grounds rationalize the custom which is practiced primarily in sub-Saharan Africa, the Arab world, Malaysia, Indonesia, and among migrant populations in Western countries. According to WHO it is correlated with poverty, illiteracy, and the low status of women. Women who escape mutilation are not sought in marriage. WHO, the UN Population Fund, the UN Children's Fund, the International Planned Parenthood Federation, and the UN Convention on the Rights of the Child have issued declarations on the eradication of female genital mutilation. In Britain, local authorities have intervened to prevent parents from mutilating their daughters. In 1984, the Inter-African Committee Against Harmful Traditional Practices Affecting Women and Children was established to work toward eliminating female genital mutilation and other damaging customs. National committees in 26 African countries coordinate projects run by local people using theater, dance, music, and storytelling for communication. In Australia, Canada, Europe, and the US women have organized to prevent the practice among vulnerable migrants and refugees.
Aswath, Manju; Pandit, Lakshmi V.; Kashyap, Karthik; Ramnath, Raguram
Persistent genital arousal disorder (PGAD) is a phenomenon, in which afflicted women experience spontaneous genital arousal, unresolved by orgasms and triggered by sexual or nonsexual stimuli, eliciting stress. The current case is a 40-year-old female who experienced such orgasms for about a month. Physical examination, investigations, and psychological testing were noncontributory. Carbamazepine (600 mg) was discontinued due to a lack of response. She improved significantly with supportive therapy. Various neuropsychological conditions, pelvic pathology, medications, etc., have been associated with this disorder. Pharmacologic strategies have included the use of antidepressants, antipsychotics, mood stabilizers, and analgesics. Validation, psycho-education, identifying triggers, distraction techniques, and pelvic massage have been tried. Living with PGAD is very demanding. There is a lack of understanding of the problem, shame, and hesitation to seek help. The syndrome has been recently described, and understanding is still evolving. PMID:27570347
Aswath, Manju; Pandit, Lakshmi V; Kashyap, Karthik; Ramnath, Raguram
Persistent genital arousal disorder (PGAD) is a phenomenon, in which afflicted women experience spontaneous genital arousal, unresolved by orgasms and triggered by sexual or nonsexual stimuli, eliciting stress. The current case is a 40-year-old female who experienced such orgasms for about a month. Physical examination, investigations, and psychological testing were noncontributory. Carbamazepine (600 mg) was discontinued due to a lack of response. She improved significantly with supportive therapy. Various neuropsychological conditions, pelvic pathology, medications, etc., have been associated with this disorder. Pharmacologic strategies have included the use of antidepressants, antipsychotics, mood stabilizers, and analgesics. Validation, psycho-education, identifying triggers, distraction techniques, and pelvic massage have been tried. Living with PGAD is very demanding. There is a lack of understanding of the problem, shame, and hesitation to seek help. The syndrome has been recently described, and understanding is still evolving.
Introduction Genital chlamydia is the most commonly reported bacterial sexually transmitted infection (STI) in developed countries. In women, infection occurs most commonly between the ages of 16 and 19 years. Methods and outcomes We conducted a systematic review and aimed to answer the following clinical questions: What are the effects of antibiotic treatment for men and non-pregnant women with uncomplicated genital chlamydial infection?What are the effects of antibiotic treatment for pregnant women with uncomplicated genital chlamydial infection? We searched: Medline, Embase, The Cochrane Library, and other important databases up to September 2009 (Clinical Evidence reviews are updated periodically; please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA). Results We found 24 systematic reviews, RCTs, or observational studies that met our inclusion criteria. We performed a GRADE evaluation of the quality of evidence for interventions. Conclusions In this systematic review we present information relating to the effectiveness and safety of the following interventions: amoxicillin, ampicillin, azithromycin, ciprofloxacin, clarithromycin, clindamycin, doxycycline, erythromycin, lymecycline, minocycline, ofloxacin, pivampicillin, rifampicin, roxithromycin, sparfloxacin, tetracycline, and trovafloxacin. PMID:21718568
Johnsdotter, Sara; Essén, Birgitta
The discrepancy in societal attitudes toward female genital cosmetic surgery for European women and female genital cutting in primarily African girl children and women raises the following fundamental question. How can it be that extensive genital modifications, including reduction of labial and clitoral tissue, are considered acceptable and perfectly legal in many European countries, while those same societies have legislation making female genital cutting illegal, and the World Health Organization bans even the "pricking" of the female genitals? At present, tensions are obvious as regards the modification of female genitalia, and current legislation and medical practice show inconsistencies in relation to women of different ethnic backgrounds. As regards the right to health, it is questionable both whether genital cosmetic surgery is always free of complications and whether female genital cutting always leads to them. Activists, national policymakers and other stakeholders, including cosmetic genital surgeons, need to be aware of these inconsistencies and find ways to resolve them and adopt non-discriminatory policies. This is not necessarily an issue of either permitting or banning all forms of genital cutting, but about identifying a consistent and coherent stance in which key social values - including protection of children, bodily integrity, bodily autonomy, and equality before the law - are upheld.
Dia, A; Toure, C T; Diop, M B; Thognon, P; Diop, A
Genital prolapses are the result of musculo-ligamentary alterations often caused or complicated by traumatic delivery and senible atrophy of the tissues. From 1969 to 1988, we gathered 104 files of patients with genital prolapses. The age of the patients ranged from 20 to 70 years with an average age of 30. The subject between the ages of 20 and 39 were the most affected (64%). The average number of children per woman was 4. 60 patients had 5 children. No case of prolapses was found among virgin or mulliparous women. In 48 cases delivery was dystocic. The clinical symptomatology was a feeling of intravaginal globus, pelvic algia and discomfort (57 cases). Straingul urinary incontinence wax manifest in 15 patients. Colpocystocele (88 cases), rectocele (66 cases) and hysterocele (50 cases) were among the most frequently evidence lesions. On the therapeutic matter, the low passage was used 58 times and the high passage 32 times. An urinary gesture was made 33 times. There was no operatory fatality. Urinary troubles related to infection, acute retention of urine and strainful urinary incontinence were observed. Later 10 cases of recurrence were observed within an average time interval of 2 years. This work is characterized by the young age of the patients. It denotes the noticeable role played by obstétrical traumatisms in the genesis of genital prolapses in the African context. The senescence and atrophy of the tissues seem to have a less important role in contrast with the developed countries. Finally, the surgical treatment of these patients must take into account, among other things, the child bearing desire of the patients, given the social and psychological weight of maternity in our society.
Genital amebiasis is not a frequent entity. Its association with cancer is still more rare. The author found just two other cases reported in the literature reviewed since 1892 up to date. A clinico-pathologic study was made of 4 cases of this uncommon coexistence: in two patients the lesions were located in the vulva; in the other two at the cervix uteri. Two of them showed eczematous reactions that disappeared with the antiamebian treatment; they were considered as Amebids, though mechanisms of photosensitivity.
Neri, I; Marzaduri, S; Passarini, B; Patrizi, A
Porokeratosis of Mibelli is a disorder of epidermal proliferation in which many different clinical forms can be distinguished. Two male patients with a localized type of porokeratosis limited to the genitalia are reported. Later in life they developed an annular skin lesion with peripheral keratotic ridge. The histological examination of a biopsy specimen showed the characteristic features of porokeratosis. There was no family history of similar skin disorders and the patients were not on any drugs. Genital porokeratosis is probably underdiagnosed and we believe that these patients should be followed up on account of the precancerous potential of this disease. Images PMID:8566987
Herpes - genital - self-care; Herpes simplex - genital - self-care; Herpesvirus 2 - self-care; HSV-2 - self-care ... Call your health care provider if you have any of the following: Symptoms of an outbreak that worsen despite medicine and self-care ...
Beauman, John G
Genital herpes simplex virus infection is a recurrent, lifelong disease with no cure. The strongest predictor for infection is a person's number of lifetime sex partners. The natural history includes first-episode mucocutaneous infection, establishment of latency in the dorsal root ganglion, and subsequent reactivation. Most infections are transmitted via asymptomatic viral shedding. Classic outbreaks consist of a skin prodrome and possible constitutional symptoms such as headache, fever, and inguinal lymphadenopathy. As the infection progresses, papules, vesicles on an erythematous base, and erosions appear over hours to days. These lesions usually crust, re-epithelialize, and heal without scarring. First-episode infections are more extensive: primary lesions last two to six weeks versus approximately one week for lesions in recurrent disease. Atypical manifestations are common. Infected persons experience a median of four recurrences per year after their first episode, but rates vary greatly. Genital herpes simplex virus type 2 recurs six times more frequently than type 1. Viral culture is preferred over polymerase chain reaction testing for diagnosis. Serologic testing can be useful in persons with a questionable history. Effective oral antiviral medications are available for initial, episodic, and suppressive therapy but are not a cure. There is some evidence that alternative therapies such as L-lysine, zinc, and some herbal preparations may offer some benefit. Counseling patients about the risk of transmission is crucial and helps prevent the spread of disease and neonatal complications.
Groves, Mary Jo
Genital herpes is a common sexually transmitted disease, affecting more than 400 million persons worldwide. It is caused by herpes simplex virus (HSV) and characterized by lifelong infection and periodic reactivation. A visible outbreak consists of single or clustered vesicles on the genitalia, perineum, buttocks, upper thighs, or perianal areas that ulcerate before resolving. Symptoms of primary infection may include malaise, fever, or localized adenopathy. Subsequent outbreaks, caused by reactivation of latent virus, are usually milder. Asymptomatic shedding of transmissible virus is common. Although HSV-1 and HSV-2 are indistinguishable visually, they exhibit differences in behavior that may affect management. Patients with HSV-2 have a higher risk of acquiring human immunodeficiency virus (HIV) infection. Polymerase chain reaction assay is the preferred method of confirming HSV infection in patients with active lesions. Treatment of primary and subsequent outbreaks with nucleoside analogues is well tolerated and reduces duration, severity, and frequency of recurrences. In patients with HSV who are HIV-negative, treatment reduces transmission of HSV to uninfected partners. During pregnancy, antiviral prophylaxis with acyclovir is recommended from 36 weeks of gestation until delivery in women with a history of genital herpes. Elective cesarean delivery should be performed in laboring patients with active lesions to reduce the risk of neonatal herpes.
Introduction Genital chlamydia is the most commonly reported bacterial sexually transmitted disease (STD) in resource-rich countries. In women, infection occurs most commonly between the ages of 16 and 19 years. Methods and outcomes We conducted a systematic review and aimed to answer the following clinical questions: What are the effects of antibiotic treatment in men, non-pregnant women, and pregnant women with uncomplicated genital chlamydia infection? We searched: Medline, Embase, The Cochrane Library, and other important databases up to January 2007 (BMJ Clinical Evidence reviews are updated periodically; please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA). Results We found 24 systematic reviews, RCTs, or observational studies that met our inclusion criteria. We performed a GRADE evaluation of the quality of evidence for interventions. Conclusions In this systematic review, we present information relating to the effectiveness and safety of the following interventions: amoxicillin, ampicillin, azithromycin, ciprofloxacin, clarithromycin, clindamycin, doxycycline, erythromycin, lymecycline, minocycline, ofloxacin, pivampicillin, rifampicin, roxithromycin, sparfloxacin, tetracycline, and trovafloxacin. PMID:19450291
Héla, Zakraoui; Samy, Fenniche; Rym, Benmously; Hajlaoui, Khaoula; Hayet, Marrak; Mohamed, Ben Ayed; Inçaf, Mokhtar
Lichen sclerosus is a chronic inflammatory mucocutaneous disease which origin remains unknown. Its prevalence ranges from one in 300 to one in 1000 of all patients referred to a dermatology clinic in the seventeenth. Through the analysis of a hospital survey, we outline the epidemio-clinical aspects of this dermatosis. Over a 19-year period (1984-2002), we have conducted a retrospective and monocentric study of all patients with genital lichen sclerosus were examined at the dermatology department of Habib Thameur hospital. Thirty-four patients suffered from lichen sclerosus. There were 33 female and only one male (sex-ratio: 0.03). All patients underwent topical corticosteroid therapy (level I, II or IV). The recovery rate of lichen sclerosus was about 20% (7/34). An epidermoid carcinoma occurred in three patients. The frequency of lichen sclerosus in our study is estimated at 1,8 new cases per year. This frequency is probably under-estimated because of some patients' reluctance to seek help. A relatively low recovery rate of genital lichen sclerosus was found in our study. This may be related to an inadequate follow up added to an insufficient treatment adherence.
Delgado-García, Silvia; Palacios-Marqués, Ana; Martínez-Escoriza, Juan Carlos; Martín-Bayón, Tina-Aurora
Acute genital ulcers, also known as acute vulvar ulcers, ulcus vulvae acutum or Lipschütz ulcers, refer to an ulceration of the vulva or lower vagina of non-venereal origin that usually presents in young women, predominantly virgins. Although its incidence is unknown, it seems a rare entity, with few cases reported in the literature. Their aetiology and pathogenesis are still unknown. The disease is characterised by an acute onset of flu-like symptoms with single or multiple painful ulcers on the vulva. Diagnosis is mainly clinical, after exclusion of other causes of vulvar ulcers. The treatment is mainly symptomatic, with spontaneous resolution in 2 weeks and without recurrences in most cases. We present a case report of a 13-year-old girl with two episodes of acute ulcers that fit the clinical criteria for Lipschütz ulcers.
Bunker, Christopher Barry; Shim, Tang Ngee
Male genital lichen sclerosus (MGLSc) is a chronic inflammatory skin disease responsible for male sexual dyspareunia and urological morbidity. An afeared complication is squamous cell carcinoma (SCC) of the penis. The precise etiopathogenesis of MGLSc remains controversial although genetic, autoimmune and infective (such as human papillomavirus (HPV) hepatitis C (HCV), Epstein-Barr virus (EBV) and Borrelia) factors have been implicated: Consideration of all the evidence suggests that chronic exposure of susceptible epithelium to urinary occlusion by the foreskin seems the most likely pathomechanism. The mainstay of treatment is topical ultrapotent corticosteroid therapy. Surgery is indicated for cases unresponsive to topical corticosteroid therapy, phimosis, meatal stenosis, urethral stricture, carcinoma in situ (CIS) and squamous cell carcinoma. PMID:25814697
Delgado-García, Silvia; Palacios-Marqués, Ana; Martínez-Escoriza, Juan Carlos; Martín-Bayón, Tina-Aurora
Acute genital ulcers, also known as acute vulvar ulcers, ulcus vulvae acutum or Lipschütz ulcers, refer to an ulceration of the vulva or lower vagina of non-venereal origin that usually presents in young women, predominantly virgins. Although its incidence is unknown, it seems a rare entity, with few cases reported in the literature. Their aetiology and pathogenesis are still unknown. The disease is characterised by an acute onset of flu-like symptoms with single or multiple painful ulcers on the vulva. Diagnosis is mainly clinical, after exclusion of other causes of vulvar ulcers. The treatment is mainly symptomatic, with spontaneous resolution in 2 weeks and without recurrences in most cases. We present a case report of a 13-year-old girl with two episodes of acute ulcers that fit the clinical criteria for Lipschütz ulcers. PMID:24473429
Senegal has joined Burkina Faso, the Central African Republic, Djibouti, Ghana, and Togo in outlawing female genital mutilation and assigning penalties of up to five years imprisonment to those who order or perform the procedure. Currently, 20% of Senegalese women have undergone female genital mutilation, and many girls are thought to have died as a result. UN agencies have made their opposition to female genital mutilation clear and have argued that women attempting to avoid the procedure should be granted asylum in other countries.
Genital symptoms in tropical countries and among returned travellers can arise from a variety of bacterial, protozoal, and helminthic infections which are not usually sexually transmitted. The symptoms may mimic classic sexually transmitted infections (STIs) by producing ulceration (for example, amoebiasis, leishmaniasis), wart-like lesions (schistosomiasis), or lesions of the upper genital tract (epididymo-orchitis caused by tuberculosis, leprosy, and brucellosis; salpingitis as a result of tuberculosis, amoebiasis, and schistosomiasis). A variety of other genital symptoms less suggestive of STI are also seen in tropical countries. These include hydrocele (seen with filariasis), which can be no less stigmatising than STI, haemospermia (seen with schistosomiasis), and hypogonadism (which may occur in lepromatous leprosy). This article deals in turn with genital manifestations of filariasis, schistosomiasis, amoebiasis, leishmaniasis, tuberculosis and leprosy and gives clinical presentation, diagnosis, and treatment. PMID:14755029
Forsum, U; Hjelm, E; Holmberg, K; Nord, C E; Wallin, J
Recent studies indicate that tonsillar gonococcal infection or colonization is fairly common. Carriage rates of about 8% have been found. These studies also indicate that oro-genital contacts are common. Since very little is known about the amount of oral microbiota transmitted to the genitals, we have studied the occurrence of oral streptococci and Neisseria species in urethra and cervix. Among 128 patients attending an STD-clinic we found 10 carriers of oral streptococci, one Streptococcus mitior, four Streptococcus sanguis, one Streptococcus mutans and four Streptococcus salivarius and case of urethritis due to Neisseria menigitidis. Seventy-three of the patients had recently had their genitals exposed to the oral flora of their partners. Despite the heavy contamination with oral microbiota that can be assumed to occur in these cases, there seems to be no colonization of the genitals with oral microbiota.
Jordan, G.H.; Gilbert, D.A.
We have attempted to discuss genital trauma in relatively broad terms. In most cases, patients present with relatively minimal trauma. However, because of the complexity of the structures involved, minimal trauma can lead to significant disability later on. The process of erection requires correct functioning of the arterial, neurologic, and venous systems coupled with intact erectile bodies. The penis is composed of structures that are compliant and distensible to the limits of their compliance. These structures therefore tumesce in equal proportion to each other, allowing for straight erection. Relatively minimal trauma can upset this balance of elasticity, leading to disabling chordee. Likewise, relatively minimal injuries to the vascular erectile structures can lead to significantly disabling spongiofibrosis. The urethra is a conduit of paramount importance. Whereas the development of stricture is generally related to the nature of the trauma, the extent of stricture and of attendant complications is clearly a function of the immediate management. Overzealous debridement can greatly complicate subsequent reconstruction. A delicate balance between aggressive initial management and maximal preservation of viable structures must be achieved. 38 references.
Introduction Warts are caused by the human papillomavirus (HPV), of which there are over 100 types. HPV probably infects the skin via areas of minimal trauma. Risk factors include use of communal showers, occupational handling of meat, and immunosuppression. In immunocompetent people, warts are harmless and resolve as a result of natural immunity within months or years. Methods and outcomes We conducted a systematic review and aimed to answer the following clinical question: What are the effects of treatments for warts (non-genital)? We searched: Medline, Embase, The Cochrane Library, and other important databases up to October 2013 (Clinical Evidence reviews are updated periodically; please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA). Results We found 17 studies that met our inclusion criteria. We performed a GRADE evaluation of the quality of evidence for interventions. Conclusions In this systematic, review we present information relating to the effectiveness and safety of the following interventions: intralesional bleomycin; intralesional candida antigen; contact immunotherapy; cryotherapy; duct tape occlusion; photodynamic treatment; pulsed dye laser; surgical procedures; and topical salicylic acid. PMID:24921240
Introduction Warts are caused by the human papillomavirus (HPV), of which there are over 100 types, which probably infects the skin via areas of minimal trauma. Risk factors include use of communal showers, occupational handling of meat, and immunosuppression. In immunocompetent people, warts are harmless and resolve as a result of natural immunity within months or years. Methods and outcomes We conducted a systematic review and aimed to answer the following clinical question: What are the effects of treatments for warts (non-genital)? We searched: Medline, Embase, The Cochrane Library, and other important databases up to June 2008 (Clinical Evidence reviews are updated periodically; please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA). Results We found 12 systematic reviews, RCTs, or observational studies that met our inclusion criteria. We performed a GRADE evaluation of the quality of evidence for interventions. Conclusions In this systematic, review we present information relating to the effectiveness and safety of the following interventions: intralesional bleomycin; cimetidine; contact immunotherapy; cryotherapy; duct tape occlusion; formaldehyde, glutaraldehyde; homeopathy; photodynamic treatment; pulsed dye laser; surgical procedures; topical salicylic acid; and zinc sulphate. PMID:21726478
O’Connell, Catherine M.; Ferone, Morgan E.
Etiology, transmission and protection: Chlamydia trachomatis is the leading cause of bacterial sexually transmitted infection (STI) globally. However, C. trachomatis also causes trachoma in endemic areas, mostly Africa and the Middle East, and is a leading cause of preventable blindness worldwide. Epidemiology, incidence and prevalence: The World Health Organization estimates 131 million new cases of C. trachomatis genital infection occur annually. Globally, infection is most prevalent in young women and men (14-25 years), likely driven by asymptomatic infection, inadequate partner treatment and delayed development of protective immunity. Pathology/Symptomatology: C. trachomatis infects susceptible squamocolumnar or transitional epithelial cells, leading to cervicitis in women and urethritis in men. Symptoms are often mild or absent but ascending infection in some women may lead to Pelvic Inflammatory Disease (PID), resulting in reproductive sequelae such as ectopic pregnancy, infertility and chronic pelvic pain. Complications of infection in men include epididymitis and reactive arthritis. Molecular mechanisms of infection: Chlamydiae manipulate an array of host processes to support their obligate intracellular developmental cycle. This leads to activation of signaling pathways resulting in disproportionate influx of innate cells and the release of tissue damaging proteins and pro-inflammatory cytokines. Treatment and curability: Uncomplicated urogenital infection is treated with azithromycin (1 g, single dose) or doxycycline (100 mg twice daily x 7 days). However, antimicrobial treatment does not ameliorate established disease. Drug resistance is rare but treatment failures have been described. Development of an effective vaccine that protects against upper tract disease or that limits transmission remains an important goal. PMID:28357377
Renner-Martin, T F P; Forstenpointner, G; Weissengruber, G E; Eberhardt, L
Although donkeys play an important role as companion or pack and draught animals, theriogenological studies and anatomical data on the genital organs of the jenny are sparse. To provide anatomical descriptions and morphometric data, the organa genitalia feminina, their arteries and the ligamentum latum uteri of 10 adult but maiden jennies were examined by means of gross anatomical and morphometric techniques. In comparison with anatomical data of horses obtained from literature the genital organs of jennies appear to be more voluminous in relation to the body mass and the position of the ovaries is slightly further cranial than in mares. In asses, the ovaries contain large follicles reaching a diameter of up to 40 mm. The mesosalpinx is much wider than in the horse forming a considerably spacious bursa ovarica. The asinine ligamentum teres uteri reveals a very prominent cranial end, the 'appendix'. Tortuous mucosal folds occur in the wall of the jenny's cervical channel. The vascularization of the female genital organs of asses is very similar to that of horses. One of the examined specimens reveals a large mucosal fold dividing the cranial part of the vagina into a left and right compartment.
Martinelli, M; Ollé-Goig, J E
The practice of female genital mutilation (we will use the latest definition adopted by WHO/UNFP: female genital mutilation/cutting or FGM/C) is still widespread in 28 African countries. The World Health Organisation (WHO) estimates that more than two million females undergo some form of genital mutilation every year. Its negative health impact and its ethical and human rights aspects have been discussed and attempts to eliminate it have been the objectives of several meetings promoted by national and international organisations thanks to an increased awareness related to FGM/C in those countries practicing it and also, maybe due to the number of Africans migrating to industrialized countries. We review the present situation in Djibouti, a small country in the Horn of Africa, where 98 % of the female population has suffered different forms of FGM/C.
Farage, Miranda A; Warren, Raphael
Emollients are known to lubricate, moisturize and soothe the skin. Prior to their incorporation into feminine hygiene pads, thorough premarket toxicological testing is conducted to evaluate their safety and effectiveness via in-use clinical settings. Product testing has been conducted on various body sites proven previously to be valid and reliable, such as the arm and popliteal fossa and, more recently, the genital area. Several clinical studies have confirmed the safety and efficacy of emollient-containing feminine hygiene products, which have also been shown to provide dermatological benefits in the genital area. Copyright © 2011 S. Karger AG, Basel.
Hunter, Stanley R; Lishnak, Timothy S; Powers, Andria M; Lisle, David K
Male genital trauma is a rare but potentially serious sports injury. Although such an injury can occur by many different mechanisms, including falls, collisions, straddle injuries, kicks, and equipment malfunction, the clinical presentation is typically homogeneous, characterized by pain and swelling. Almost all sports-related male genital injury comes from blunt force trauma, with involvement of scrotal structures far more common than penile structures. Most injuries can be treated conservatively, but catastrophic testicular injury must first be ruled out. Despite being relatively uncommon compared with other sports injuries, more than half of all testicular injuries are sustained during sports.
Hernandez, Brenda Y; Shvetsov, Yurii B; Goodman, Marc T; Wilkens, Lynne R; Thompson, Pamela J; Zhu, Xuemei; Tom, James; Ning, Lily
Objectives To evaluate the relationship of warts in different parts of the body and the risk of asymptomatic genital human papillomavirus (HPV) infection in men. Methods We examined the relationship of self-reported genital and extra-genital warts with the subsequent acquisition of asymptomatic genital HPV infection in a cohort of 331 adult men. Participants were followed at 2-month intervals for up to 4 years. Past and current presence of warts was queried at study entry. At each visit, the external genitals were sampled for HPV DNA testing. Results Men who reported a history of genital warts, including current warts, were at increased risk of acquisition of asymptomatic HPV infection of the penis glans/corona, penis shaft and scrotum. The magnitude of these associations was greatest for HPV 6/11 infection. History of warts on the fingers, arms and trunk of the body was also associated with increased risk of genital HPV infection. Current presence of warts on the fingers and trunk specifically increased the risk of acquisition of HPV types not typically found on the genitals. Conclusions Men with a history of warts on the genitals, fingers, arms and trunk may be at increased risk for acquisition of new genital HPV infections. Warts may provide an efficient reservoir for the transmission of virions to the genitals through auto-inoculation. The potential for the spread of HPV throughout the body through auto-inoculation has important implications for prevention and control of HPV infection. PMID:21602516
... bladder control and how the genitals look and work. Hydronephrosis. In this condition, one or both kidneys swell because a blockage ... condition. Polycystic kidney disease (also called PKD). This condition ... cysts make the kidneys work poorly, leading to kidney failure. Cysts also may ...
Shaw, Dorothy; Lefebvre, Guylaine; Bouchard, Celine; Shapiro, Jodi; Blake, Jennifer; Allen, Lisa; Cassell, Krista; Leyland, Nicholas; Wolfman, Wendy; Allaire, Catherine; Awadalla, Alaa; Best, Carolyn; Dunn, Sheila; Heywood, Mark; Lemyre, Madeleine; Marcoux, Violaine; Menard, Chantal; Potestio, Frank; Rittenberg, David; Singh, Sukhbir; Shapiro, Jodi; Akhtar, Saima; Camire, Bruno; Christilaw, Jan; Corey, Julie; Nelson, Erin; Pierce, Marianne; Robertson, Deborah; Simmonds, Anne
Objectif : Fournir aux gynécologues canadiens des directives factuelles en matière de chirurgie esthétique génitale chez la femme, en réponse au nombre grandissant de demandes (et d’interventions) de chirurgie vaginale et vulvaire se situant bien au-delà des reconstructions traditionnellement indiquées sur le plan médical. Résultats : La littérature publiée a été récupérée par l’intermédiaire de recherches menées dans PubMed ou MEDLINE, CINAHL et The Cochrane Library en 2011 et en 2012 au moyen d’un vocabulaire contrôlé et de mots clés appropriés (« female genital cosmetic surgery »). Les résultats ont été restreints aux analyses systématiques, aux essais comparatifs randomisés / essais cliniques comparatifs et aux études observationnelles. Aucune restriction n’a été appliquée en matière de date ou de langue. Les recherches ont été mises à jour de façon régulière et intégrées à la directive clinique jusqu’en mai 2012. La littérature grise (non publiée) a été identifiée par l’intermédiaire de recherches menées dans les sites Web d’organismes s’intéressant à l’évaluation des technologies dans le domaine de la santé et d’organismes connexes, dans des collections de directives cliniques, dans des registres d’essais cliniques et auprès de sociétés de spécialité médicale nationales et internationales. Valeurs : La qualité des résultats est évaluée au moyen des critères décrits dans le rapport du Groupe d’étude canadien sur les soins de santé préventifs (Tableau). Recommandations 1. Un des rôles importants des obstétriciens-gynécologues devrait consister à aider les femmes à comprendre leur anatomie et à en respecter les variantes qui leur sont propres. (III-A) 2. Lorsqu’une femme demande la tenue d’interventions esthétiques vaginales, une anamnèse médicale, sexuelle et gynécologique exhaustive devrait être obtenue et l’absence de tout dysfonctionnement
In Djibouti, the prevalence of female genital mutilations (FGMs) amounts to 98% and the practice is still in use. When I left, in 1999, I knew I would involve myself in the fight against FGMs and I describe here the outcome of an obstacle course of more than ten years duration. This paper is written on behalf of innumerable women, who could give you a similar account.
Legoff, Jérôme; Aymard, Michèle; Braig, Suzanne; Ramel, Françoise; Dreno, Brigitte; Bélec, Laurent; Malkin, Jean-Elie
The epidemiology of genital herpes is changing. The seroprevalence of HSV-2 infections is increasing, while HSV-1 is an increasingly common cause of herpetic ulcerations. The reference examination provides direct diagnosis after viral isolation in a cell culture or genome amplification. Herpes serology is indicated principally if direct examination is negative and in the absence of lesions. Non-type-specific serology detects antibodies common to HSV-1 and HSV-2. Its specificity and sensitivity are excellent, and it is approved as a reimbursable laboratory procedure. It cannot specify the viral type involved. Type-specific serology can distinguish between anti-HSV-1 and anti-HSV-2 antibodies. Currently available kits have a sensitivity and specificity, depending on the population studied, of 90 to 100%. It is not approved as a reimbursable laboratory procedure. HSV-1-specific serology cannot diagnose old HSV-1 genital infections, but seropositivity for HSV-2 generally suffices to diagnose HSV-2 genital herpes. The indication for type-specific serology must be discussed according to clinical context. The value of non-type-specific serology is limited.
Perron, Liette; Senikas, Vyta; Burnett, Margaret; Davis, Victoria
Objectif : Renforcer le cadre national des soins offerts aux adolescentes et aux femmes affectées par l’excision génitale féminine (EGF) au Canada en fournissant aux professionnels de la santé : (1) des renseignements ayant pour but d’approfondir leur compréhension de cette pratique et leurs connaissances à ce sujet; (2) des consignes quant aux aspects légaux liés à cette pratique; (3) des directives cliniques pour la gestion des soins obstétricaux et gynécologiques, y compris la prise en charge des complications liées à l’EGF; et (4) des conseils quant à l’offre de soins compétents au plan culturel aux adolescentes et aux femmes ayant subi une EGF. Résultats : La littérature publiée a été récupérée par l’intermédiaire de recherches menées dans PubMed, CINAHL et The Cochrane Library en septembre 2010 au moyen d’un vocabulaire contrôlé (p. ex. « Circumcision », « Female ») et de mots clés (p. ex. « female genital mutilation », « clitoridectomy », « infibulation ») appropriés. Nous avons également mené des recherches dans Social Science Abstracts, Sociological Abstracts, Gender Studies Database et ProQuest Dissertations and Theses en 2010 et en 2011. Aucune restriction n’a été appliquée en matière de date ou de langue. Les recherches ont été mises à jour de façon régulière et intégrées à la directive clinique jusqu’en décembre 2011. La littérature grise (non publiée) a été identifiée par l’intermédiaire de recherches menées dans les sites Web d’organismes s’intéressant à l’évaluation des technologies dans le domaine de la santé et d’organismes connexes, dans des collections de directives cliniques, dans des registres d’essais cliniques et auprès de sociétés de spécialité médicale nationales et internationales. Valeurs : La qualité des résultats a été évaluée au moyen des critères décrits dans le rapport du Groupe d’étude canadien sur les soins
Clinical, subclinical, and latent human papillomavirus (HPV) infections are distinguished from HPV-associated neoplasia. Besides HPV additional cofactors are necessary to transform HPV infected tissue to intraepithelial or invasive neoplasia. Risk factors for the presence of HPV are high number of sexual partners, early cohabitarche, young age at first delivery, suppression and alteration of immune status, young age and hormonal influences. While the fact of a high number of sexual partners exclusively increases the risk of HPV infection, it is not known whether the other factors lead to either an increased risk for HPV infection and/or to HPV-associated neoplasia. Subclinical and latent genital HPV infections are highly prevalent. The prevalence rate depends on the sensitivity of the HPV detection system used, on age and sexual activity of the population screened, and on the number of subsequent examinations performed for each subject. Sexual transmission is the main pathway for genital HPV's, however, vertical, peripartal, and oral transmission are also possible. Seroreactivity against genital HPV may be due to an active infection or the result of contact with HPV earlier in life. Antibodies against the HPV 16 E7 protein indicate an increased risk for cervical cancer. Compared with humoral response cellular immune response is probably more important for regression of genital HPV infection: impaired cellular response is characterized by depletion of T helper/inducer cells and/or Langerhans cells and impaired function of natural killer cells and/or the infected keratinocyte. In condylomata replication and transcription of viral nucleic acids and antigen production coincide with cellular differentiation. However, the interaction between HPV and the keratinocyte on a molecular level in subclinical and latent disease is not well understood. Regression or persistence of subclinical and latent genital HPV infections as observed in longitudinal investigations show a
Clinical, subclinical, and latent human papillomavirus (HPV) infections are distinguished from HPV-associated neoplasia. Besides HPV additional cofactors are necessary to transform HPV infected tissue to intraepithelial or invasive neoplasia. Risk factors for the presence of HPV are high number of sexual partners, early cohabitarche, young age at first delivery, suppression and alteration of immune status, young age and hormonal influences. While the fact of a high number of sexual partners exclusively increases the risk of HPV infection, it is not known whether the other factors lead to either an increased risk for HPV infection and/or to HPV-associated neoplasia. Subclinical and latent genital HPV infections are highly prevalent. The prevalence rate depends on the sensitivity of the HPV detection system used, on age and sexual activity of the population screened, and on the number of subsequent examinations performed for each subject. Sexual transmission is the main pathway for genital HPV's, however, vertical, peripartal, and oral transmission are also possible. Seroreactivity against genital HPV may be due to an active infection or the result of contact with HPV earlier in life. Antibodies against the HPV 16 E7 protein indicate an increased risk for cervical cancer. Compared with humoral response cellular immune response is probably more important for regression of genital HPV infection: impaired cellular response is characterized by depletion of T helper/inducer cells and/or Langerhans cells and impaired function of natural killer cells and/or the infected keratinocyte. In condylomata replication and transcription of viral nucleic acids and antigen production coincide with cellular differentiation. However, the interaction between HPV and the keratinocyte on a molecular level in subclinical and latent disease is not well understood. Regression or persistence of subclinical and latent genital HPV infections as observed in longitudinal investigations show a
Marfatia, Yogesh S.; Patel, Dimpal; Menon, Devi S.; Naswa, Smriti
Genital allergy should be considered as a possible diagnosis in all patients with genital soreness or irritation for which no infection or dermatosis can be identified and in whom symptoms remain unchanged or worsen with treatment. It is an underreported and underdiagnosed condition as patients may not complain about symptoms in this area. Moreover, diagnosis and therapy may not often be conducted by a dermatologist or allergologist. Therefore, many cases of allergic diseases in the genital area remain undetected. PMID:27190404
Lupše, Nik; Cheng, Ren-Chung; Kuntner, Matjaž
In most animal groups, it is unclear how body size variation relates to genital size differences between the sexes. While most morphological features tend to scale with total somatic size, this does not necessarily hold for genitalia because divergent evolution in somatic size between the sexes would cause genital size mismatches. Theory predicts that the interplay of female-biased sexual size dimorphism (SSD) and sexual genital size dimorphism (SGD) should adhere to the 'positive genital divergence', the 'constant genital divergence', or the 'negative genital divergence' model, but these models remain largely untested. We test their validity in the spider family Nephilidae known for the highest degrees of SSD among terrestrial animals. Through comparative analyses of sex-specific somatic and genital sizes, we first demonstrate that 99 of the 351 pairs of traits are phylogenetically correlated. Through factor analyses we then group these traits for MCMCglmm analyses that test broader correlation patterns, and these reveal significant correlations in 10 out of the 36 pairwise comparisons. Both types of analyses agree that female somatic and internal genital sizes evolve independently. While sizes of non-intromittent male genital parts coevolve with male body size, the size of the intromittent male genital parts is independent of the male somatic size. Instead, male intromittent genital size coevolves with female (external and, in part, internal) genital size. All analyses also agree that SGD and SSD evolve independently. Internal dimensions of female genitalia evolve independently of female body size in nephilid spiders, and similarly, male intromittent genital size evolves independently of the male body size. The size of the male intromittent organ (the embolus) and the sizes of female internal and external genital components thus seem to respond to selection against genital size mismatches. In accord with these interpretations, we reject the validity of the
Shamloul, Rany; el-Sakka, Ahmed; Bella, Anthony J
Genital morphology (especially male) among the animal kingdom is characterized by extensive differences that even members of closely related species with similar general morphology may have remarkably diverse genitalia. To present the sexual medicine specialist with a basic understanding of the current hypotheses on genital evolution with an emphasis on the sexual selection theories. A review of current literature on the theories of genital evolution. Analysis of the supporting evidence for the sexual selection theories of genital evolution. Several theories have been proposed to explain genital evolution. Currently, the sexual selection theories are being considered to present valid and solid evidence explaining genital evolution. However, other theories, including sexual conflict, are still being investigated. All theories of genital evolution have their own weaknesses and strengths. Given that many complex biological mechanisms, mostly unknown yet, are involved in the process of genital evolution, it is thus reasonable to conclude that not one theory can independently explain genital evolution. It is likely that these mechanisms may prove to have synergistic rather than exclusive effects.
... Lucy* Yes — it is possible to get genital herpes from oral sex. Genital herpes is caused by the herpes ... Genital herpes is usually caused by HSV-2; oral herpes (cold sores) is usually caused by HSV-1. ...
Kolehmainen, Maija; Suominen, Sinikka
Genital surgery is performed at the final stage of the gender reassignment process and is in Finland by statutory regulation of 2003 concentrated to be carried out by the HUCH multiprofessional team. Statutory recommendations from the psychiatry units at both HUCH and Tays Central Hospital are required for this. Sex reassignment surgery will be undertaken on the basis of a steadfast wish of an adult patient on the condition that he/she understands the risks associated with surgery and is mentally and physically fit for the operation.
Goldenstein, Rachel A
Female genital cutting (FGC) is a practice that affects millions of girls and women worldwide. This deeply rooted practice has cultural, religious, and psychosexual meaning to its practitioners, but it also carries long-term physical and mental complications. Decried as a human rights violation, nonetheless this practice is still carried out today. Nurses are in a unique position to contact and educate women who have been cut or are at risk for mutilation. To advocate for these women, a thorough understanding of the practice of FGC, its cultural overtones, religious implications, and psychosexual effects is needed.
Cummings, Anne L.
Explores potential benefits of incorporating concepts and interventions from experimental therapy to help clients with psychosocial difficulties in learning to live with genital herpes. Recommends experimental counseling of two-chair dialog, empty chair, and metaphor for helping clients with emotional sequelae of genital herpes. Presents case…
Guerra, B; Puccetti, C; Cervi, F
Genital herpes is a common sexually transmitted infection. In reproductive age it involves the additional risk of vertical transmission to the neonate. Rates of transmission are affected by the viral type and whether the infection around delivery is primary or recurrent. Neonatal herpes is a rare but very severe complication of genital herpes infection and is caused by contact with infected genital secretions at the time of labor. Maternal acquisition of herpes simplex virus (HSV) in the third trimester of pregnancy carries the highest risk of neonatal transmission. Prevention of neonatal herpes depends on preventing acquisition of genital HSV infection during late pregnancy and avoiding exposure of the infant to herpetic lesions during delivery. Uninfected woman should be counselled about the need of avoiding sexual contact during the third trimester. Elective caesarean section before the onset of labor is the choice mode of delivery for women with genital lesions or with prodromal symptoms near the term, even if it offers only a partial protection against neonatal infection. Antiviral suppressive therapy is used from 36 weeks of gestation until delivery in pregnant women with recurrences to prevent genital lesions at the time of labor so reducing the need of caesarean sections. Currently, routine maternal serologic screening is not yet recommended. Because most mothers of infants who acquire neonatal herpes lack histories of clinically evident genital herpes, researchers should focus on the recognition of asymptomatic primary genital HSV infections.
Farmer, Melissa A.; Meston, Cindy M.
Despite the high prevalence of genital pain in healthy young adult women, limited research has addressed genital pain during intercourse using contemporary models of multidimensional sexual function. The objectives of this study were threefold: (1) to identify differences in sexual functioning in women who experience genital pain compared to pain free women; (2) to identify predictors of sexual functioning in women with and without genital pain; and (3) to identify predictors of sexual satisfaction in women with and without genital pain. Sexually active female undergraduates (n = 651) were administered the Female Sexual Function Index and the Derogatis Sexual Functioning Inventory. We evaluated the sexual factors that impact the sexual function of women with any pain (including high and low pain groups) versus women with no history of pain. Women with genital pain reported greater rates of sexual dysfunction as compared to pain-free women; however, sexual functioning in the high versus low pain groups was distinguished primarily by vaginal lubrication. Women in the high pain group showed negative correlations between domains of sexual satisfaction and genital pain frequency and intensity that were not found in the low pain group. For pain-free women, intercourse played a strong role in sexual satisfaction, whereas non-intercourse sexual behavior was central to sexual satisfaction in women who reported pain. The evaluation of levels of genital pain may provide insight into the mechanisms underlying the impairment of sexual function, sexual behavior, and sexual satisfaction. PMID:17674182
Handsfield, H H; Stone, K M; Wasserheit, J N
Few meeting participants envisioned a prevention and control program on the scale or scope of CDC's programs to prevent HIV infection, syphilis, gonorrhea, and chlamydial infection, but all agreed that the virtual absence of public health interventions to prevent genital herpes is no longer appropriate in light of evolving epidemiologic knowledge and other research advances. The ultimate scope of a national genital herpes prevention effort will depend in part on the results of the recommended research agenda, which probably will evolve over the better part of a decade. Numerous other STD prevention partners will also need to contribute to this effort and help to determine the makeup of future programs. Substantial new fiscal resources will be required both to implement the proposed research agenda and, depending on the results, to undertake the prevention efforts indicated by those studies. Competing STD prevention priorities and other national health needs will influence the availability of those resources. The consultants' meeting and the research and program activities summarized above are described in more detail in the full meeting report, which is posted on the Division's web site (www.cdc.gov/nchstp/dstd/dstdp.html) or may be requested directly from the Division. DSTDP is interested in receiving comments and suggestions about herpes prevention.
As one of the most common sexually transmitted diseases, genital herpes is a global medical problem with significant physical and psychological morbidity. Genital herpes is caused by herpes simplex virus type 1 or type 2 and can manifest as primary and/or recurrent infection. This manuscript provides an overview about the fundamental knowledge on the virus, its epidemiology, and infection. Furthermore, the current possibilities of antiviral therapeutic interventions and laboratory diagnosis of genital herpes as well as the present situation and perspectives for the treatment by novel antivirals and prevention of disease by vaccination are presented. Since the medical management of patients with genital herpes simplex virus infection is often unsatisfactory, this review aims at all physicians and health professionals who are involved in the care of patients with genital herpes. The information provided would help to improve the counseling of affected patients and to optimize the diagnosis, treatment, and prevention of this particular disease.
As one of the most common sexually transmitted diseases, genital herpes is a global medical problem with significant physical and psychological morbidity. Genital herpes is caused by herpes simplex virus type 1 or type 2 and can manifest as primary and/or recurrent infection. This manuscript provides an overview about the fundamental knowledge on the virus, its epidemiology, and infection. Furthermore, the current possibilities of antiviral therapeutic interventions and laboratory diagnosis of genital herpes as well as the present situation and perspectives for the treatment by novel antivirals and prevention of disease by vaccination are presented. Since the medical management of patients with genital herpes simplex virus infection is often unsatisfactory, this review aims at all physicians and health professionals who are involved in the care of patients with genital herpes. The information provided would help to improve the counseling of affected patients and to optimize the diagnosis, treatment, and prevention of this particular disease. PMID:27358569
Shin, Haina; Iwasaki, Akiko
Genital herpes is an incurable, chronic disease that affects millions of people worldwide. Not only does genital herpes cause painful, recurrent symptoms, it is also a significant risk factor for the acquisition of other sexually transmitted infections such as HIV-1. Antiviral drugs are used to treat herpes simplex virus (HSV) infection, but they cannot stop viral shedding and transmission. Thus, developing a vaccine that can prevent or clear infection will be crucial in limiting the spread of disease. In this review we outline recent studies that improve our understanding of host responses against HSV infection, discuss past clinical vaccine trials, and highlight new strategies for vaccine design against genital herpes.
Kluger, N; Garcia, C; Guillot, B
Lipschütz acute genital ulcer is a rare distinctive cause of nonvenereal acute genital ulcers that occurs particularly in adolescents described in 1913. We report here a typical case that occurred in a 24-year-old virgin woman who developed flu-like symptoms and painful genital ulcers that healed spontaneously within a week and without any infection (Epstein Barr Virus, toxoplasmosis, salmonella). The physiopathogeny remains unknown. However, there are body of evidences pointing out a possible link to several nonvenereal infections, including mainly Epstein-Barr virus acute infection. This rare benign but disabling entity should be known by gynecologists.
The increasing incidence of human papillomavirus (HPV) infection and HPV-associated conditions such as genital warts in women is a global concern. Genital warts are a clinical manifestation of HPV types 6 and 11, and are estimated to affect 1% of sexually active adults aged between 15 and 49. HPV infection is also strongly associated with cervical cancer, and is prevalent in as many as 99% of cases. The psychological stress of having genital warts is often greater than the morbidity of the disease, and therefore successful treatment is crucial. Current treatments are patient-applied and provider-administered therapies. Imiquimod 5% cream, a patient-applied therapy, is an efficacious treatment with tolerable side-effects and a low recurrence rate, and has the potential to be an effective strategy for the management of genital warts. PMID:11516064
Gall, S A
The increasing incidence of human papillomavirus (HPV) infection and HPV-associated conditions such as genital warts in women is a global concern. Genital warts are a clinical manifestation of HPV types 6 and 11, and are estimated to affect 1% of sexually active adults aged between 15 and 49. HPV infection is also strongly associated with cervical cancer, and is prevalent in as many as 99% of cases. The psychological stress of having genital warts is often greater than the morbidity of the disease, and therefore successful treatment is crucial. Current treatments are patient-applied and provider-administered therapies. Imiquimod 5% cream, a patient-applied therapy, is an efficacious treatment with tolerable side-effects and a low recurrence rate, and has the potential to be an effective strategy for the management of genital warts.
Suárez-Peñaranda, José Manuel; Vieites, Begoña; Evgenyeva, Elena; Vázquez-Veiga, Hugo; Forteza, Jeronimo
Genital leiomyoma in men include those superficial leiomyomas arising in the scrotum and the areola. They are unusual neoplasms: few cases have been reported in the literature and they usually escape clinical diagnosis. Three cases of male genital leiomyomas are reported: two in the scrotum and one in the areola. They were all conservatively excised and the behaviour was completely benign in all cases. Histopathological examination showed the typical findings of superficial leiomyomas, with some minor differences between cases arising in the scrotum and those from the areola. Immunohistochemical findings not only confirmed the smooth muscle nature of all cases but also showed unequivocal immunostaining for androgen receptors in the leiomyomas from the scrotum. Immunostaining for androgen receptors in scrotal leiomyomas is, as far as we are aware, a previously unknown characteristic of male genital leiomyomas. This finding supports the role of steroid hormones in the growth of genital leiomyomas, similar to leiomyomas found in other locations.
Malhotra, Meenakshi; Sood, Seema; Mukherjee, Anjan; Muralidhar, Sumathi; Bala, Manju
Chlamydia trachomatis is the most common cause of curable bacterial sexually transmitted infection (STI) worldwide. It manifests primarily as urethritis in males and endocervicitis in females. Untreated chlamydial infection in man can cause epididymitis and proctitis. Though most women with Chlamydia infection are asymptomatic or have minimal symptoms, some develop salpingitis, endometritis, pelvic inflammatory disease (PID), ectopic pregnancy and tubal factor infertility. It is associated with an increased risk for the transmission or acquisition of HIV and is also attributed to be a risk factor for the development of cervical carcinoma. Early diagnosis and treatment of infected individuals is required to prevent the spread of the disease and severe sequelae. Traditionally, tissue culture was considered the gold standard for the diagnosis. However, with the availability of newer diagnostic techniques particularly molecular methods which are not only highly sensitive and specific but are cost-effective also, the diagnosis has became fast and easy. The purpose of this review is to study the various aspects of genital C. trachomatis infection. Also the advances related to the clinical picture, various diagnostic modalities, prevention, treatment, drug resistance and control measures will be dealt with. PMID:24135174
As immigrant women from African countries enter the U.S., Canada, Australia, and Western Europe, western health care providers are beginning to see patients affected by the cultural practice of Female Genital Mutilation (FGM). Unfamiliar with the practice, either medically or culturally, these providers are turning to medical librarians for information. Complicating the issue are the strong negative feelings most western health care workers have about FGM, which appears to them to be both barbaric and cruel. These feelings may conflict strongly with those of their immigrant patients, who regard the practice as normal and desirable. Both medical and cultural information are needed for the professional to provide treatment of medical conditions, while also establishing a good relationship with the FGM affected patient. This article identifies and describes the most important refereed journal article databases, available now over the Internet, providing both medical and cultural information on FGM, and the most useful Web sites for health professionals, librarians, and interested laypersons who need information about this difficult multicultural issue.
Zhang, William R.; Garrett, Giorgia L.; Arron, Sarah T.
Genital gender affirming surgery (GAS) involves reconstruction of the genitals to match a patient’s identified sex. The use of hair-bearing flaps in this procedure may result in postoperative intra-vaginal and intra-urethral hair growth and associated complications, including lower satisfaction with genital GAS. Despite the significant increase in genital GAS within the past 50 years, there is limited data regarding hair removal practices in preparation for genital GAS and notable variation in hair removal techniques among dermatologists and other practitioners. We present a literature review, recommendations from our experience, and a practical laser hair removal (LHR) approach to hair removal prior to genital GAS. PMID:27298787
Zhang, William R; Garrett, Giorgia L; Arron, Sarah T; Garcia, Maurice M
Genital gender affirming surgery (GAS) involves reconstruction of the genitals to match a patient's identified sex. The use of hair-bearing flaps in this procedure may result in postoperative intra-vaginal and intra-urethral hair growth and associated complications, including lower satisfaction with genital GAS. Despite the significant increase in genital GAS within the past 50 years, there is limited data regarding hair removal practices in preparation for genital GAS and notable variation in hair removal techniques among dermatologists and other practitioners. We present a literature review, recommendations from our experience, and a practical laser hair removal (LHR) approach to hair removal prior to genital GAS.
Pellati, Donatella; Mylonakis, Ioannis; Bertoloni, Giulio; Fiore, Cristina; Andrisani, Alessandra; Ambrosini, Guido; Armanini, Decio
Infectious agents can impair various important human functions, including reproduction. Bacteria, fungi, viruses and parasites are able to interfere with the reproductive function in both sexes. Infections of male genito-urinary tract account for about 15% of the case of male infertility. Infections can affect different sites of the male reproductive tract, such as the testis, epididymis and male accessory sex glands. Spermatozoa themselves subsequently can be affected by urogenital infections at different levels of their development, maturation and transport. Among the most common microorganisms involved in sexually transmitted infections, interfering with male fertility, there are the Chlamydia trachomatis and Neisseria gonorrhoeae. Less frequently male infertility is due to non-sexually transmitted epididymo-orchitis, mostly caused by Escherichia coli. In female, the first two microorganisms are certainly involved in cervical, tubal, and peritoneal damage, while Herpes simplex cervicitis is less dangerous. The overall importance of cervical involvement is still under discussion. Tubo-peritoneal damage seems to be the foremost manner in which microorganisms interfere with human fertility. C. trachomatis is considered the most important cause of tubal lacerations and obstruction, pelvic inflammatory disease (PID) and adhesions. N. gonorrhoeae, even though its overall incidence seems to decline, is still to be considered in the same sense, while bacterial vaginosis should not be ignored, as causative agents can produce ascending infections of the female genital tract. The role of infections, particularly co-infections, as causes of the impairment of sperm quality, motility and function needs further investigation. Tropical diseases necessitate monitoring as for their diffusion or re-diffusion in the western world.
Tétrault, I.; Boivin, G.
OBJECTIVE: To provide an update on new diagnostic tests and antiviral strategies for managing genital herpes. QUALITY OF EVIDENCE: Treatment guidelines are based on randomized clinical trials and recommendations from the Expert Working Group on Canadian Guidelines for Sexually Transmitted Diseases. Recommendations concerning other aspects of managing genital herpes (e.g., indications for using type-specific serologic tests) are mainly based on expert opinion. MAIN MESSAGE: Genital herpes is one of the most common sexually transmitted diseases, affecting about 20% of sexually active people; up to 80% of cases are undiagnosed. Because of frequent atypical presentation and the emotional burden associated with genital herpes, clinical diagnosis should be confirmed by viral culture. Type-specific serologic assays are now available, but their use is often restricted to special situations and requires adequate counseling. New antivirals (valacyclovir and famciclovir) with improved pharmacokinetic profiles have now been approved for episodic treatment of recurrences and suppressive therapy. CONCLUSION: Wise use of new diagnostic assays for herpes simplex coupled with more convenient treatment regimens should provide better management of patients with genital herpes. Images Figure 1 PMID:10955181
Gupta, Somesh; Ajith, C; Kanwar, Amrinder J; Sehgal, Virendra N; Kumar, Bhushan; Mete, Uttam
Genital elephantiasis is an important medical problem in the tropics. It usually affects young and productive age group, and is associated with physical disability and extreme mental anguish. The majority of cases are due to filariasis; however, a small but significant proportion of patients develop genital elephantiasis due to bacterial sexually transmitted infections (STIs), mainly lymphogranuloma venereum (LGV) and donovanosis. STI-related genital elephantiasis should be differentiated from elephantiasis due to other causes, including filariasis, tuberculosis, haematological malignancies, iatrogenic, or dermatological diseases. Laboratory investigations like microscopy of tissue smear and nucleic acid amplification test for donovanosis, and serology and polymerase chain reaction for LGV may help in the diagnosis, but in endemic areas, in the absence of laboratory facilities, diagnosis largely depends on clinical characteristics. The causative agent of LGV, Chlamydia trachomatis serovar L1-L3, is a lymphotropic organism which leads to the development of thrombolymphangitis and perilymphangitis, and lymphadenitis. Long-standing oedema, fibrosis and lymphogranulomatous infiltration result in the final picture of elephantiasis. Elephantiasis in donovanosis is mainly due to constriction of the lymphatics which are trapped in the chronic granulomatous inflammatory response generated by the causative agent, Calymmatobacterium (Klebsiella) granulomatis. The LGV-associated genital elephantiasis should be treated with a prolonged course of doxycycline given orally, while donovanosis should be treated with azithromycin or trimethoprim-sulphamethoxazole combination given for a minimum of three weeks. Genital elephantiasis is not completely reversible with medical therapy alone and often needs to be reduced surgically.
Farmer, Melissa A; Maykut, Caroline A; Huberman, Jackie S; Huang, Lejian; Khalifé, Samir; Binik, Yitzchak M; Apkarian, A Vania; Schweinhardt, Petra
Provoked vestibulodynia (PVD) is characterized by the presence of vulvar touch and pain hypersensitivity. Pain with vaginal distension, which motivates treatment seeking and perpetuates distress, is frequently reported with PVD. However, the concordance between the perception of vulvar and vaginal sensation (ie, somatic and visceral genital sensations, respectively) remains unstudied in healthy women, as well as in clinical populations such as PVD. To evaluate the static and dynamic (time-varying) properties of somatic and visceral genital sensation, women with PVD (n=14) and age- and contraceptive-matched healthy controls (n=10) rated varying degrees of nonpainful and painful genital stimulation. Somatic (vulvar) mechanical sensitivity to nonpainul and painful degrees of force were compared to visceral (vaginal) sensitivity to nonpainful and painful distension volumes. Results indicated that healthy women showed substantial individual variation in and high discrimination of vulvar and vaginal sensation. In contrast, PVD was associated with vulvar allodynia and hyperalgesia, as well as vaginal allodynia. Modeling of dynamic perception revealed novel properties of abnormal PVD genital sensation, including temporal delays in vulvar touch perception and reduced perceptual thresholds for vaginal distension. The temporal properties and magnitude of PVD distension pain were indistinguishable from vaginal fullness in healthy controls. These results constitute the first empirical comparison of somatic and visceral genital sensation in healthy women. Findings provide novel insights into the sensory abnormalities that characterize PVD, including an experimental demonstration of visceral allodynia. This investigation challenges the prevailing diagnostic assessment of PVD and reconceptualizes PVD as a chronic somatic and visceral pain condition.
Johnston, Christine; Corey, Lawrence
Herpes simplex virus 2 (HSV-2) is a DNA virus that is efficiently transmitted through intimate genital tract contact and causes persistent infection that cannot be eliminated. HSV-2 may cause frequent, symptomatic self-limited genital ulcers, but in most persons infection is subclinical. However, recent studies have demonstrated that the virus is frequently shed from genital surfaces even in the absence of signs or symptoms of clinical disease and that the virus can be transmitted during these periods of shedding. Furthermore, HSV-2 shedding is detected throughout the genital tract and may be associated with genital tract inflammation, which likely contributes to increased risk of HIV acquisition. This review focuses on HSV diagnostics, as well as what we have learned about the importance of frequent genital HSV shedding for (i) HSV transmission and (ii) genital tract inflammation, as well as (iii) the impact of HSV-2 infection on HIV acquisition and transmission. We conclude with discussion of future areas of research to push the field forward.
SUMMARY Herpes simplex virus 2 (HSV-2) is a DNA virus that is efficiently transmitted through intimate genital tract contact and causes persistent infection that cannot be eliminated. HSV-2 may cause frequent, symptomatic self-limited genital ulcers, but in most persons infection is subclinical. However, recent studies have demonstrated that the virus is frequently shed from genital surfaces even in the absence of signs or symptoms of clinical disease and that the virus can be transmitted during these periods of shedding. Furthermore, HSV-2 shedding is detected throughout the genital tract and may be associated with genital tract inflammation, which likely contributes to increased risk of HIV acquisition. This review focuses on HSV diagnostics, as well as what we have learned about the importance of frequent genital HSV shedding for (i) HSV transmission and (ii) genital tract inflammation, as well as (iii) the impact of HSV-2 infection on HIV acquisition and transmission. We conclude with discussion of future areas of research to push the field forward. PMID:26561565
Farage, Miranda A; Lennon, Lisa; Ajayi, Funmi
A wide variety of products are used by women in the genital area and, therefore, come into contact with the genital mucosa. The largest category of such products would be those used for cleanliness and odor control, such as soaps and body washes, douches, premoistened wipes and towelettes, dusting powder and deodorant sprays. A second large category of products are those intended to absorb fluids, such as products used for menstrual protection (tampons, pads and panty liners) and incontinence protection. Lubricants and moisturizers, and aesthetic products (hair removal products and dyes) are also fairly common. In addition, over the counter medications are now available for the treatment of fungal infections. This chapter briefly discusses the products women use on or around the genital area, the perceived or real benefits, and the potential health effects of these products. Copyright © 2011 S. Karger AG, Basel.
Sharp, Gemma; Tiggemann, Marika
The study investigated the effectiveness of two online resources aimed at improving women's knowledge of the variation in normal female genital appearance and their attitudes towards their own genitals. The first consisted of a photographic array of normal female genitals and the second consisted of a video addressing digital airbrushing of women's genitals in media images. A sample of 136 female undergraduate students were randomly assigned to view the photographs, video, both the photographs and video, or neither. The video significantly increased women's perceptions of genital appearance diversity as well as awareness of digital airbrushing of genital images. Owing to relatively low levels of genital appearance concern, there was no effect of either resource on women's attitudes towards their own genitals; however, women who viewed the video indicated they would pass on their knowledge to help other women. Our results suggest that an educational video could be a useful tool. Copyright © 2015 Elsevier Ltd. All rights reserved.
Hebert, Leah J
This article was written by a student interested in female genital mutilation as part of a school project. The article reviews exactly what female genital mutilation entails, its history, and the role of the forensic and critical-care nurse.
Brantley, Julie S; Hicks, Lindsey; Sra, Karan; Tyring, Stephen K
Genital herpes is the most prevalent sexually transmitted infection in the USA. While sometimes mild in severity, it can be a distressing and painful chronic condition. Likewise, herpes labialis and herpes zoster can be both physically and psychologically painful. While there is no cure for these conditions, treatment to alleviate symptoms, suppress recurrences and reduce transmission has been drastically improved over the past 20 years with the use of guanine nucleoside antivirals, such as valacyclovir hydrochloride (Valtrex), GlaxoSmithKline) the highly bioavailable prodrug of acyclovir (Zovirax((R)), GlaxoSmithKline), and famciclovir (Famvir, Novartis), a highly bioavailable prodrug of penciclovir (Denavir, Novartis). Clinical trials involving approximately 10,000 patients (including patients from nongenital herpes studies, such as herpes zoster) have assessed the safety and efficacy of valacyclovir in the treatment of initial genital herpes outbreaks, episodic treatment of recurrent episodes and daily suppressive therapy. It was shown that valacyclovir has similar efficacy to acyclovir in the episodic and suppressive treatment of genital herpes. Valacyclovir is the only antiviral drug approved for a once-daily dose of suppressive therapy for genital herpes, as well as the only antiviral drug US FDA approved for a 3-day regimen of episodic treatment of recurrent genital herpes. In addition, valacyclovir is also indicated in the reduction of the sexual transmission of herpes simplex virus infection and for the treatment of herpes labialis. In herpes zoster, valacyclovir is more effective than acyclovir or placebo (and as equally effective as famciclovir) in shortening the length and severity of herpes zoster-associated pain and postherpetic neuralgia. Valacyclovir has an acceptable safety profile in patients with herpes simplex and herpes zoster. The less frequent dosing regimen makes it an attractive option in the treatment of genital herpes and other viral
Andreassi, Lucio; Bilenchi, Roberta
The genitalia may be the site of non-infectious inflammatory lesions that are generally manifested as balanoposthitis and vulvovaginitis. In men, these forms constitute 50% of all balanoposthitis forms, and in women, vulvovaginitis frequency is even higher. They consist of genital locations of general skin diseases, such as psoriasis, lichen planus, lichen sclerosus, and other clinical entities with their own physiognomy, such as Zoon's balanitis-vulvitis. Diagnosis of genital non-infectious inflammatory lesions is usually made on clinical criteria. A biopsy is only necessary for the identification of clinical conditions that may simulate inflammatory form but are actually premalignant processes.
Zayabaatar, Dalai; Dashdavaa, Vanchinsuren; Enkhjargal, Dagvasumberel; Onon, Tsulbaatar
This paper presents peculiarities of the genitive case marked subject in Modern Mongolian. First, we argue that subordinate clauses with the genitive case-marked subject in Modern Mongolian are CP. Second, we provide an explanation for certain conditions of the genitive subject construction in Modern Mongolian (MM). Third, we attempt to show the…
Sudenga, Staci L.; Ingles, Donna J.; Pierce Campbell, Christine M.; Lin, Hui-Yi; Fulp, William J.; Messina, Jane L.; Stoler, Mark H.; Abrahamsen, Martha; Villa, Luisa L.; Lazcano-Ponce, Eduardo; Giuliano, Anna R.
Background Human papillomavirus (HPV) causes two types of external genital lesions (EGLs) in men: genital warts (condyloma) and penile intraepithelial neoplasia (PeIN). Objective The purpose of this study was to describe genital HPV progression to a histopathologically confirmed HPV-related EGL. Design, Setting and Participants A prospective analysis nested within the HPV Infection in Men (HIM) Study was conducted among 3033 men. At each visit, visually distinct EGLs were biopsied, subjected to pathological evaluation, and categorized by pathological diagnoses. Genital swabs and biopsies were used to identify HPV types using the Linear Array genotyping method for swabs and INNO-LiPA for biopsies. Outcome Measurements EGL incidence was determined among 1788 HPV-positive men, and cumulative incidence rates at 6, 12, and 24 months were estimated. The proportion of HPV infections that progressed to EGL was also calculated, along with median time to EGL development. Results and Limitations Among 1788 HPV-positive men, 92 developed an incident EGL during follow-up (9 PeIN and 86 condyloma). During the first 12 months of follow-up, 16% of men with a genital HPV6 infection developed a HPV6-positive condyloma, and 22% of genital HPV11 infections progressed to an HPV11-positive condyloma. During the first 12-months of follow-up, 0.5% of men with a genital HPV16 infection developed an HPV16-positive PeIN. Although we expected PeIN to be a rare event, the sample size for PeIN (n=10) limited the types of analyses that could be performed. Conclusions Most EGLs develop following infection with HPV 6, 11, or 16, all of which could be prevented with the 4-valent HPV vaccine. Patient Summary In this study, we looked at genital HPV infections that can cause lesions in men. The HPV that we detected within the lesions could be prevented through a vaccine. PMID:26051441
Lopaschuk, Catharine C.
Abstract Objective To summarize and determine the appropriate use for the new and old management tools for genital warts. Sources of information The following databases were searched: MEDLINE, PubMed, EMBASE, Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials, ACP Journal Club, and Trip. The bibliographies of retrieved papers were also reviewed. Clinical trials, qualitative review articles, consensus reports, and clinical practice guidelines were retrieved. Main message Symptomatic warts are prevalent in at least 1% of the population between the ages of 15 and 49, with estimates of up to 50% of the population being infected with human papillomavirus at some point in their lifetime. Imiquimod and podophyllotoxin are 2 new treatments for external genital warts that are less painful and can be applied by patients at home. In addition, the quadrivalent human papillomavirus vaccine has been shown to be efficacious in preventing genital warts and cervical cancer. There is still a role for the older treatment methods in certain situations, such as intravaginal, urethral, anal, or recalcitrant warts; or for pregnant patients. Conclusion The new treatments of external genital warts can reduce the pain of treatment and the number of office visits. Other treatment methods are still useful in certain situations. PMID:23851535
Hypospadias is a developmental defect of urethral tube closure that has a complex etiology. Here, we describe a multicellular agent-based model of genital tubercle development that simulates urethrogenesis from the urethral plate stage to urethral tube closure in differentiating male embryos. The model, constructed in CompuCell3D, implemented spatially dynamic signals from SHH, FGF10, and androgen signaling pathways. These signals modulated stochastic cell behaviors, such as differential adhesion, cell motility, proliferation, and apoptosis. Urethral tube closure was an emergent property of the model that was quantitatively dependent on SHH and FGF10 induced effects on mesenchymal proliferation and endodermal apoptosis, ultimately linked to androgen signaling. In the absence of androgenization, simulated genital tubercle development defaulted to the female condition. Intermediate phenotypes associated with partial androgen deficiency resulted in incomplete closure. Using this computer model, complex relationships between urethral tube closure defects and disruption of underlying signaling pathways could be probed theoretically in multiplex disturbance scenarios and modeled into probabilistic predictions for individual risk for hypospadias and potentially other developmental defects of the male genital tubercle. We identify the minimal molecular network that determines the outcome of male genital tubercle development in mice.
Sacks, Stephen L.
This article offers some background information on diagnosis and treatment of three major causes of genital ulcers: syphilis, herpes simplex virus (HSV), and chancroid. The author also discusses differential diagnoses and suggests an approach to treatment. ImagesFigure 1Figure 2Figure 3Figure 4Figure 6Figure 7 PMID:21263799
Martínez-García, F; Regadera, J; Mayer, R; Sanchez, S; Nistal, M
We reviewed the literature on protozoan infections in the male genital tract, with special reference to histopathological findings and their repercussions on different andrological functions. A literature search of the MEDLINE data base from 1966 to May 1995 was done and related articles were identified. The considered terms were parasitology and the male genital organs. Additional searches on infertility, semen and sexually transmitted diseases were performed. Protozoan infections of the male genital tract are rare and only a few species of parasites are involved. Trichomonas vaginalis, Trypanosoma species, Leishmania donovani, Entamoeba histolytica, Acanthamoeba species, Toxoplasma gondii and Plasmodium falciparum have been described in the male genital tract as producing testicular damage or secondary hypogonadism via hypothalamic-hypophyseal axis alterations. Topics of interest were the role of sexual transmission by some parasites, principally T. vaginalis, relationship with subfertility or infertility in the male subject, clinical significance in differential diagnosis with other inflammatory processes, and for some parasites the relationship with opportunistic behavior and immunodeficiency syndromes, including the acquired immunodeficiency syndrome.
Ah-King, Malin; Barron, Andrew B; Herberstein, Marie E
The diversity, variability, and apparent rapid evolution of animal genitalia are a vivid focus of research in evolutionary biology, and studies exploring genitalia have dramatically increased over the past decade. These studies, however, exhibit a strong male bias, which has worsened since 2000, despite the fact that this bias has been explicitly pointed out in the past. Early critics argued that previous investigators too often considered only males and their genitalia, while overlooking female genitalia or physiology. Our analysis of the literature shows that overall this male bias has worsened with time. The degree of bias is not consistent between subdisciplines: studies of the lock-and-key hypothesis have been the most male focused, while studies of cryptic female choice usually consider both sexes. The degree of bias also differed across taxonomic groups, but did not associate with the ease of study of male and female genital characteristics. We argue that the persisting male bias in this field cannot solely be explained by anatomical sex differences influencing accessibility. Rather the bias reflects enduring assumptions about the dominant role of males in sex, and invariant female genitalia. New research highlights how rapidly female genital traits can evolve, and how complex coevolutionary dynamics between males and females can shape genital structures. We argue that understanding genital evolution is hampered by an outdated single-sex bias.
Davis, Dena S
The traditional custom of ritual cutting and alteration of the genitalia of female infants, children, and adolescents, referred to as female genital mutilation or female genital cutting (FGC), persists primarily in Africa and among certain communities in the Middle East and Asia. Immigrants in the United States from areas in which FGC is common may have daughters who have undergone a ritual genital procedure or may request that such a procedure be performed by a physician. The American Academy of Pediatrics believes that pediatricians and pediatric surgical specialists should be aware that this practice has life-threatening health risks for children and women. The American Academy of Pediatrics opposes all types of female genital cutting that pose risks of physical or psychological harm, counsels its members not to perform such procedures, recommends that its members actively seek to dissuade families from carrying out harmful forms of FGC, and urges its members to provide patients and their parents with compassionate education about the harms of FGC while remaining sensitive to the cultural and religious reasons that motivate parents to seek this procedure for their daughters.
Ahanonu, E. L.; Victor, O.
The practice of female genital mutilation (FGM) is widespread in Nigeria. This study was conducted to assess the perceptions of FGM among mothers at a primary healthcare centre in Lagos, Nigeria. A convenience sample of 95 mothers completed the pre-tested, semi-structured questionnaires. Data analysis was carried out using descriptive statistics…
Ahanonu, E. L.; Victor, O.
The practice of female genital mutilation (FGM) is widespread in Nigeria. This study was conducted to assess the perceptions of FGM among mothers at a primary healthcare centre in Lagos, Nigeria. A convenience sample of 95 mothers completed the pre-tested, semi-structured questionnaires. Data analysis was carried out using descriptive statistics…
Longo, David J.; And Others
Assigned 21 individuals with recurrent genital herpes to psychosocial intervention, social support, or waiting-list control conditions. Those receiving psychosocial intervention (herpes simplex virus information, relaxation training, stress management instructions, and an imagery technique) reported significantly greater reductions in herpes…
Longo, David J.; And Others
Assigned 21 individuals with recurrent genital herpes to psychosocial intervention, social support, or waiting-list control conditions. Those receiving psychosocial intervention (herpes simplex virus information, relaxation training, stress management instructions, and an imagery technique) reported significantly greater reductions in herpes…
Tran, Christine; Tamburro, Joan; Rhee, Audrey; Golden, Alex
Genital infantile hemangiomas are vascular anomalies that often require complex management and interdisciplinary care. Propranolol was first used to treat patients with infantile hemangiomas in 2008 and has since gained acceptance as first-line therapy. We review the presentation, course, management and outcomes of all cases of genital infantile hemangiomas managed by propranolol administration at a single institution from April 2010 to July 2014. During the study period 9 patients with genital infantile hemangiomas were referred to our hemangioma treatment clinic. Propranolol was initially administered under careful outpatient monitoring at a dose of 1 mg/kg daily in 8 patients. One patient, a 700 gm premature infant, was started on therapy in the inpatient setting at 0.5 mg/kg daily, given the history of prematurity. All patients underwent successful increase of dose to at least 2 mg/kg for the observation phase after tolerating the starting doses. One patient discontinued propranolol prematurely per parental request due to concern regarding peripheral vasoconstriction. Otherwise, no patient demonstrated significant hypotension, symptomatic bradycardia, hypoglycemia or other major side effect requiring treatment discontinuation. All patients who continued the treatment protocol had excellent response to therapy. Propranolol therapy for genital infantile hemangiomas was successfully initiated and the dosage increased in 9 young children without significant side effects and with marked improvement in all patients who continued on treatment. Propranolol is the only Food and Drug Administration approved therapy for treatment of patients with this vascular anomaly and should be considered first-line therapy for genital infantile hemangiomas. Copyright © 2016 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.
Sharma, Jai B; Naha, Moumita; Kumar, Sunesh; Roy, Kallol K; Singh, Neeta; Arora, Raksha
To assess the role of genital tuberculosis as an etiological factor for ectopic pregnancy. A total of eighteen women of ectopic pregnancy with concomitant female genital tuberculosis and a total of one hundred thirty six patients of ectopic pregnancy over a period of three years were enrolled. Mean age of patients with ectopic pregnancy and concomitant female genital tuberculosis was twenty-six and mean parity was 0.7. Most of these patients were in poor socio-economic group. Diagnosis of female genital tuberculosis was made by presence of granuloma in histopathological examination of endometrial aspirate or tubal specimen, positive acid fast bacilli in microscopy or culture, positive polymerase chain reaction in endometrial tissue and positive findings of genital tuberculosis during laparoscopy or laparotomy. Genital tuberculosis was responsible for 13.2% of all cases of ectopic pregnancy in the present study. Genital tuberculosis appears to be an important cause of ectopic pregnancy in India.
DeLago, Cynthia; Deblinger, Esther; Schroeder, Christine; Finkel, Martin A
Little information is available about idiosyncratic historical details provided by sexually abused girls, yet this information can help medical professionals diagnose sexual abuse. Our goals were to describe types and frequencies of urogenital symptoms/signs reported by girls who disclosed direct genital contact and to explore factors associated with this reporting. We reviewed 161 medical charts of 3- to 18-year-old girls who disclosed sexual abuse by direct genital contact for urogenital symptoms/signs, type of genital contact (oral, object, digital, or genital), time interval between last perpetrator contact and physical examination, age and sexual maturity at the time of last perpetrator contact, genital findings, and other medical diagnoses. Regression analyses were performed to determine factors that were most predictive of symptom/sign reporting. Many of the girls reported multiple types of genital contact; 33% reported oral/object-genital contact, 72% reported digital-genital contact, and 55% reported genital-genital contact. Sixty percent of the girls reported experiencing >or=1 symptom/sign; 53% of the total sample had genital pain, 37% had dysuria, and 11% had genital bleeding. Symptoms/signs were highly associated with genital-genital contact: 48% of the girls reporting genital-genital contact had dysuria compared with 25% of girls not reporting genital-genital contact, 72% had genital pain/soreness compared with 32% not reporting genital-genital contact, and 16% had bleeding compared with 4% of those not reporting genital-genital contact. Using regression analysis, the strongest factor predictive of symptom reporting by the girls was genital-genital contact. Sexually abused girls who experienced direct genital contact frequently reported symptoms related to the abusive episode. These symptoms were reported most frequently with genital-to-genital contact. This information sheds some light on the mechanism of injury leading to symptom reporting and can
LeGoff, J; Roques, P; Jenabian, M-A; Charpentier, C; Brochier, C; Bouhlal, H; Gresenguet, G; Frost, E; Pepin, J; Mayaud, P; Belec, L
Clinical and subclinical genital herpes simplex virus type 2 (HSV-2) reactivations have been associated with increases in human immunodeficiency virus (HIV)-1 genital shedding. Whether HSV-2 shedding contributes to the selection of specific genital HIV-1 variants remains unknown. We evaluated the genetic diversity of genital and blood HIV-1 RNA and DNA in 14 HIV-1/HSV-2-co-infected women, including seven with HSV-2 genital reactivation, and seven without as controls. HIV-1 DNA and HIV-1 RNA env V1-V3 sequences in paired blood and genital samples were compared. The HSV-2 selection pressure on HIV was estimated according to the number of synonymous substitutions (dS), the number of non-synonymous substitutions (dN) and the dS/dN ratio within HIV quasi-species. HIV-1 RNA levels in cervicovaginal secretions were higher in women with HSV-2 replication than in controls (p0.02). Plasma HIV-1 RNA and genital HIV-1 RNA and DNA were genetically compartmentalized. No differences in dS, dN and the dS/dN ratio were observed between the study groups for either genital HIV-1 RNA or plasma HIV-1 RNA. In contrast, dS and dN in genital HIV-1 DNA were significantly higher in patients with HSV-2 genital reactivation (p <0.01 and p <0.05, respectively). The mean of the dS/dN ratio in genital HIV-1 DNA was slightly higher in patients with HSV-2 genital replication, indicating a trend for purifying selection (p 0.056). HSV-2 increased the genetic diversity of genital HIV-1 DNA. These observations confirm molecular interactions between HSV-2 and HIV-1 at the genital tract level. Copyright © 2015 European Society of Clinical Microbiology and Infectious Diseases. Published by Elsevier Ltd. All rights reserved.
Dhawan, Jyoti; Singh, Saurabh; Gupta, Somesh
A 23-year-old woman presented with large exophytic genital wart arising from perineum, vulva, introitus of the vagina, and inner aspect of thighs. Patient developed severe itching and formication (insect-crawling sensation) in the lesions for past 1 week, though careful examination did not reveal any insects. Considering that the disease was causing psychological stress and physical symptoms, radiofrequency excision was planned. However, during the procedure, several maggots appeared from the crypts. The procedure was abandoned and maggots were removed manually. Subsequently external giant warts were removed using radiofrequency device. There was no recurrence of excised warts during 3 month follow-up. To our knowledge, this is the second reported case of maggots in genital warts. PMID:21976905
Dhawan, Jyoti; Singh, Saurabh; Gupta, Somesh
A 23-year-old woman presented with large exophytic genital wart arising from perineum, vulva, introitus of the vagina, and inner aspect of thighs. Patient developed severe itching and formication (insect-crawling sensation) in the lesions for past 1 week, though careful examination did not reveal any insects. Considering that the disease was causing psychological stress and physical symptoms, radiofrequency excision was planned. However, during the procedure, several maggots appeared from the crypts. The procedure was abandoned and maggots were removed manually. Subsequently external giant warts were removed using radiofrequency device. There was no recurrence of excised warts during 3 month follow-up. To our knowledge, this is the second reported case of maggots in genital warts.
Paštar, Zrinjka; Lipozenčić, Jasna
Dermatoscopy as a non-invasive technique has become an integrative part in the evaluation of pigmented and non-pigmented skin lesions, particularly for the early detections of melanoma. Although dermatoscopy improves diagnosis of pigmented and nonpigmented lesions of the skin, it is unknown if dermatoscopy improves the diagnostic accuracy of pigmented mucosal lesions. The "entodermatoscopy" is used for the dermatoscopy of skin infections and infestations and revised as entomodermatoscopy, as it connects the research fields of dermatology and entomology, with its roots being found in these two words. In genital dermatology along with the clinical examination, dermatoscopy is also used for the diagnosis and treatment follow-up of pediculosis pubis, genital warts, molluscum contagiosum, and scabies.
Poggensee, G; Feldmeier, H
In this paper we summarise the parasitological, clinical and epidemiological characteristics of female genital schistosomiasis (FGS), a frequent manifestation of the infection with Schistosoma haematobium. Means to diagnose and treat lesions in the lower and upper genital tract are discussed. Based on clinical findings and available pathophysiological as well as immunological data it is conceivable that FGS of the cervix and vagina not only facilitates the infection with agents of sexually transmitted diseases, but presumably also alters the natural history of such infections. Two infectious agents are of particular concern: the Human Immunodeficiency Virus and the oncogenic Human Papilloma Viruses. Possible interactions and their consequences are discussed and research areas which should be addressed are outlined.
Chi, Ching-Chi; Kirtschig, Gudula; Baldo, Maha; Brackenbury, Fabia; Lewis, Fiona; Wojnarowska, Fenella
Lichen sclerosus is a chronic, inflammatory skin condition that most commonly occurs in adult women, although it may also be seen in men and children. It primarily affects the genital area and around the anus, where it causes persistent itching and soreness. Scarring after inflammation may lead to severe damage by fusion of the vulval lips (labia); narrowing of the vaginal opening; and burying of the clitoris in women and girls, as well as tightening of the foreskin in men and boys, if treatments are not started early. Affected people have an increased risk of genital cancers. To assess the effects of topical interventions for genital lichen sclerosus and adverse effects reported in included trials. We searched the following databases up to 16 September 2011: the Cochrane Skin Group Specialised Register, the Cochrane Central Register of Controlled Trials (CENTRAL) in The Cochrane Library, MEDLINE (from 2005), EMBASE (from 2007), LILACS (from 1982), CINAHL (from 1981), British Nursing Index and Archive (from 1985), Science Citation Index Expanded (from 1945), BIOSIS Previews (from 1926), Conference Papers Index (from 1982), and Conference Proceedings Citation Index - Science (from 1990). We also searched ongoing trial registries and scanned the bibliographies of included studies, published reviews, and papers that had cited the included studies. Randomised controlled trials (RCTs) of topical interventions in genital lichen sclerosus. Two authors independently selected trials, extracted data, and assessed the risk of bias. A third author was available for resolving differences of opinion. We included 7 RCTs, with a total of 249 participants, covering 6 treatments. Six of these RCTs tested the efficacy of one active intervention against placebo or another active intervention, while the other trial tested three active interventions against placebo.When compared to placebo in one trial, clobetasol propionate 0.05% was effective in treating genital lichen sclerosus in
A 54-year-old woman presented to a community-based psychiatric clinic with unique problem of persistent genital arousal disorder. All relevant investigations were normal. Treatment with psychotropic medication and psychotherapy did not help. The patient though reported improvement in mood. The patient has been followed up since 2011 and visits the clinic every 3 months without much improvement in the disorder. Hence, this case has become a clinical challenge in terms of treatment. PMID:23697448
Graziottin, Alessandra; Gambini, Dania; Bertolasi, Laura
This chapter discusses the all too common problem of sex-related pain in women. Pain is a complex perceptive experience, involving biologic as well as psychologic and relational meanings. They become increasingly important with the chronicity of pain. Neurologists are quite aware of the painful aspect of many neurologic disorders, but lifelong and acquired genital and sexual pain is still neglected in a consistent percentage of women. One reason is the view - still held by many - that psychologic factors play the most important role in sex-related pain complaints. The consequences of diagnostic delay can be dramatic. Persisting tissue inflammation induces pain to change from acute and "nociceptive," which indicates a "friendly signal," alerting one to ongoing tissue damage, to chronic and "neuropathic," a disease per se. Whilst the primary disease is progressing and neuroinflammation becomes a prominent feature, affected women have to bear years of pain and distress, huge quantifiable and non-quantifiable costs, and a progressive deterioration of personal and relational health and happiness. The scenario is even more dramatic when pain complicates an already disabling disease. The main aspects considered in this chapter include neuroinflammation as a key feature of pain; genital and sexual pain as part of neurologic diseases; and genital and sexual pain syndrome (dyspareunia and vaginismus) as primary problems, and their pelvic comorbidities (bladder pain syndrome, endometriosis, irritable bowel syndrome, provoked vestibulodynia/vulvodynia). Finally, we discuss iatrogenic pain, i.e., genital and sexual pain caused by ill-conceived medical, surgical, pharmacologic or radiologic therapeutic interventions.
Graziottin, Alessandra; Gambini, Dania
"Anatomy is destiny": Sigmund Freud viewed human anatomy as a necessary, although not a sufficient, condition for understanding the complexity of human sexual function with a solid biologic basis. The aim of the chapter is to describe women's genital anatomy and physiology, focusing on women's sexual function with a clinically oriented vision. Key points include: embryology, stressing that the "female" is the anatomic "default" program, differentiated into "male" only in the presence of androgens at physiologic levels for the gestational age; sex determination and sex differentiation, describing the interplay between anatomic and endocrine factors; the "clitoral-urethral-vaginal" complex, the most recent anatomy reading of the corpora cavernosa pattern in women; the controversial G spot; the role of the pelvic floor muscles in modulating vaginal receptivity and intercourse feelings, with hyperactivity leading to introital dyspareunia and contributing to provoked vestibulodynia and recurrent postcoital cystitis, whilst lesions during delivery reduce vaginal sensations, genital arousability, and orgasm; innervation, vessels, bones, ligaments; and the physiology of women's sexual response. Attention to physiologic aging focuses on "low-grade inflammation," genital and systemic, with its impact on women sexual function, especially after the menopause, if the woman does not or cannot use hormone replacement therapy. © 2015 Elsevier B.V. All rights reserved.
Female genital mutilation is still practiced in 28 African countries despite international calls for its abolishment. A 1991 survey of 1365 14-year-old girls undertaken by a nongovernmental organization in Kenya revealed that 90% had suffered mutilation ranging from the least mutilating form, "sunna" to excision to infibulation. Most of the procedures had taken place when the girls were aged 10-14 years as part of a ritual where the same unsterile knife was used on several girls. Whereas 65% of respondents stated that they approved of female genital mutilation, a little more than a third would abolish the practice. In Sudan, a 1989-90 Demographic and Health Survey of 5860 ever married women aged 15-49 included a number of questions related to female genital mutilation. 89% of respondents were mutilated, and 82% of these had suffered infibulation. This prevalence rate showed a decrease from the 96% level recorded in 1977-78. Among younger women, the incidence of sunna is increasing. Most of these procedures were performed by medical workers such as trained midwives or traditional birth attendants. 79% of the respondents favored continuation of the procedure, but women with a secondary-level education and urban women showed strong opposition. Most women cite tradition as the reason for their approval, and almost half of the women who disapprove cite medical complications. This survey provided the necessary data to implement a policy of eradication of this harmful practice through increasing women's education and provoking open discussion about the procedure.
Chene, Gautier; Lamblin, Gery; Lebail-Carval, Karine; Chabert, Philippe; Marès, Pierre; Coppens, Yves; Mellier, Georges
The female bony pelvis has to fulfil opposing functions: it has to be sufficiently closed to support the pelvic viscera in the upright position, while remaining sufficiently open to allow vaginal delivery. We aim to give an evolutionary perspective and the possible evolution of the bony pelvis from Lucy to the modern female with the implications in terms of genital prolapse. Thirteen pelvimetric measurements were performed on 178 bony pelves: 1 fossil pelvis from Australopithecus Lucy, 128 female Caucasian modern adult pelves and 49 female Catarrhine pelves (29 gorillas and 20 chimpanzees). Lucy's pelvis shape was the most transversely oval, short and broad, termed platypelloid. Modern female pelves were transversely oval only at the inlet. A protruding ischial spine, fairly small ischial tuberosities and a sacral concavity made Lucy closer to Homo sapiens and less like the great apes. In the last group, pelvic planes were anteroposteriorly oval, except in the gorilla, where the outlet was round or slightly transversely oval. The subpubic angle was narrowest in Lucy, whereas it was greater than 90° in the great apes. The female pelvis is involved in both visceral support and parturition and represents a compromise. The narrower pelvis of Australopithecus Lucy provided protection against genital prolapse, but resulted in complex obstetrical mechanics. From an evolutionary perspective, the pelvis of Homo sapiens became modified to make parturition easier, but increased the risk of genital prolapse: the ilia became wide open laterally and the sacrum broadened with a shorter distance between the sacroiliac and coxofemoral joints.
Sheth, Anandi N.; Evans-Strickfaden, Tammy; Haaland, Richard; Martin, Amy; Gatcliffe, Chelsea; Adesoye, Adebola; Omondi, Michael W.; Lupo, L. Davis; Danavall, Damien; Easley, Kirk; Chen, Cheng-Yen; Pau, Chou-Pong; Hart, Clyde; Ofotokun, Igho
Background. It is not known if fluctuations in genital tract antiretroviral drug concentrations correlate with genital virus shedding in human immunodeficiency virus (HIV)–infected women on antiretroviral therapy (ART). Methods. Among 20 HIV-infected women on ART (tenofovir [TFV], emtricitabine [FTC], and ritonavir-boosted atazanavir [ATV]) with suppressed plasma virus loads, blood and cervicovaginal samples collected twice weekly for 3 weeks were tested for antiretroviral concentrations, HIV-1 RNA, and proviral DNA. Results. Cervicovaginal:plasma antiretroviral concentration ratios were highest for FTC (11.9, 95% confidence interval [CI], 8.66–16.3), then TFV (3.52, 95% CI, 2.27–5.48), and ATV (2.39, 95% CI, 1.69–3.38). Within- and between-person variations in plasma and genital antiretroviral concentrations were observed. Low amounts of genital HIV-1 RNA (<50 copies/mL) were detected in 45% of women at 16% of visits. Genital HIV-1 DNA was detected in 70% of women at 35% of visits. Genital virus detection was associated with higher concentrations of mucosal leukocytes but not with genital antiretroviral concentrations, menstrual cycle phase, bacterial vaginosis, genital bleeding, or plasma virus detection. Conclusions. Standard doses of ART achieved higher genital than plasma concentrations across the menstrual cycle. Therapeutic ART suppresses genital virus shedding throughout the menstrual cycle, even in the presence of factors reported to increase virus shedding. PMID:24643223
Cavalcanti, Marta G; Gonçalves, Margareth M I; Barreto, Magali M; Silva, Aline Helen da; Madi, Kalil; Peralta, José Mauro; Igreja, Ricardo P
Genital infection by Schistosoma mansoni is usually misdiagnosed in individuals who reside in, or travel to endemic areas. We describe two cases of genital tumor associated with S. mansoni infection manifested by methrorragy. Surgical specimens revealed leiomyomas in both cases associated with S. mansoni. In one of them, granulomas were found in the ovary and in the other they were found in the uterine tube. Although none presented intestinal/hepatic disease, fecal egg excretion was detected in one. Both had elevated pretreatment antibody reactivity to S. mansoni antigen, but follow-up showed different outcomes. Schistosomiasis should be considered as a diagnosis in individuals with methrorragy residing in or having traveled to endemic areas. Since diagnosis follows genital amputation, and cure control is troublesome, improvement of diagnostic tools and follow-up markers are important priorities to decrease schistosomiasis morbidity.
To present an overview of the prevalence of genital herpes in older women and to present case studies of older women diagnosed with genital herpes in a geriatric practice in the southeastern United States. Review of current scientific literature and treatment/practice guidelines. Specific descriptive cases are reviewed to illustrate the clinical problem. Genital herpes is an important differential diagnosis to include when assessing and treating older women for recurrent genital symptoms. Given the large numbers of older individuals potentially infected with genital herpes, the nurse practitioner (NP) is well positioned to accurately diagnose and initiate treatment that can improve quality of life. The NP's skill in education and counseling is essential to the ongoing management of genital herpes infections.
Narang, T; Kanwar, A J
Genital elephantiasis is a disease that is characterized by massive enlargement of the genitalia. Early aetiological diagnosis is of paramount importance so that development of genital elephantiasis can be prevented; otherwise it is not completely reversible with medical therapy and often requires surgical intervention. Chronic mental distress and disability can result as it interferes with daily/routine activities of the affected individual. Over time, the infectious causes of genital elephantiasis have evolved, from syphilis in the pre-penicillin era to donovanosis, lymphogranuloma venereum and recently filariasis, tuberculosis, leishmaniasis, HIV and chromoblastomycosis. With a declining prevalence globally, donovanosis is at risk of being forgotten as a cause of genital swelling; however, it is known to persist for years without treatment and can lead to complications such as lymphoedema and genital mutilation. We herein present a case of genital elephantiasis that was eventually diagnosed as being due to donovanosis.
Lenschow, Constanze; Copley, Sean; Gardiner, Jayne M; Talbot, Zoe N; Vitenzon, Ariel; Brecht, Michael
Mammalian external genitals show sexual dimorphism [1, 2] and can change size and shape upon sexual arousal. Genitals feature prominently in the oldest pieces of figural art  and phallic depictions of penises informed psychoanalytic thought about sexuality [4, 5]. Despite this longstanding interest, the neural representations of genitals are still poorly understood . In somatosensory cortex specifically, many studies did not detect any cortical representation of genitals [7-9]. Studies in humans debate whether genitals are represented displaced below the foot of the cortical body map [10-12] or whether they are represented somatotopically [13-15]. We wondered what a high-resolution mapping of genital representations might tell us about the sexual differentiation of the mammalian brain. We identified genital responses in rat somatosensory cortex in a region previously assigned as arm/leg cortex. Genital responses were more common in males than in females. Despite such response dimorphism, we observed a stunning anatomical monomorphism of cortical penis and clitoris input maps revealed by cytochrome-oxidase-staining of cortical layer 4. Genital representations were somatotopic and bilaterally symmetric, and their relative size increased markedly during puberty. Size, shape, and erect posture give the cortical penis representation a phallic appearance pointing to a role in sexually aroused states. Cortical genital neurons showed unusual multi-body-part responses and sexually dimorphic receptive fields. Specifically, genital neurons were co-activated by distant body regions, which are touched during mounting in the respective sex. Genital maps indicate a deep homology of penis and clitoris representations in line with a fundamentally bi-sexual layout  of the vertebrate brain.
House, Clarissa M; Lewis, Zenobia; Hodgson, Dave J; Wedell, Nina; Sharma, Manmohan D; Hunt, John; Hosken, David J
Rapid and divergent evolution of male genital morphology is a conspicuous and general pattern across internally fertilizing animals. Rapid genital evolution is thought to be the result of sexual selection, and the role of natural selection in genital evolution remains controversial. However, natural and sexual selection are believed to act antagonistically on male genital form. We conducted an experimental evolution study to investigate the combined effects of natural and sexual selection on the genital-arch lobes of male Drosophila simulans. Replicate populations were forced to evolve under lifetime monogamy (relaxed sexual selection) or lifetime polyandry (elevated sexual selection) and two temperature regimes, 25°C (relaxed natural selection) or 27°C (elevated natural selection) in a fully factorial design. We found that natural and sexual selection plus their interaction caused genital evolution. Natural selection caused some aspects of genital form to evolve away from their sexually selected shape, whereas natural and sexual selection operated in the same direction for other shape components. Additionally, sexual and natural selection tended to favour larger genitals. Thus we find that the underlying selection driving genital evolution is complex, does not only involve sexual selection, and that natural selection and sexual selection do not always act antagonistically.
Hodgson, Dave J.; Wedell, Nina; Sharma, Manmohan D.; Hunt, John; Hosken, David J.
Rapid and divergent evolution of male genital morphology is a conspicuous and general pattern across internally fertilizing animals. Rapid genital evolution is thought to be the result of sexual selection, and the role of natural selection in genital evolution remains controversial. However, natural and sexual selection are believed to act antagonistically on male genital form. We conducted an experimental evolution study to investigate the combined effects of natural and sexual selection on the genital-arch lobes of male Drosophila simulans. Replicate populations were forced to evolve under lifetime monogamy (relaxed sexual selection) or lifetime polyandry (elevated sexual selection) and two temperature regimes, 25°C (relaxed natural selection) or 27°C (elevated natural selection) in a fully factorial design. We found that natural and sexual selection plus their interaction caused genital evolution. Natural selection caused some aspects of genital form to evolve away from their sexually selected shape, whereas natural and sexual selection operated in the same direction for other shape components. Additionally, sexual and natural selection tended to favour larger genitals. Thus we find that the underlying selection driving genital evolution is complex, does not only involve sexual selection, and that natural selection and sexual selection do not always act antagonistically. PMID:23717488
Okwudili, Obi Anselm; Chukwudi, Onoh Robinson
Female genital mutilation (FGM) is the partial or total removal of the female external genitalia or other deliberate injury to the female genital organs, either for cultural or non-therapeutic reasons. This barbaric act is accompanied by a variety of complications ranging from hemorrhage, fracture, infective complications, gynetresia, with its attendant sexual and obstetric difficulties, and death. A 23-year-old girl, with urinary and genital tract obstruction following female genital mutilation(infibulation) is presented. She was managed by elective defibulation, with a satisfactory outcome. Robust health education strategies are needed for the eradication of FGM.
Okwudili, Obi Anselm; Chukwudi, Onoh Robinson
Female genital mutilation (FGM) is the partial or total removal of the female external genitalia or other deliberate injury to the female genital organs, either for cultural or non-therapeutic reasons. This barbaric act is accompanied by a variety of complications ranging from hemorrhage, fracture, infective complications, gynetresia, with its attendant sexual and obstetric difficulties, and death. A 23-year-old girl, with urinary and genital tract obstruction following female genital mutilation(infibulation) is presented. She was managed by elective defibulation, with a satisfactory outcome. Robust health education strategies are needed for the eradication of FGM. PMID:23066470
Ferraioli, Domenico; Lamblin, Gery; Mathevet, Patrice; Hetu, Jessika; Berakdar, Isabelle; Beurrier, Frederic; Chopin, Nicolas
Genital melanoma is a rare pathology. We present the experience of two comprehensive cancer centers in Lyon (France) in the management of genital melanoma in order to identify prognostic factors and optimal treatments. Between April 1992 and Mars 2014, 16 patients with a primary genital melanoma were referred to our department. Nine patients presented a vaginal melanoma, six vulvar melanomas and only one cervical melanoma. The median dimension of the lesion was 33.7 mm (5-100 mm). The AJCC stage ranged from IB to IIIC. 12 cases were the classic dark-blue flat melanoma and the other 4 cases were an atypical amelanotic tumor. Wide local surgery was performed in nine patients. A radical surgery was performed in six patients. In the large cervical melanoma, radiotherapy was performed as first-line treatment. In all the patients regional lymph node staging was performed. Adjuvant treatment was realized in nine patients. Two patients are alive without recurrence. Only one patient was lost to the first follow-up. The other 13 patients experienced a rapid recurrence. The median disease-free survival and the median overall survival were 11.8 months (2-49 m) and of 30.4 m (11-144 m), respectively. The disease-free survival and overall survival could be linked to a clinical presentation (Breslow thickness and morphology of lesion) associated to the early diagnosis. In our small series, the most important prognosis factor remains the tumor thickness. These rare lesions should be treated in experienced centers in order to improve their prognostic.
Nour, Nawal M
More than 130 million women worldwide have undergone female genital cutting (FGC). FGC occurs in parts of Africa and Asia, in societies with various cultures and religions. Reasons for the continuing practice of FGC include rite of passage, preserving chastity, ensuring marriageability, religion, hygiene, improving fertility, and enhancing sexual pleasure for men. The World Health Organization has classified FGC into 4 types depending on the extent of tissue removed. Immediate complications include hemorrhage, infection, sepsis, and death. Long-term complications include pain, scarring, urinary issues, and poor obstetric and neonatal outcomes. Efforts are being made nationally and internationally to eradicate this practice. PMID:19015765
Morris, R I
Female genital mutilation, traditionally known as female circumcision, is a surgically unnecessary modification of the female genitalia, practiced in nations in Africa, the Arab Peninsula, among some communities in Asia, and among immigrants and refugees from these areas who have settled in other areas. The practice is known across socio-economic classes and among many different ethnic and cultural groups, including Christians, Muslims, Jews, and followers of indigenous African religions. As people from these areas immigrate to North America, health care professionals need to understand the important aspects of this growing problem, including management of complications, cultural attitudes, and sensitivities.
Gültekin, İsmail Burak; Altınboğa, Orhan; Dur, Rıza; Kara, Osman Fadıl; Küçüközkan, Tuncay
Female genital mutilation (FGM) is an unusual condition for our country. However, an increase in FGM in future days can be predicted with the increasing numbers of exchange students coming from African countries, migration of refugees and socioeconomic relations with the African countries. We want to share our experience of two FGM victims admitted to our clinic with the request of reconstructive vulvar surgery before their marriage. Both women had WHO Type III FGM. Physical examination findings and surgical reconstruction techniques were presented. PMID:27274899
Davis, A J
This paper provides some basic information about female genital mutilation (FGM) as a social problem and as a health problem. It includes selected actions taken over the last 45 years by the United Nations regarding FGM. The focus here is on the ethics of individuals and institutions, such as the World Health Organization, attempting to intervene in traditional cultural practices like FGM. This discussion raises some questions about ethical universals and ethical relativism with regards to FGM and the attempts to change or eradicate this practice.
Ventskivs'ka, I B
The article contains results of case follow-up of 84 female patients with genital endometriosis. In the above patients, different combination of enzyme therapy and surgical treatment were instituted depending on the site of endometriosis and gravity of the pathological process. On the basis of the secured findings criteria are recommended for the policy of treating patients with genital endometriosis.
The -"s" genitives of English and Swedish play an important role in grammaticalization theory, as they are often used as counterexamples to the main tenet of that theory, viz. that grammatical change is unidirectional. In this paper I look at the emergence of the -"s" genitive in Danish, hoping that it may shed some new light on the evolution of…
The -"s" genitives of English and Swedish play an important role in grammaticalization theory, as they are often used as counterexamples to the main tenet of that theory, viz. that grammatical change is unidirectional. In this paper I look at the emergence of the -"s" genitive in Danish, hoping that it may shed some new light on the evolution of…
Vaccari, Sabina; Barisani, Alessia; Dika, Emi; Fanti, Pier A; DE Iaco, Pierandrea; Gurioli, Carlotta; Tosti, Giulio
Melanoma of the genital mucosa is a rare melanocytic neoplasm that affects both sexes. The diagnosis is often delayed; a useful diagnostic tool may be represented by videodermatoscopy, The treatment is complex and multidisciplinary. We report the main diagnostic features and therapeutic approaches for mucosal melanoma of the genital tract.
Contrasts the English past tense inflection with a more complex morphological subsystem, the Polish genitive. The genitive case has three different markers, each restricted to a different subset of nouns, in both the singular and the plural. Analysis of the spontaneous speech of three children between 1 and 5 years of age showed that they…
Sharma, Nidhi; Marfatia, Y. S.
Over the decades, causes of genital elephantiasis have changed only to become elusive to etiological diagnosis. This is a case of 20 year old male who presented with genital elephantiasis occurring due to lymphatic obstruction caused by chromoblastomycosis and super added erysipelas. The diagnosis of chromoblastomycosis was clenched by biopsy. We describe this case for the rarity of its occurrence. PMID:21938115
Guy, Jean-Baptiste; Trone, Jane-Chloé; Casteillo, François; Forest, Fabien; Pacaut, Cécile; Moncharmont, Coralie; Espenel, Sophie; Vallard, Alexis; Langrand Escure, Julien; Collard, Olivier; Peoc'h, Michel; Magné, Nicolas
Carcinosarcoma, also known as mixed mesodermal tumor or malignant mixed Mullerian tumor (MMMT) is a pathological entity combining a sarcomatous and a carcinomatous component. Found in thoracic, digestive, genitourinary, liver or skin locations, the most common location is the female genital tract. In gynecological tumors, carcinosarcoma accounts for about 2-5% of endometrial cancers, and 1% of ovarian cancers. To date, there is no consensus on the therapeutic strategy. It relies mostly on maximum cytoreductive surgery. Adjuvant therapy remains controversial, and few prospective studies investigating its interest. Retrospective studies show the benefits of adjuvant chemotherapy based on platinum in most cases. Radiation therapy has a place in the adjuvant situations of endometrial and cervical carcinosarcoma. A more detailed pathological knowledge, and the use of targeted therapies may be promising in this histological subtype whose prognosis remains very poor. The objective of this study is to present the main principles of carcinosarcoma management in female genital tracts, describing pathological and prognostic features at the same time.
Several major breakthroughs have occurred in our understanding of the epidemiology, immunology and biological behavior of the human herpes virus I and II. The family physician, however, is still confronted with four basic clinical situations: patients who present with a genital erosion or ulcer, affected patients in the reproductive age group, patients who ask if herpes causes cervical cancer, and patients who are very troubled by endless recurrences. As syphilitic chancre is becoming rare, the family physician has to recognize the increasing importance of herpes viruses in the etiology of the genital erosion-ulcer syndrome to acquire the clinical and laboratory skills to make that distinction. The prevention of neonatal disease is now possible in the majority of cases provided that pregnancies at risk are identified. Adequate virological surveillance should make it possible to virtually eliminate the disease. The evidence for the oncogenecity is circumstantial. Potential intra- and interpersonal effects of the disease are outlined. ImagesFig. 1Fig. 3 PMID:21286567
Khanna, A; Agrawal, A
Although genital tuberculosis is a condition that is prevalent worldwide, it is still a diagnostic dilemma. This study aimed to find an effective diagnostic modality for the condition. A total of 100 infertile women were clinically evaluated with haemoglobin estimation, total and differential count, Mantoux test, tubercle bacilli enzyme-linked immunosorbent assay (TB ELISA), hysterosalpingography, pelvic ultrasonography, laparohysteroscopy, premenstrual endometrial biopsy for histopathology, culture and tubercle bacilli polymerase chain reaction (TBPCR). The womens' Day 2 hormonal profile (luteinising, follicle-stimulating, prolactin and thyroidstimulating hormones) and their husbands' semen analysis were also conducted. A total of 58 women had primary infertility and 42 had secondary infertility. Female factor infertility was present in 63 percent of the cases (mostly tubal; 45.97 percent). 26 women tested positive for endometrial TBPCR. Erythrocyte sedimentation rate, Mantoux test, TB ELISA and hysterosalpingography were found to have high negative predictive value (greater than 80 percent), while the positive predictive value was 35-45 percent. Laparoscopy findings were suggestive of tuberculosis in 13 percent of the women, out of which 83.3 percent were positive for endometrial TBPCR. Hysteroscopy revealed intrauterine adhesions in 34.8 percent of the women, with 68.8 percent being positive for tubercular bacilli. Our study established that in cases of genital tuberculosis, the use of expensive endometrial TBPCR tests may be avoided with a detailed workup, which would also help in the institution of anti-tubercular treatment in early disease, thus enhancing the chance of pregnancy.
Omer-hashi, K H
According to 1991 census data, 72,285 East Africans are residing in Canada. Many female immigrants underwent female genital mutilation (FGM) in their countries of origin. This article, prepared by a Somalian midwife and health educator, describes FGM and its implications for obstetric-gynecologic care in Canada. Canadian obstetricians, especially males, must be sensitive to the cultural backgrounds of women who present with FGM and keep in mind that these women are reluctant to expose their genitals. Fear that they will be denied the right to natural childbirth prevents many women with FGM from presenting to a hospital. Medical mismanagement of women with FGM during childbirth can result in complications such as urine retention, perineal tears, and infection. Although infibulation after childbirth is customary for women with FGM, physicians in Ontario are authorized only to repair the surgically incised area. The Council of the College of Physicians and Surgeons of Ontario has designated performance of FGM by a Canadian physician as professional misconduct. Several organizations in Ontario are available to serve as resources for obstetricians who care for women with FGM. The Toronto Birth Control and Venereal Disease Information Center offers classes on childbirth and sexuality and contraception counseling to women with FGM.
Awasthi, Sita; Friedman, Harvey M
A half billion people have genital herpes infections worldwide. Approximately one-fifth of American women between ages 14 and 49 are HSV-2 seropositive. The development of an effective genital herpes vaccine is a global health necessity based on the mental anguish genital herpes causes for some individuals, the fact that pregnant women with genital herpes risk transmitting infection to their newborn children, and the observation that HSV-2 infection is associated with a 3-fold to 4-fold increased probability of HIV acquisition. We review the strengths and limitations of preclinical animal models used to assess genital herpes vaccine candidates and the goals of prophylactic and therapeutic vaccines. We also discuss the current pipeline of vaccine candidates and lessons learned from past clinical trials that serve as a stimulus for new strategies, study designs and endpoint determinations.
Yu, Xin; Zheng, Heyi
Abstract Adult-onset Still disease (AOSD) is a systemic autoimmune disease (AIID) that can develop after exposure to infectious agents. Genital human papillomavirus (HPV) infection has been reported to induce or exacerbate AIIDs, such as systemic lupus erythematosus (SLE). No guidelines are available for the management of genital warts in AOSD. Case report and literature review. We report a patient who was diagnosed AOSD in the setting of refractory and recurrent genital HPV infection, demonstrating a possible link between HPV infection and AOSD. In addition, we also discuss the management of genital warts in patients with AOSD. To the best of our knowledge, no previous cases of AOSD with genital HPV infection have been reported in literature. We then conclude that the patient AOSD may be triggered by primary HPV infection. Larger number of patient samples is needed to confirm whether HPV could trigger AOSD. PMID:27082556
Sarhan, Deena; Mohammed, Ghada F A; Gomaa, Amal H A; Eyada, Moustafa M K
Vitiligo has a major effect on sexual health because of the disfiguring skin lesions affecting self-image and self-esteem. However, this topic has not explored. This article aimed to assess the effect of vitiligo on genital self-image, sexual function, and quality of life in female patients. This cross-sectional study included 50 sexually active women with vitiligo and 25 women without vitiligo. All participants subjected to full history taking and examination. Extent of vitiligo was assessed with the Vitiligo Area Scoring Index score, sexual function with the Female Sexual Function Index, genital self-image with Female Genital Self-Image Score and quality of life with the Dermatology Life Quality Index questionnaires. The main outcome measures were correlation between Vitiligo Area Scoring Index, Female Genital Self-Image Score, Female Sexual Function Index, and Dermatology Life Quality Index domains was determined using t test and Pearson correlation. This study revealed a negative correlation between the Vitiligo Area Scoring Index score and sexual satisfaction. Vitiligo Area Scoring Index and Dermatology Life Quality Index score was significantly correlated with Arabic Version of the Female Genital Self-Image Score alone and with Arabic Version of the Female Sexual Functioning Index alone and with both the Arabic Version of the Female Genital Self-Image Score and the Arabic Version of the Female Sexual Functioning Index (p <.05). Sexual and psychological assessment of patients with vitiligo is imperative to improve outcomes and increase patients' compliance with treatment.
Cokluk, Erdem; Sekeroglu, Mehmet Ramazan; Aslan, Mehmet; Balahoroglu, Ragip; Bilgili, Serap Gunes; Huyut, Zubeyir
Warts are abnormal skin growths caused by human papilloma virus (HPV) infections within the skin of patients. Genital warts usually appear in the perianal and perigenital regions. Asymptomatic warts may be activated after years and may damage natural immunity. The inflammation that occurs during this process may lead to an imbalance between the prooxidant and the antioxidant systems. The aim of this study was to investigate erythrocyte glutathione peroxidase (GSH-Px) activity, serum paraoxonase enzyme levels, and oxidative stress levels in patients with genital warts. In total, 32 patients with genital warts and 35 healthy subjects were included in this study. Erythrocyte GSH-Px activity, serum catalase activity, and paraoxonase enzyme, and malondialdehyde (MDA) levels were determined. Erythrocyte GSH-Px activity, serum MDA levels, and catalase activity were significantly higher in patients with genital warts than in controls (P < 0.01, P < 0.05, and P < 0.05, respectively). However, serum paraoxonase enzyme levels were not significantly different between groups (P > 0.05). Serum triglyceride levels were significantly lower in patients with genital warts than in controls (P < 0.01). However, there were no statistically significant differences between groups with respect to total cholesterol, high-density lipoprotein cholesterol, or low-density lipoprotein cholesterol levels (all P > 0.05). Our data suggest that oxidative stress is increased in genital warts. Increased oxidative stress levels may contribute to the pathogenesis of genital warts, and prolonged HPV infection due to chronic inflammation could also affect oxidative stress.
Slaughter, L; Brown, C R; Crowley, S; Peck, R
New colposcopic protocols for US forensic examiners enable documentation of genital trauma in 87-92% of rape victims--a significant improvement over protocols based on gross visualization or toluidine blue dye enhancement. It remains unresearched, however, whether colposcopic genital findings in sexual assault victims differ substantially from those in women who have had consensual intercourse. Thus, the type, extent, and distribution of genital injuries observed through colposcopy in 311 rape victims seen by the San Luis Obispo (California) County's Suspected Abuse Response Team in 1985-93 were compared to genital changes in 75 healthy women who had engaged in consensual intercourse in the past 24 hours. 213 assault victims (68%) had evidence of anogenital trauma. Among the 178 women (57%) with nongenital trauma, 132 (74%) also had genital injury (tears, ecchymoses, abrasions, redness, and swelling). The most common trauma site was the posterior fourchette (70%). Examination findings were significantly greater at 24 hours after rape than at 72 hours or more, but almost half the women seen at 72 hours or more after assault had positive genital findings. The injury pattern was not affected by age. In the consensual sex group, trauma was noted in eight women (11%). The proportion with genital injury was significantly higher for women reporting nonconsensual sex than those reporting consensual sex.
Li, De-Kun; Raebel, Marsha A; Cheetham, T Craig; Hansen, Craig; Avalos, Lyndsay; Chen, Hong; Davis, Robert
To examine the risks of genital herpes and antiherpes treatment during pregnancy in relation to preterm delivery (PTD), we conducted a multicenter, member-based cohort study within 4 Kaiser Permanente regions: northern and southern California, Colorado, and Georgia. The study included 662,913 mother-newborn pairs from 1997 to 2010. Pregnant women were classified into 3 groups based on genital herpes diagnosis and treatment: genital herpes without treatment, genital herpes with antiherpes treatment, and no herpes diagnosis or treatment (unexposed controls). After controlling for potential confounders, we found that compared with being unexposed, having untreated genital herpes during first or second trimester was associated with more than double the risk of PTD (odds ratio (OR) = 2.23, 95% confidence interval (CI): 1.80, 2.76). The association was stronger for PTD due to premature rupture of membrane (OR = 3.57, 95% CI: 2.53, 5.06) and for early PTD (≤35 weeks gestation) (OR = 2.87, 95% CI: 2.22, 3.71). In contrast, undergoing antiherpes treatment during pregnancy was associated with a lower risk of PTD compared with not being treated, and the PTD risk was similar to that observed in the unexposed controls (OR = 1.11, 95% CI: 0.89, 1.38). The present study revealed increased risk of PTD associated with genital herpes infection if left untreated and a potential benefit of antiherpes medications in mitigating the effect of genital herpes infection on the risk of PTD.
Rouzi, A A; Alturki, F
Female genital mutilation/cutting (FGM/C) is a cultural practice involving several types of external female genitalia cutting. FGM/C is known to occur in all parts of the world but is most prevalent in 28 countries in Africa and the Middle East and among immigrant communities in Europe, Australia, New Zealand, Canada, and the United States. Studies of FGM/C suffer from many methodological problems including inadequate analysis and an unclear reporting of results. The evidence to link FGM/C to infertility is weak. The management of epidermal clitoral inclusion cysts includes expensive investigations like comprehensive endocrinology tests and MRI resulting in unnecessary anxiety due to delay in surgical treatment. Similarly, unnecessary cesarean sections or rupture of the infibulation scar continue to occur because of the inadequate use of intrapartum defibulation. A significant amount of efforts is required to improve and correct the inadequate care of FGM/C women and girls.
Šefčíková, A; Turková, M; Žurková, M
To present the findings of sarcoidosis on female genital tract. Review. Department of Obstetric and Gynecology, Silesian Hospital Opava. Overview of published findings from case studies. Sarcoidosis is a multisystem granulomatous disorder of unclear cause. It typically involves the lymph nodes of mediastinum, predominantly billateral and/or pulmonary infiltrates. We find extrapulmonary involvement in 30-50% of cases. Sarcoidosis of the female reproductive system is a rare, it represent less than 1% cases of sarcoidosis. Lesions there may affect any organ, including the vulva, vagina, cervix, uterus, fallopian tube and ovary, but also for example placenta and breast. There is also recorded the incidence of multiple localization on female genitalia. Since sarcoidosis of this area is so rare, often proceeds asymptomatic and recognized only as an incidental finding, there are mention only the case histories in literature yet.Clinical symptoms may be non-specific, often imitating a tumor, or tend to be specific, depending on the localization of disability such as perineal pain, pain in the scar after the previous birth trauma, persistent pruritus, itching, irritation, dyspareunia, menstrual cycle disorders, menorrhagia, metrorrhagia, postmenopausal bleeding, amenorrhoe, abdominal pain, endometrial polypoid lesions, recurrent or persistent serometra or discharge. The diagnosis is made up of histologically - we are demonstrating noncaseating granulomas.The therapy is difficult, there are no available official guidelines. If the lesions are clinically silent, we can observed them because they may spontaneously disappear. If we are embarking on medical therapy, we start from a local application, and if this is unsuccessful then we approach the systemic administration. Corticosteroids are the drug of choice. If we diagnose the sarcoidosis of the female genital organs we must exclude systemic disease of sarcoidosis. The prognosis of disease is good.
The clinical effect of imiquimod stems from cytokine-induced activation of the immune system. A randomized study was conducted to study the efficacy and safety of daily applications of 5% imiquimod cream in female patients with external genital warts and molluscum contagiosum (MC). The clearance rate of lesions was 75% in genital MC patients and 50% in patients with genital warts. Erythema was the commonest adverse reaction seen in 24% patients with the use of 5% imiquimod. Other side effects were excoriation seen in 16% patients, erosions in 10% patients, excoriation in 6% patients and pain was seen in 4% patients. PMID:21938126
If the best way of preventing genital infections is probably to restrict the number of partners, physicians should not forget that local contraceptives provide a mechanical or chemical barrier, the protection of which is certainly not ineffective.
... page: https://medlineplus.gov/news/fullstory_165905.html 2 Doses of HPV Shot Enough to Prevent Genital ... New research supports the recent U.S. recommendation for two, rather than three, doses of the human papillomavirus ( ...
Tilley, Donna Scott
Female genital cutting (FGC), commonly called female genital mutilation, affects millions of women but is poorly understood by many health care providers. FGC procedures intentionally alter the female genital organs for nonmedical reasons and include partial or total removal of female genital organs. These procedures, which have no medical value, are usually done between birth and puberty. Health consequences vary in severity but can be devastating. Women who have experienced FGC may be reluctant to seek health care or to disclose their condition to providers. Suggestions for culturally competent care of women who have experienced FGC are outlined, focusing on understanding the cultural beliefs and values of women who have undergone these procedures and providing informed and sensitive care. © 2015 AWHONN.
Lu, David Y; Chang, Sue; Cook, Heather; Alizadeh, Yalda; Karam, Amer K; Moatamed, Neda A; Dry, Sarah M
Extracardiac rhabdomyomas are rare benign entities that usually occur in the head and neck region. Although genital rhabdomyoma is known to occur in the lower genital tract of young and middle-aged women, involvement of the anatomically adjacent urethra by rhabdomyoma is exceedingly rare. We present a case of genital rhabdomyoma arising from the urethra of an infant girl. The tumor was characterized by the submucosal presence of mature-appearing rhabdomyoblastic cells containing conspicuous cross-striations, with the cells set in a collagenous stroma. Necrosis and mitoses were absent. Skeletal muscle differentiation of the tumor cells was supported by positive immunohistochemical staining for desmin and myogenin. To our knowledge, this is the first case of urethral genital-type rhabdomyoma in a child.
... 163137.html Genital Herpes Vaccine Shows Promise in Animal Trials Two-pronged approach tested on lab monkeys, ... researchers say. The vaccine has proven effective in animals against herpes simplex virus 2, the sexually transmitted ...
... during any type of sex (oral, vaginal, or anal). Girls should have their partners use a dental_ ... BC Date reviewed: January 2015 For Teens For Kids For Parents MORE ON THIS TOPIC Genital Herpes ...
Paladini, Dario; Di Spiezio Sardo, Attilio; Mandato, Vincenzo Dario; Guerra, Germano; Bifulco, Giuseppe; Mauriello, Silvana; Nappi, Carmine
Cutis laxa (CL) is an extremely inherited or acquired connective tissue disorder characterised by a markedly reduced systemic elastin content. Genital abnormalities in patients with CL have been rarely reported. We report such a case in a 48-year-old CL patient affected by genital prolapse, focusing on immunohistological and molecular biology assessment of elastin and collagen type I, III, VI content in the main uterine ligaments. The woman was referred to our department for the onset of a rapidly progressing genital prolapse and urinary incontinence. The patient underwent total abdominal hysterectomy with bilateral salpingo-oophorectomy and sacrocolpopexy. Punch biopsies from both cardinal and uterosacral ligaments revealed a dramatic reduction in elastin and an increase in collagen type VI content. The present report seems to underline the central role exerted primarily by elastin in the supportive connective tissue and might contribute to the knowledge of extracellular matrix abnormalities at the basis of genital abnormalities in CL patients.
Lane, S D; Rubinstein, R A
Traditional female genital circumcision, or female genital mutilation, performed upon women in some non-Western cultures has provoked considerable international controversy since the late 1970s. Western feminists, physicians, and ethicists condemn such practice. Having made moral judgement against female genital mutilation, however, what is the next step? There is clearly an impasse between cultural relativism on the one hand and universalism on the other. Those at the forefront of the debate on female genital mutilation must learn to work respectfully with, instead of independently of, local resources for cultural self-examination and change. The authors discuss cultural relativism and moral universalism; female circumcision in sections on epidemiology, health effects, and culture, religion, and social change; the debate historically; the response of Arab and African women; and moving beyond the impasse.
Shabila, Nazar P; Saleh, Abubakir M; Jawad, Rojan K
Understanding women's perspectives of female genital cutting is particularly critical for understanding the roots of the problem and enhancing effectiveness of any prevention program. Very limited research has examined how people in Iraqi Kurdistan Region think about this practice. This study aimed to explore the perspectives of women of female genital cutting with the aim of uncovering discrepancies and commonalities between women of different socio-educational groups. An explorative study using Q-methodology was conducted with 29 women from different educational and socio-economic statuses in Erbil, the main city of the Iraqi Kurdistan Region. Participants were asked to rank-order a set of 39 statements about different aspects of female genital cutting into a distribution on a scale of nine from "disagree most" to "agree most". By-person factor analysis was performed with factors or latent viewpoints extracted through centroid method and varimax rotation. A four-factor solution and one consensus perspective provided the best conceptual fit for the women's perspectives about female genital cutting. Factor 1, entitled "positive cultural tradition", centers on recognizing female genital cutting as a positive cultural aspect and an essential part of the Kurdish culture. Factor 2, "active opponents", positions around actively opposing the practice of female genital cutting and considering the practice a violation of human rights. Factor 3, "role of law", stresses the importance of developing and enforcing law for combating female genital cutting. Factor 4, "health concerns and passive opposition", represents the perspectives of recognizing the importance of health concerns resulting from female genital cutting and opposition of the practice but not in an active manner. A consensus perspective, "marital role", centers primarily on lack of effect of female genital cutting on women's marital role. Female genital cutting is still a contentious issue among women in Iraqi
Wise, T N; Kalyanam, R C
A case is presented of a 49-year-old man who amputated his penis following instructions that he had obtained from the Internet. The patient had a long-standing amputee fetish, which evolved into eroticized genital mutilation. The transformation of the preferred fetish occurred in a setting of depression due to environmental stressors. The literature about amputee fetishism, also called "apotemnophilia," is reviewed, and possible connections with the genital mutilation are discussed.
Afzali, Nargess; Ahmadi, Firoozeh; Akhbari, Farnaz
Background: Genital tuberculosis is a chorionic disease and mostly occurs by haematogenous spread from extra genital source like lungs, peritoneum, lymph nodes and bones. Transmission through a sexual intercourse is also possible. Since the majority of patients are in reproductive ages, involvement of fallopian tubes and endometrium cause infertility in patients. Cases: Reviewing 4 cases of female genital tuberculosis, which referred to an infertility treatment center with various symptoms, we encountered various appearances on hysterosalpingography (HSG). Conclusion: The genitourinary tract is the most common site of extra pulmonary TB. The primary focus of genital tuberculosis is fallopian tubes, which are almost always affected bilaterally but not symmetrically. Because of common involvement of fallopian tubes and endometrial cavity, disease causes infertility. Diagnosis is not easy because genital tuberculosis has a wide range of clinical and radiological manifestations with slow growing symptoms. Detailed hysterosalpingography finding may be helpful in better diagnosis of the disease. This case series aims to depict the various hystrosalpingographic appearances and pathology produced by tuberculosis and related literatures are reviewed in order to establish a better diagnostic evaluation of genital tuberculosis. PMID:24639787
Kaggwa, Sam; Galukande, Moses
Genital losses from ritual attacks are often reported in the media and often discussed in the social media but are hardly reported in medical literature. Male genital mutilation (MGM) refers to permanent modification of the external genitalia that involves ablation of genital tissues.When found, it is usually as a consequence of poor circumcision skills, auto mutilation/castration or genital injuries caused by attacks or accidents. Male circumcision on its own is widely regarded as a rather safe and acceptable practice which is known to have some health benefits and in keeping with several religious customs as rite of passage. Outside of professional performed circumcision, MGM is usually associated with dark arts and malicious intentions like witchcraft or as a consequence of torture of prisoners of war for information. In this case we describe a 5-year old Ugandan boy who had his genitals mutilated in bizarre circumstances within a ritual attack. He survived and a urethrostomy was fashioned. There is need to document more of these cases in order to gather enough information to inform prevention and treatment strategies. Issues of hormonal replacement therapy (HRT) and possible sex change require much debate. These genital sex changing operations should preferably be avoided until a child can fully participate in decision making.
Birge, Özer; Akbaş, Murat; Özbey, Ertuğrul Gazi; Adıyeke, Mehmet
We aimed to describe the presentation of long-term complications of female genital mutilation/cutting and the surgical management of clitoral keloids secondary to female genital mutilation/cutting. Twenty-seven women who underwent surgery because of clitoral keloid between May 2014 and September 2015 in Sudan Nyala Turkish Hospital were evaluated in this retrospective descriptive case series study. The prevalence of type 1, type 2, and type 3 female genital mutilation/cutting were 3.7%, 22.2%, and 74.1%, respectively (type 1: 1/27, type 2: 6/27, and type 3: 20/27). All patients had long-term health problems (dysuria, chronic pelvic pain, vaginal discharge, and chronic pruritus) and sexual dysfunction. Keloids were removed by surgical excision. There were no postoperative complications in any patient. Although clitoral keloid lesions can be seen after any type of female genital mutilation/cutting, they usually develop after type 3 female genital mutilation/cutting. Most of these keloids were noticed after menarche. Keloids can be removed by surgical excision and this procedure can alleviate some long-term morbidities of female genital mutilation/cutting. PMID:28913112
Birge, Özer; Akbaş, Murat; Özbey, Ertuğrul Gazi; Adıyeke, Mehmet
We aimed to describe the presentation of long-term complications of female genital mutilation/cutting and the surgical management of clitoral keloids secondary to female genital mutilation/cutting. Twenty-seven women who underwent surgery because of clitoral keloid between May 2014 and September 2015 in Sudan Nyala Turkish Hospital were evaluated in this retrospective descriptive case series study. The prevalence of type 1, type 2, and type 3 female genital mutilation/cutting were 3.7%, 22.2%, and 74.1%, respectively (type 1: 1/27, type 2: 6/27, and type 3: 20/27). All patients had long-term health problems (dysuria, chronic pelvic pain, vaginal discharge, and chronic pruritus) and sexual dysfunction. Keloids were removed by surgical excision. There were no postoperative complications in any patient. Although clitoral keloid lesions can be seen after any type of female genital mutilation/cutting, they usually develop after type 3 female genital mutilation/cutting. Most of these keloids were noticed after menarche. Keloids can be removed by surgical excision and this procedure can alleviate some long-term morbidities of female genital mutilation/cutting.
Melanocytic lesions of the genital area are rare. They arise mainly in the vulva, although they can also occur less frequently in the perineum, mons pubis and male genitalia and represent 10-12% of pigmented lesions of White women. These pigmented lesions include melanocytic nevi, lentigines, melanocytic nevi with architectural disorder and atypia of melanocytes (dysplastic nevi) and melanomas with microscopic features similar to those seen elsewhere on the body. There is a small subset of benign nevi named atypical melanocytic nevi of the genital type (AMNGT) that occur in young women, with distinctive histologic features in some cases overlapping morphologically with those of melanoma. Thus, it is important to distinguish AMNGT from melanomas in terms of prognosis and treatment. We retrieved 58 cases of genital pigmented lesions diagnosed at our hospital from 1986 to 2008 to evaluate their clinicopathologic features with especial consideration to those cases with atypical features. Thirty-two cases (55%) were common nevi, 10 (17%) lentigines, 6 (10%) melanomas, 3 (5%) dysplastic nevi and 1 blue nevus. Six cases (10%) corresponded to AMNGT and were taken from women with a median age of 21 years. All cases showed symmetry, and the melanocytic proliferation was well demarcated at the lateral margins. The junctional component was very prominent and formed by round or fusiform nests with common retraction artifact and/or cellular dyshesion or as a single cell proliferation with mild (33%) to moderate (67%) cytologic atypia, focal pagetoid spread (17%) and a benign-appearing dermal component (83%) with maturation and dense eosinophilic fibrosis in the superficial dermis. Neither nuclear atypia of melanocytes in the superficial dermis nor dermal mitoses were observed. AMNGT were excised, and no recurrences were recorded in the follow up (median 10.5 years). Therefore, it seems that there is no evidence that AMNGT are precursors of dysplastic nevi or melanomas.
McAninch, J W; Kahn, R I; Jeffrey, R B; Laing, F C; Krieger, M J
Major injuries to the testicles, penis, and genital skin from trauma and infection were seen in 62 patients over a 6-year period (1977 to 1983). Urethral injuries were excluded. In the past blunt testicle injuries were infrequently diagnosed and surgically ignored because of large surrounding hematomas. With the use of real-time ultrasound, 17 of 18 cases of testicle rupture were correctly diagnosed preoperatively. Surgical repair resulted in testicle salvage in 16 patients. Penetrating testicle injuries resulted in a high orchiectomy rate secondary to the infrequently described but recognized entity of self-emasculation in transsexuals. Penile rupture from blunt injuries (8) was successfully repaired and complete function was recovered. Penetrating penile injuries (4) were extensive and involved the urethra in two cases; full function returned after reconstruction. Major skin loss of the penis and/or scrotum (19) occurred from necrotizing fasciitis, burns, avulsion and penetrating injuries. Early debridement, bowel and urinary diversion followed by penile skin grafting, thigh pouches to protect testicles, and scrotal reconstruction resulted in acceptable cosmetic and functional results in all cases of major skin loss.
Nour, Nawal M
More than 130 million women worldwide have undergone female genital cutting (FGC). FGC is practiced in parts of Africa and Asia, in societies with various cultures and religions. Reasons for the continuing practice of FGC include rite of passage, preserving chastity, ensuring marriageability, religion, hygiene, improving fertility, and enhancing sexual pleasure for men. The World Health Organization has classified FGC into four types depending on the extent of tissue removed. Immediate complications include hemorrhage, infection, sepsis, and death. Long-term complications include pain, scarring, urinary issues, and poor obstetric and neonatal outcomes. Efforts are being made nationally and internationally to eradicate this practice. In December 2012, the UN General Assembly accepted a resolution on the elimination of FGC. Although it is illegal to perform FGC in the United States, women from countries where the practice occurs have been and are still immigrating here. Many enter as refugees from war-torn, famine-stricken, or politically unstable countries. They bring along with them their cultural pride, health complications, and fears of being judged when visiting a health provider. A deeper understanding of the history, cultural beliefs, medical complications, and methods of surgical reconstruction is necessary to provide culturally and linguistically competent care to this unique group of women. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.
Odukogbe, Akin-Tunde A; Afolabi, Bosede B; Bello, Oluwasomidoyin O; Adeyanju, Ayodeji S
Female genital mutilation/cutting (FGM/C) is a traditional practice in which the external female genitalia is partially or totally incised or excised for a non-therapeutic reason, usually without the consent of the individual. FGM/C is common in Africa with varying prevalence in different countries, though the incidence is reducing because it is considered a human rights issue with tremendous advocacy for its elimination by mainly nongovernmental organizations. It is mainly underreported in many countries in Africa especially where it has been declared illegal. FGM/C is often performed by a nonmedical practitioner with the aim of fulfilling religious or cultural rites and sometimes for economic benefits with the resultant acute, intermediate and late complications. It is sometimes performed by medical practitioners when it is speciously believed that its medicalization reduces the complications associated with the practice. The sensitivity of FGM/C is amplified when compared to male circumcision and voluntary alterations of the female external genitalia like piercing and tattooing as similar practices. The magnitude of the physical and psychosocial consequences of FGM/C outweighs the presumed benefits of the procedures highlighting the need for improvement of the multiple preventive measures by all the stakeholders and in all the sectors.
Afolabi, Bosede B.; Bello, Oluwasomidoyin O.; Adeyanju, Ayodeji S.
Female genital mutilation/cutting (FGM/C) is a traditional practice in which the external female genitalia is partially or totally incised or excised for a non-therapeutic reason, usually without the consent of the individual. FGM/C is common in Africa with varying prevalence in different countries, though the incidence is reducing because it is considered a human rights issue with tremendous advocacy for its elimination by mainly nongovernmental organizations. It is mainly underreported in many countries in Africa especially where it has been declared illegal. FGM/C is often performed by a nonmedical practitioner with the aim of fulfilling religious or cultural rites and sometimes for economic benefits with the resultant acute, intermediate and late complications. It is sometimes performed by medical practitioners when it is speciously believed that its medicalization reduces the complications associated with the practice. The sensitivity of FGM/C is amplified when compared to male circumcision and voluntary alterations of the female external genitalia like piercing and tattooing as similar practices. The magnitude of the physical and psychosocial consequences of FGM/C outweighs the presumed benefits of the procedures highlighting the need for improvement of the multiple preventive measures by all the stakeholders and in all the sectors. PMID:28540220
Ahanonu, E L; Victor, O
The practice of female genital mutilation (FGM) is widespread in Nigeria. This study was conducted to assess the perceptions of FGM among mothers at a primary healthcare centre in Lagos, Nigeria. A convenience sample of 95 mothers completed the pre-tested, semi-structured questionnaires. Data analysis was carried out using descriptive statistics and a chi-square test was used to test for association between variables. Findings showed that the mothers held ambivalent beliefs about the practice. Although over half of the respondents (56.8%) perceived the practice of FGM as not being beneficial, 44.2% thought that uncircumcised girls will become promiscuous. Nearly a third (30.5%) believed that FGM promotes a woman's faithfulness to her husband. About a quarter (26.3%) reported that women who have undergone FGM are not at any risk of gynaecological complications. There was a significant relationship between the educational background of the mothers and the perception that uncircumcised girls will be promiscuous. These perceptions about FGM show that government at all levels should continue with educational efforts aimed at eradicating this practice.
Female genital cutting (FGC), a prevalent practice in most African countries not just seriously endangers a girl's lifetime health, but it is also considered a human rights violation. In June 1999, the Intra-Agency Working Group on FGC held a symposium with US Agency for International Development (USAID) staff to explore ways of incorporating into USAID program activities to eradicate the practice of FGC. One of the presentations at the symposium concerned "circumcision with words". This ceremony is an alternative rite of passage; it is conducted through a 5-day seclusion, culminating in a 1-day celebration including feasting and gift giving. The alternative rites include 1) self-esteem and coping with criticism; 2) responsibility for one¿s own decision; 3) dating and courtship; 4) coping with peer pressure; 5) personal hygiene; 6) marriage; 7) pregnancy and sexually transmitted disease and AIDS prevention; 8) contraception; 9) FGC, early marriage, and gender empowerment, including the rights of the girl child; 10) respect for community; and 11) respect for elders. Alternative rites of passage are gaining community acceptance and by Kenya Medical Association. None of the girls who participated in the ceremony were circumcised later.
Arora, Kavita Shah; Jacobs, Allan J
Despite 30 years of advocacy, the prevalence of non-therapeutic female genital alteration (FGA) in minors is stable in many countries. Educational efforts have minimally changed the prevalence of this procedure in regions where it has been widely practiced. In order to better protect female children from the serious and long-term harms of some types of non-therapeutic FGA, we must adopt a more nuanced position that acknowledges a wide spectrum of procedures that alter female genitalia. We offer a revised categorisation for non-therapeutic FGA that groups procedures by effect and not by process. Acceptance of de minimis procedures that generally do not carry long-term medical risks is culturally sensitive, does not discriminate on the basis of gender, and does not violate human rights. More morbid procedures should not be performed. However, accepting de minimis non-therapeutic f FGA procedures enhances the effort of compassionate practitioners searching for a compromise position that respects cultural differences but protects the health of their patients.
Schneider, A; Koutsky, L A
The spectrum of genital HPV infections comprises clinical, subclinical, and latent disease in addition to HPV-associated neoplasia. The definition of subclinical and latent HPV infection is still incomplete and awaits clarification by highly sensitive HPV detection systems that preserve the morphology of the tissue. Genital HPVs infect the human body mainly by sexual transmission, but other pathways of HPV transmission may be possible as suggested by (a) high prevalences of antibody reactivity in children; (b) lack of association of HPV seropositivity with sexual activity; (c) presence of HPV DNA in oral cavity scrapings of children and adults; and (d) development of recurrent respiratory papillomatosis among children exposed to HPV 6 or 11 during birth. Successful infection depends on the infection site and the immunological state of the host: susceptibility to genital HPVs seems highest for the squamous epithelium of the lower genital tract. HPV DNA is also present in extragenital sites but this is rarely accompanied by clinical or subclinical lesions. The molecular basis for this specific tropism is unknown. The immune response in HPV-infected tissues is characterized by depletion of T helper/inducer cells or Langerhans cells and an impaired immunological function of natural killer cells or the infected keratinocyte. Epidemiological studies indicate that individuals with cell-mediated immunodeficiencies are at increased risk for genital HPV infections. Data about the biological course of genital HPV infections are just beginning to emerge. Regression or persistence of subclinical and latent genital HPV infections as analysed in longitudinal investigations show a constant come-and-go of HPV presence. In an infected individual, complete clearing of the virus seems rather exceptional. With respect to progression, the biological potential of cervical HPV infections is characterized by an increased risk for development of HPV-associated neoplasia, especially in
Kumashiro, Mikihiko; Sakai, Masaki
We found that the genitalia of the male cricket Gryllus bimaculatus are equipped with an autocleaning system. The cricket keeps its genitalia clean by removing foreign matter and endogenous waste. Morphological study showed that the membrane complex consists of a median pouch and a genital chamber floor covered by small scales, each of which has a base of approximately 10 µm in width and a fringe with 5-10 spines 3-20 µm in length. The scales are arranged symmetrically about the midline, curving gradually in the lateral direction and continuing to the lateral pouch serving as a trash container. Observation of cleaning revealed that a small piece of artificial dirt placed on the membrane complex was conveyed over a distance of 1.3 mm to the lateral pouch in 12 minutes. Inspection of the dorsal pouch just after spermatophore extrusion in the mating stage revealed that there were patchy remnants of spermatophore material on the inner surface of the pouch, but that these were evacuated in a few minutes. Surgical elimination of the median pouch caused the formation of abnormal spermatophores with the sperm tube and attachment plate being deformed. These results suggest that genital autocleaning is indispensable for the production of a normal spermatophore in the male cricket.
Gomez, F. M. Martinez-Rodrigo, J.; Marti-Bonmati, L.; Santos, E.; Forner, I.; Lloret, M.; Perez-Enguix, D.; Garcia-Marcos, R.
Purpose: To report the success of groin nodal lymphography in the diagnosis and treatment of genital lymphedema. Methods and Materials: We present one female (8 years old [patient no. 1]) and two male (69 and [patient no. 2] 31 years old [patient no. 3], respectively) patients with genital lymphedema in whom conservative treatment failed. The girl also had lymphorrhagia. Genital lymphedema was caused by radical cystectomy (patient no. 2), lymphatic hyperplasia (patient no. 1), and idiopathic lymphangitis (patient no. 3). All of them underwent ultrasound-guided bilateral groin lymph node puncture. Afterward, 4-8 ml Lipiodol Ultra-Fluide (Guerbet) were injected at a rate of 0.2 ml/s. Lipiodol progression was assessed by fluoroscopy. Computed tomography scan of the abdomen and pelvis was performed immediately after and again at 24 h after the procedure to confirm the leak. The follow-up period was 15, 13, and 9 months, respectively. Technical success was considered as bilateral pelvic and abdominal filling of lymphatic vessels. Therapeutic success was considered as improvement or disappearance of genital lymphedema and/or lymphorrhagia. Results: Lipiodol leak to the scrotum was observed in patients no. 2 and 3. Lymphaticopelvic fistula and genital lymphatic hyperplasia were seen in patient no. 1. Genital lymphedema diminished within 1 week and almost disappeared in two cases (patients no. 1 and 3) or significantly improved (patient no. 2). lymphorrhagia also resolved in patient no. 1. No recurrence or worsening was detected during follow-up. Conclusion: Therapeutic lymphangiography by lymph node injection seems to be effective to treat genital lymphedema. Lymph node puncture lymphangiography is feasible and less cumbersome than pedal lymphangiography.
Vogt, Sonja; Mohmmed Zaid, Nadia Ahmed; El Fadil Ahmed, Hilal; Fehr, Ernst; Efferson, Charles
As globalization brings people with incompatible attitudes into contact, cultural conflicts inevitably arise. Little is known about how to mitigate conflict and about how the conflicts that occur can shape the cultural evolution of the groups involved. Female genital cutting is a prominent example. Governments and international agencies have promoted the abandonment of cutting for decades, but the practice remains widespread with associated health risks for millions of girls and women. In their efforts to end cutting, international agents have often adopted the view that cutting is locally pervasive and entrenched. This implies the need to introduce values and expectations from outside the local culture. Members of the target society may view such interventions as unwelcome intrusions, and campaigns promoting abandonment have sometimes led to backlash as they struggle to reconcile cultural tolerance with the conviction that cutting violates universal human rights. Cutting, however, is not necessarily locally pervasive and entrenched. We designed experiments on cultural change that exploited the existence of conflicting attitudes within cutting societies. We produced four entertaining movies that served as experimental treatments in two experiments in Sudan, and we developed an implicit association test to unobtrusively measure attitudes about cutting. The movies depart from the view that cutting is locally pervasive by dramatizing members of an extended family as they confront each other with divergent views about whether the family should continue cutting. The movies significantly improved attitudes towards girls who remain uncut, with one in particular having a relatively persistent effect. These results show that using entertainment to dramatize locally discordant views can provide a basis for applied cultural evolution without accentuating intercultural divisions.
Vender, Ronald; Bourcier, Marc; Bhatia, Neal; Lynde, Charles
The primary goal of treatment for external genital warts (EGWs) is to eradicate visible lesions and address symptoms that may accompany them, but it does not address the underlying virus. Left untreated, warts may grow, remain the same, or spontaneously regress as a result of being cleared by the immune system. However, recurrence is common with or without treatment and may occur within 3 months of ending treatment in one-quarter to two-thirds of cases. Treatment options fall into two categories: provider or patient applied. Provider-based therapies include cryotherapy, trichloroacetic and bichloroacetic acid, electrocautery, surgical excision, and CO2 laser therapy. Patient-applied therapy choices include imiquimod and podophyllotoxin. Imiquimod 3.75% is a fairly new, patient-administered topical cream approved by Health Canada in 2011. Another recently approved patient-applied choice is sinecatechins, a green tea extract with immunomodulatory effects. Self-treatment options are attractive to patients because they offer privacy, convenience, and autonomy. In contrast, provider-administered therapies may boast increased precision (especially for areas that are hard to reach) and closer monitoring, which can be augmented by patient education and counseling. Available topical and surgical therapies vary widely in terms of cost, efficacy, adverse effects, dosage/frequency, and length of treatment. No one treatment is ideally suited to all patients or constitutes a gold standard. Treatment regimens must be tailored to each patient's needs and preferences. The health care provider's skills and experience will also factor into treatment decisions. In addition, the size, number, and location of lesions and whether the infection is new or recurrent will help guide the decision process toward the best treatment for a given patient.
Yeruva, Laxmi; Bowlin, Anne K.; Spencer, Nicole; Maurelli, Anthony T.
An important question in the study of chlamydial genital tract disease is why some women develop severe upper tract disease while others have mild or even “silent” infections with or without pathology. Animal studies suggest that the pathological outcome of an infection is dependent upon both the composition of the infecting chlamydial population and the genotype of the host, along with host physiological effects, such as the cyclical production of reproductive hormones and even the size of the infecting inoculum or the number of repeated infections. In this study, we compared two variants of Chlamydia caviae, contrasting in virulence, with respect to their abilities to ascend the guinea pig genital tract. We then determined the effect of combining the two variants on the course of infection and on the bacterial loads of the two variants in the genital tract. Although the variants individually had similar infection kinetics in the cervix, SP6, the virulent variant, could be isolated from the oviducts more often and in greater numbers than the attenuated variant, AZ2. SP6 also elicited higher levels of interleukin 8 (IL-8) in the lower genital tract and increased leukocyte infiltration in the cervix and uterus compared to AZ2. When the two variants were combined in a mixed infection, SP6 outcompeted AZ2 in the lower genital tract; however, AZ2 was able to ascend the genital tract as readily as SP6. These data suggest that the ability of SP6 to elicit an inflammatory response in the lower genital tract facilitates the spread of both variants to the oviducts. PMID:26015484
Browning, Andrew; Allsworth, Jenifer E; Wall, L Lewis
To evaluate any association between female genital cutting and vesicovaginal fistula formation during obstructed labor. A comparison was made between 255 fistula patients who had undergone type I or type II female genital cutting and 237 patients who had not undergone such cutting. Women were operated on at the Barhirdar Hamlin Fistula Centre in Ethiopia. Data points used in the analysis included age; parity; length of labor; labor outcome (stillbirth or not); type of fistula; site, size, and scarring of fistula; outcomes of surgery (fistula closed; persistent incontinence with closed fistula; urinary retention with overflow; site, size, and scarring of any rectovaginal fistula; and operation outcomes), and specific methods used during the operation (use of a graft or not, application of a pubococcygeal or similar autologous sling, vaginoplasty, catheterization of ureters, and flap reconstruction of vagina). Primary outcomes were site of genitourinary fistula and persistent incontinence despite successful fistula closure. The only statistically significant differences between the two groups (P=.05) were a slightly greater need to place ureteral catheters at the time of surgery in women who had not undergone a genital cutting operation, a slightly higher use of a pubococcygeal sling at the time of fistula repair, and a slightly longer length of labor (by 0.3 day) in women who had undergone genital cutting. Type I and type II female genital cutting are not independent causative factors in the development of obstetric fistulae from obstructed labor.
Browning, Andrew; Allsworth, Jenifer E.; Wall, L. Lewis
Objective To evaluate any association between female genital cutting and vesicovaginal fistula formation during obstructed labor. Methods A comparison was made between 255 fistula patients who had undergone Type I or Type II female genital cutting and 237 patients who had not undergone such cutting. Women were operated on at the Barhirdar Hamlin Fistula Centre in Ethiopia. Data points used in the analysis included age, parity, length of labor, labor outcome (stillbirth or not), type of fistula, site, size and scarring of fistula, outcomes of surgery (fistula closed, persistent incontinence with closed fistula, urinary retention with overflow, site, size, and scarring of any rectovaginal fistula and operation outcomes, as well as specific methods employed during the operation (utilization of a graft or not, application of a pubococcygeal or similar autologous sling, vaginoplasty, catheterization of ureters, and flap reconstruction of vagina). Primary outcomes were site of genitourinary fistula and persistent incontinence despite successful fistula closure. Results The only statistically significant differences between the two groups (p = 0.05) was a slightly greater need to place ureteral catheters at the time of surgery in women who had not undergone a genital cutting operation, and slightly higher use of a pubococcygeal sling at the time of fistula repair and a slightly longer length of labor (by 0.3 of a day) in women who had undergone genital cutting. Conclusion Type I and Type II female genital cutting are not independent causative factors in the development of obstetric fistulas from obstructed labor. PMID:20177289
Manguro, Griffins O.; Masese, Linnet N.; Deya, Ruth W.; Magaret, Amalia; Wald, Anna; McClelland, R. Scott; Graham, Susan M.
Objectives Genital ulcer disease (GUD) prevalence increases in the first month of antiretroviral treatment (ART), followed by a return to baseline prevalence by month 3. Since most GUD is caused by herpes simplex virus type 2 (HSV-2), we hypothesized that genital HSV detection would follow a similar pattern after treatment initiation. Methods We conducted a prospective cohort study of 122 HSV-2 and HIV-1 co-infected women with advanced HIV disease who initiated ART and were followed closely with collection of genital swab specimens for the first three months of treatment. Results At baseline, the HSV detection rate was 32%, without significant increase in genital HSV detection noted during the first month or the third month of ART. HIV-1 shedding declined during this period; no association was also noted between HSV and HIV-1 shedding during this period. Conclusion Because other studies have reported increased HSV detection in women initiating ART and we have previously reported an increase in GUD during early ART, it may be prudent to counsel HIV-1 infected women initiating ART that HSV shedding in the genital tract may continue after ART initiation. PMID:27683204
Schick, Vanessa R.; Calabrese, Sarah K.; Rima, Brandi N.; Zucker, Alyssa N.
Findings regarding the link between body image and sexuality have been equivocal, possibly because of the insensitivity of many of body image measures to potential variability across sensory aspects of the body (e.g., appearance versus odor), individual body parts (e.g., genitalia versus thighs), and social settings (e.g., public versus intimate). The current study refined existing methods of evaluating women’s body image in the context of sexuality by focusing upon two highly specified dimensions: satisfaction with the visual appearance of the genitalia and self-consciousness about the genitalia during a sexual encounter. Genital appearance dissatisfaction, genital image self-consciousness, and multiple facets of sexuality were examined with a sample of 217 undergraduate women using an online survey. Path analysis revealed that greater dissatisfaction with genital appearance was associated with higher genital image self-consciousness during physical intimacy, which, in turn, was associated with lower sexual esteem, sexual satisfaction, and motivation to avoid risky sexual behavior. These findings underscore the detrimental impact of negative genital perceptions on young women’s sexual wellbeing, which is of particular concern given their vulnerability at this stage of sexual development as well as the high rates of sexually transmitted infections within this age group. Interventions that enhance satisfaction with the natural appearance of their genitalia could facilitate the development of a healthy sexual self-concept and provide long-term benefits in terms of sexual safety and satisfaction. PMID:20824180
Schick, Vanessa R; Calabrese, Sarah K; Rima, Brandi N; Zucker, Alyssa N
Findings regarding the link between body image and sexuality have been equivocal, possibly because of the insensitivity of many of body image measures to potential variability across sensory aspects of the body (e.g., appearance versus odor), individual body parts (e.g., genitalia versus thighs), and social settings (e.g., public versus intimate). The current study refined existing methods of evaluating women's body image in the context of sexuality by focusing upon two highly specified dimensions: satisfaction with the visual appearance of the genitalia and self-consciousness about the genitalia during a sexual encounter. Genital appearance dissatisfaction, genital image self-consciousness, and multiple facets of sexuality were examined with a sample of 217 undergraduate women using an online survey. Path analysis revealed that greater dissatisfaction with genital appearance was associated with higher genital image self-consciousness during physical intimacy, which, in turn, was associated with lower sexual esteem, sexual satisfaction, and motivation to avoid risky sexual behavior. These findings underscore the detrimental impact of negative genital perceptions on young women's sexual wellbeing, which is of particular concern given their vulnerability at this stage of sexual development as well as the high rates of sexually transmitted infections within this age group. Interventions that enhance satisfaction with the natural appearance of their genitalia could facilitate the development of a healthy sexual self-concept and provide long-term benefits in terms of sexual safety and satisfaction.
Mark, Hayley D; Lucea, Marguerite; Nanda, Joy P; Farley, Jason E; Gilbert, Lisa
This cross-sectional survey explored the frequency of genital herpes testing among 110 people living with HIV (PLWH) and reported barriers and facilitators related to testing. Forty-four percent of the respondents had not been tested for genital herpes since receiving an HIV diagnosis, 34% had been tested, and 22% preferred not to say. Respondents' most frequently cited factors affecting a decision to not be tested were: (a) testing not being recommended by a provider, (b) not having herpes symptoms, and (c) not thinking they had herpes. Data from this study indicated that PLWH were not frequently tested for genital herpes; there was a limited understanding of the frequently subclinical nature of infection; and provider recommendations for testing, or lack thereof, affected testing decisions.
Mell, Howard K
The epidemiology of oral and genital herpes has dramatically changed over the past decade. Herpes simplex virus-1, traditionally associated with oral herpes, is now implicated in an increasing percentage of genital herpes cases. The possibility of "autoinoculation" (or self-infection) of anatomic sites other than that of the primary infection has been recognized. New methods of suppression therapy are being examined. These changes have led to a revision in the recommendations by the Centers for Disease Control and Prevention (CDC). This review discusses herpes infections of the oral and genital mucosa and the suggested approach to the infected patient who presents in the emergency department. Specific attention is given to the CDC's 2006 guidelines for the treatment of sexually transmitted diseases.
Reis Machado, Juliana; da Silva, Marcos Vinícius; Cavellani, Camila Lourencini; Antônia dos Reis, Marlene; Monteiro, Maria Luiza Gonçalves dos Reis; Teixeira, Vicente de Paula Antunes; Rosa Miranda Corrêa, Rosana
Mucosal immunity consists of innate and adaptive immune responses which can be influenced by systemic immunity. Despite having been the subject of intensive studies, it is not fully elucidated what exactly occurs after HIV contact with the female genital tract mucosa. The sexual route is the main route of HIV transmission, with an increased risk of infection in women compared to men. Several characteristics of the female genital tract make it suitable for inoculation, establishment of infection, and systemic spread of the virus, which causes local changes that may favor the development of infections by other pathogens, often called sexually transmitted diseases (STDs). The relationship of these STDs with HIV infection has been widely studied. Here we review the characteristics of mucosal immunity of the female genital tract, its alterations due to HIV/AIDS, and the characteristics of coinfections between HIV/AIDS and the most prevalent STDs. PMID:25313360
Ruiz, Ismael Jiménez; Martínez, María Pilar Almansa; Bravo, María Del Mar Pastor
To relate the Female Genital Mutilation as a negative factor for the achievement of the Millennium Development Goals 1, 3, 4, 5 and 6. Data collection was through review literature review between in the years 2014 and 2015 in the databases Medline/PubMed, Web of Science, LILACS, SCIELO, Tesis Doctorales TESEO and in the webs of WOK, UNICEF, UNAF and WHO using the descriptors: female circumcision, millennium development goals, rights of women. Articles published between years 2010 y 2015, were included and finally 24 articles were selected. The Female Genital Mutilation is based on gender discrimination, and reinforces and encourages the circle of poverty. This practice causes physical complications that may affect the infant mortality and morbidity, complications in pregnancy and childbirth and there is a relationship between the practice and the transmission of human immunodeficiency virus. The fight against Female Genital Mutilation contributes to the achievement of five of the eight Millennium Goals.
Sexual abuse is a problem of epidemic proportions in the United States. Pediatric nurse practitioners (PNPs) are at the forefront of providing care to children and families. The PNP is in a unique position to educate patients and families regarding sexual abuse and dispel common myths associated with sexual abuse. One such myth is that a normal ano-genital examination is synonymous with the absence of sexual abuse. This article will provide primary care providers, including PNPs, with a framework for understanding why a normal ano-genital examination does not negate the possibility of sexual abuse/assault. Normal ano-genital anatomy, changes that occur with puberty, and physical properties related to the genitalia and anus will be discussed. Photos will provide visualization of both normal variants of the pre-pubertal hymen and genitalia as well as changes that occur with puberty. Implications for practice for PNPs will be discussed.
Female genital mutilation is the medically unnecessary modification of female genitalia. Female genital mutilation typically occurs at about 7 years of age, but mutilated women suffer severe medical complications throughout their adult lives. Female genital mutilation most frequently occurs in Africa, the Middle East, and Muslim parts of Indonesia and Malaysia, and it is generally part of a ceremonial induction into adult society. Recent political and economic problems in these regions, however, have increased the numbers of students and refugees to the United States. Consequently, US physicians are treating an increasing number of mutilated patients. The Council on Scientific Affairs recommends that US physicians join the World Health Organization, the World Medical Association, and other major health care organizations in opposing all forms of medically unnecessary surgical modification of the female genitalia.
Klein, David M; Wright, Stephen H; Cherrington, Nathan J
The male genital tract plays an important role in protecting sperm by forming a distinct compartment separate from the body which limits exposure to potentially toxic substrates. Transporters along this tract can influence the distribution of xenobiotics into the male genital tract through efflux back into the blood or facilitating the accumulation of toxicants. The aim of this study was to quantitatively determine the constitutive mRNA expression of 30 xenobiotic transporters in caput and cauda regions of the epididymis, vas deferens, prostate, and seminal vesicles from adult Sprague-Dawley rats. The epididymis was found to express at least moderate levels of 18 transporters, vas deferens 15, seminal vesicles 23, and prostate 18. Constitutive expression of these xenobiotic transporters in the male genital tract may provide insight into the xenobiotics that can potentially be transported into these tissues and may provide the molecular mechanism for site specific toxicity of select agents.
Klein, David M.; Wright, Stephen H.; Cherrington, Nathan J.
The male genital tract plays an important role in protecting sperm by forming a distinct compartment separate from the body which limits exposure to potentially toxic substrates. Transporters along this tract can influence the distribution of xenobiotics into the male genital tract through efflux back into the blood or facilitating the accumulation of toxicants. The aim of this study was to quantitatively determine the constitutive mRNA expression of 30 xenobiotic transporters in caput and cauda regions of the epididymis, vas deferens, prostate, and seminal vesicles from adult Sprague-Dawley rats. The epididymis was found to express at least moderate levels of 18 transporters, vas deferens 15, seminal vesicles 23, and prostate 18. Constitutive expression of these xenobiotic transporters in the male genital tract may provide insight into the xenobiotics that can potentially be transported into these tissues and may provide the molecular mechanism for site specific toxicity of select agents. PMID:24814985
Harmanli, Ozgur H.; Nyirjesy, Paul; Reece, E. Albert
Objective: Our objective was to determine the role of Mycoplasma hominis and Ureaplasma urealyticum in pelvic inflammatory disease (PID). Methods: The clinical and microbiologic variables in 114 patients with a clinical diagnosis of PID were compared prospectively according to the isolation of M. hominis and U. urealyticum from their endometrial cavities. Results: The groups were epidemiologically well matched. Clinical parameters such as temperature, leukocyte count, erythrocyte count, and C-reactive protein on admission and length of hospital stay were similar in the patients, regardless of their mycoplasma status. A significant percentage of the patients either continued or started to harbor genital mycoplasmas after the resolution of PID without any significant clinical sequelae. Conclusions: The presence of genital mycoplasmas does not change the clinical presentation and course of PID. Both M. hominis and U. urealyticum can persist or colonize the endometrium after complete recovery from PID. Therefore, the genital mycoplasmas do not seem to have a dominant pathogenic role in PID. PMID:18476105
Shah, Hardik Uresh; Sannananja, Bhagya; Baheti, Akshay Dwarka; Udare, Ashlesha Satish; Badhe, Padma Vikram
Genital tuberculosis (TB) is an important cause of female infertility in the world, especially in developing countries. Majority of infertility cases are due to involvement of the fallopian tubes (92%-100%), endometrial cavity (50%), and ovaries (10%-30%); cervical and vulvovaginal TB are uncommon. Genital TB has characteristic radiological appearances based on the stage of the disease process (acute inflammatory or chronic fibrotic) and the organ of involvement. Hysterosalpingography (HSG) and ultrasonography (US) remain the main imaging modalities used in the diagnosis of genital TB. HSG is the primary modality for evaluating uterine, fallopian tube, and peritubal involvement and also helps in evaluating tubal patency. US, on the other hand, allows simultaneous evaluation of ovarian and extrapelvic involvement.
... Data & Statistics Sexually Transmitted Diseases Figure 48. Genital Herpes — Initial Visits to Physicians’ Offices, United States, 1966 – ... page . NOTE : The relative standard errors for genital herpes estimates of more than 100,000 range from ...
... Data & Statistics Sexually Transmitted Diseases Figure 46. Genital Warts — Initial Visits to Physicians’ Offices, United States, 1966 – ... page . NOTE : The relative standard errors for genital warts estimates of more than 100,000 range from ...
Saleem, Rozhgar A; Othman, Nasih; Fattah, Fattah H; Hazim, Luma; Adnan, Berivan
The high prevalence of female genital mutilation has been a concern in Iraqi Kurdistan. This study was undertaken to estimate its prevalence and describe factors associated with its occurrence. A cross-sectional survey was undertaken from March to April 2011 of females aged up to 20 years using interviews and clinical examination. The survey included 1,508 participants with mean age of 13.5 years (SD 5.6). Overall female genital mutilation prevalence was 23%, and the mean age at which it had been performed was 4.6 years (SD 2.4). Type I (partial or total removal of the clitoris) comprised 76% of those who had had female genital mutilation; in 79% of cases the decision to perform it was made by the mother; and in 54% of cases it was performed by traditional birth attendants/midwives. Women aged 16 years and over were more likely to have had female genital mutilation compared to children aged below 6 years (OR 11.9, p < .001). Children of uneducated mothers were eight times as likely to have had genital mutilation compared to children of mothers with over nine years of education (OR 8.0, p < .001). Among women aged 17 years and younger, 34% of those who were married had been circumcised versus 17% of those who were not married (p < .001). Participants residing in the northeast of Kurdistan region were more likely to have been circumcised. The study results show that female genital mutilation is a frequent practice in Iraqi Kurdistan. Attention and intervention is needed to address this aspect of the well-being of girls and women.
Simms, I; Catchpole, M; Brugha, R; Rogers, P; Mallinson, H; Nicoll, A
OBJECTIVE: To describe the recent epidemiology of genital Chlamydia trachomatis infection in England and Wales. DESIGN: Retrospective study of routinely available surveillance datasets and ad hoc prevalence studies. METHODS: Numbers of new cases of genital C trachomatis infection, obtained from the Department of Health and Welsh Office, were combined with the estimated mid-year resident population of England and Wales. Rates were analysed for trend over time using a log linear age period model in GLIM4. Ad hoc prevalence and case finding studies carried out over the past 20 years were critically assessed in terms of study design and testing methodologies. RESULTS: Attendance rates at genitourinary medicine (GUM) clinics were higher for women than men over the period 1989 to 1994 as were the number of laboratory reports. The highest rate of attendance (GUM clinic data) was for women aged 16 to 19 years. There was an overall significant linear decrease in the attendance rates over time for both men (p = 0.0172) and women (p = 0.0000) between 1989 and 1994. There was considerable variation in the prevalence of genital C trachomatis infection detected within different clinical settings, together with a substantial level of asymptomatic infection. CONCLUSIONS: Genital C trachomatis infection is broadly distributed throughout the sexually active population, with a substantial reservoir of asymptomatic infection among those generally perceived to be at low risk of a sexually transmitted infection. Young people, particularly women aged 16 to 19 years, are at highest risk of genital C trachomatis infection. This is of concern since younger women are more susceptible than older women to developing complications of chlamydial infection, such as pelvic inflammatory disease. The broad distribution of infection across all sexually active health service attenders and the high level of asymptomatic infection suggest that a new, screening based, approach to the control of genital C
Stepanov, P I
Based on a survey of 467 men with genital tuberculosis, following conclusions were made. The presence of morphological signs of nonspecific prostatitis of toxic-allergic genesis in patients with newly diagnosed tuberculosis of the urinary and genital organs proves the possibility of primary infection of the epididymis with Mycobacterium tuberculosis. Primarily isolated epididymal tuberculosis was diagnosed in 21 (4,5%) patients. Tuberculous of testicles is in direct relationship to the duration of the existence of tuberculous infection in the epididymis. Bilateral tuberculous of the epididymis is always combined with tuberculosis of the prostate. Opportunity of both primary and secondary infection of the prostate gland with Mycobacterium tuberculosis can be considered as proved. 15 (3,2%) patients had initially isolated prostatic tuberculosis. Based on clinical observations, exogenous way of introduction of infection in tuberculosis of genital organs in men was not confirmed. The lymphogenous and hematogenous pathways are leading and most common pathways of Mycobacterium tuberculosis in the male genitals. In patients with tuberculosis of the prostate, which is combined with a lesion of urinary organs, without involvement of scrotum in the pathological process, infection of prostate occurs by urinogenous way. Tuberculosis of the seminal vesicles is always secondary; none of the patients were initially diagnosed with isolated process. Based on the clinical manifestations of the disease and a detailed examination of the patient, it is virtually impossible to establish a particular way of infection in the male genitals. The main value of the information about the possible ways of tuberculosis infection consists of fully examination of reproductive system with histological and bacteriological verification of the diagnosis of each genital organs in each man with suspected tuberculosis.
Nunes, Jairo Tavares; Lopes, Leonardo da Costa; Prokopowitsch, Aleksander Snioka
The Epstein-Barr virus (EBV) is associated with a broad spectrum of diseases, mainly because of its genomic characteristics, which result in different latency patterns in immune cells and infective mechanisms. The patient described in this report is a previously healthy young man who presented to the emergency department with clinical features consistent with meningitis and genital ulcers, which raised concern that the herpes simplex virus was the causative agent. However, the polymerase chain reaction of cerebral spinal fluid was positive for EBV. The authors highlight the importance of this infection among the differential diagnosis of central nervous system involvement and genital ulceration. PMID:27547743
Myers, Jaime L; Buhi, Eric R; Marhefka, Stephanie; Daley, Ellen; Dedrick, Robert
Disclosure is often a challenge for individuals living with genital herpes. This study explores determinants of genital herpes disclosure with one's most recent sexual partner using an online questionnaire (n = 93). The majority of participants reported (80.4%) disclosure. Among non-disclosers, fear of negative partner reactions was the primary reason for non-disclosure. Age, relationship commitment, time in relationship, and expectations of partner's reaction were statistically significant predictors at the bivariate level. Reaction expectations and relationship commitment remained significant in the multivariate logistic regression model. Findings indicate that future disclosure research should focus on relationship context and managing negative expectations to increase disclosure.
Jerdan, Kimberly; Aronson, Iris; Hernandez, Claudia; Fishman, Patricia M; Groth, John V
Genital ulcerations are a rare clinical finding of Epstein-Barr virus (EBV) infection. We present the case of a 16-year-old adolescent girl who reported the onset of diarrhea, headaches, dysuria, and vaginal discharge along with vulvar ulcerations with edema. Laboratory studies revealed a high-quantitative EBV IgG and early antigen as well as a positive IgM antibody for EBV. Although the association between EBV and genital ulcerations is rare, physicians should be aware of this clinical presentation to exclude other infectious entities, to be reassured to accept negative testing, and to quell patient distress or concerns of abuse.
Hosken, F P
Extensive research and field work have established that more than 74 million women and female children are mutilated by female genital operations in Africa alone. The operations are also practiced in many parts of the Middle East and, with Moslemization, were introduced into Indonesia and Malaysia where they are preformed at the present time in a less damaging form. This paper lists the countries where instances of excision and infibulation have been reported and includes case reports from Sudan, Egypt, Ethiopia, Kenya, Somalia, Nigeria, Mali, Upper Volta, and Senegal. The ethical issues posed by genital mutilation are also discussed.
Chanal, Johan; Carlotti, Agnès; Laude, Hélène; Wallet-Faber, Nadège; Avril, Marie-Françoise; Dupin, Nicolas
Lipschütz ulcers are characterised by a first flare of non-sexually related acute genital ulcers (AGU) occurring in adolescent girls. Epstein-Barr primary infection is the most frequently reported aetiology but other infectious agents are probably implicated. We report the first case of mumps associated with an AGU in a 21-year-old girl. She presented a bilateral parotitis with genital ulcers, and serology confirmed she had mumps. As in our case, most Lipschütz ulcers heal spontaneously within a couple of weeks and the diagnosis should be reconsidered in case of recurrence. Copyright © 2010 S. Karger AG, Basel.
"VIDDA" is a Portuguese acronym representing enhancement, integration, and dignity of people living with HIV/AIDS (PWAs). The groups are composed of people infected with HIV, their friends, relatives, lovers, and anyone who feels that his or her everyday life has been affected by the epidemic. They hope that through solidarity they can respond to the difficult situation facing people who are HIV positive in Brazil. Grupo pela VIDDA seeks to raise the consciousness of the government and the society and force them to take responsibility for the epidemic. Their fundamental objective is to fight for PWAs to have a full range of civil rights. "This is a fight that we have in common with all the Brazilian people who are searching for democracy, the right to work, and access to good health services," states a Grupo pela VIDDA brochure. Through their network they provide accurate and current information, counseling, legal assistance, and sponsor support groups. For more information, please contact Grupo pela VIDDA, Rua General Jardim, 556 CEP 01223-010, Cx Postal 54063, CEP 01296, Sao Paulo SP, tel/fax: +55 11 258 7729; or Rua 7 de Setembro, 48 12 andar CEP 20050-000, tel: +55 21 224 1654, fax: +55 21 294 5602. There are also offices in Curitiba, Goiania, Niteroi, Recife, and Vitoria. full text
Markos, A R; Dinsmore, Wallace
We conducted a literature review of patients' conditions described under persistent genital arousal disorder and restless genital syndrome, vulvodynia and male genital skin pain of unknown aetiology (penoscrotodynia). Our aim is to improve the understanding of the condition, unify nomenclature and promote evidence-based practice. The most prominent symptom in persistent genital arousal disorder and restless genital syndrome is a spontaneous, unwelcomed, intrusive and distressing vulval sensation. There are similarities between the clinical presentation of vulvodynia, penoscrotodynia, persistent genital arousal disorder and restless genital syndrome patients. The aetiology of persistent genital arousal disorder and restless genital syndrome, similar to vulvodynia, could be better explained in terms of neuro-vascular dysfunction, genital peripheral neuropathy and/or dysfunctional micro-vascular arterio-venous shunting. Erythromelalgia lends itself to explain some cases of restless genital syndrome, who have concurrent restless legs syndrome; and therefore draw parallels with the red scrotum syndrome. The published literature supports the concept of classifying restless genital syndrome as a sub-type of vulvodynia rather than sexual dysfunction.
Saywitz, Karen J.; And Others
Conducted medical checkups on five- and seven-year-old girls (n=72), one-half of whom also received genital examinations. Later solicited girls' memories. Most girls in genital condition revealed vaginal and anal contact only when asked directly about it. Children who had nongenital examination never falsely reported genital touch in free recall…
Abdulcadir, Jasmine; Irion, Olivier; de Tejada, Begoña Martinez
Nontherapeutic female genital modifications can cause short- and long-term consequences. Caregivers should promote women's self knowledge on genitals' anatomy and physiology, and psychophysical and sexual health. They should also inform on possible negative consequences of vulvar nontherapeutic alterations requested and avoid the medicalization of female genital mutilation.
Kuntner, Matjaž; Cheng, Ren-Chung; Kralj-Fišer, Simona; Liao, Chen-Pan; Schneider, Jutta M; Elgar, Mark A
Genital diversity may arise through sexual conflict over polyandry, where male genital features function to manipulate female mating frequency against her interest. Correlated genital evolution across animal groups is consistent with this view, but a link between genital complexity and mating rates remains to be established. In sexually size dimorphic spiders, golden orbweaving spiders (Nephilidae) males mutilate their genitals to form genital plugs, but these plugs do not always prevent female polyandry. In a comparative framework, we test whether male and female genital complexity coevolve, and how these morphologies, as well as sexual cannibalism, relate to the evolution of mating systems. Using a combination of comparative tests, we show that male genital complexity negatively correlates with female mating rates, and that levels of sexual cannibalism negatively correlate with male mating rates. We also confirm a positive correlation between male and female genital complexity. The macroevolutionary trajectory is consistent with a repeated evolution from polyandry to monandry coinciding with the evolution towards more complex male genitals. These results are consistent with the predictions from sexual conflict theory, although sexual conflict may not be the only mechanism responsible for the evolution of genital complexity and mating systems. Nevertheless, our comparative evidence suggests that in golden orbweavers, male genital complexity limits female mating rates, and sexual cannibalism by females coincides with monogyny.
Hypospadias is a developmental defect of urethral tube closure that has a complex etiology. Here, we describe a multicellular agent-based model of genital tubercle development that simulates urethrogenesis from the urethral plate stage to urethral tube closure in differentiating ...
Kashyap, Bineeta; Srivastava, Namita; R Kaur, Iqbal; Jhamb, Rajat; K Singh, Deepak
Background: Tuberculosis (TB) is an increasing public health concern worldwide. On a global scale it has a devastating impact in developing nations. Genital TB, an extrapulmonary form, is not uncommon particularly in areas where pulmonary TB is prevalent. Genital TB may be asymptomatic or may even masquerade as other gynaecological conditions; hence, diagnosis requires a high degree of suspicion and the use of appropriate investigations. Objective: This study attempted to identify endometrial TB in endometrial biopsies taken from women evaluated for infertility by comparison of various staining techniques. Materials and Methods: A comparative cross sectional study was conducted from February 2011 to April 2011 in Guru Teg Bahadur Hospital, New Delhi. Endometrial biopsy specimens from 55 endometrial TB suspects were stained for acid fast bacilli by Ziehl Neelson staining and Gabbet staining. The biopsy samples were also subjected to Auramine Phenol fluroscent staining and H and E staining. Culture on Lowenstein Jensen medium was taken as the gold standard. Results: Three samples were culture positive giving positivity rate of 5.4%. Considering culture as the gold standard the senstivities of ZN, Gabbet, fluorescent and H and E staining were 33, 33, 66, and 66% respectively while their specificities were 100, 100, 98, and100% respectively. Conclusion: Combination of fluorescent staining techniques along with one of the acid fast staining techniques or histopathology achieves sufficient sensitivity and specificity for the diagnosis of female genital tuberculosis. There is an urgent need for developing definitive diagnostic methods to make a conclusive diagnosis of genital TB. PMID:24639789
Scattoni, R; Verrotti, A; Rinaldi, V E; Paglino, A; Carelli, A; D'Alonzo, R
Vaginal ulcers can be associated with a number of different diseases. We describe two girls who presented genital ulcers as a persistent symptom of PFAPA (periodic fever, aphthous stomatitis, pharyngitis, cervical adenitis) syndrome. The possibility of considering this clinical manifestation as a clue for the diagnosis of PFAPA is discussed.
... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Genital vibrator for therapeutic use. 884.5960 Section 884.5960 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES... of sexual dysfunction or as an adjunct to Kegel's exercise (tightening of the muscles of the...
... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Genital vibrator for therapeutic use. 884.5960 Section 884.5960 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES... of sexual dysfunction or as an adjunct to Kegel's exercise (tightening of the muscles of the...
... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Genital vibrator for therapeutic use. 884.5960 Section 884.5960 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES... of sexual dysfunction or as an adjunct to Kegel's exercise (tightening of the muscles of the...
... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Genital vibrator for therapeutic use. 884.5960 Section 884.5960 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES... of sexual dysfunction or as an adjunct to Kegel's exercise (tightening of the muscles of the...
Mestecky, Jiri; Moldoveanu, Zina; Russell, Michael W
Although the genital tract is considered to be a component of the mucosal immune system, it displays several distinct features not shared by other typical mucosal tissues and external secretions. Both male and female genital tract tissues lack inductive mucosal sites analogous to intestinal Peyer's patches. Consequently, local humoral and cellular immune responses stimulated by infections [with e.g. Neisseria gonorrhoeae, Chlamydia trachomatis, papilloma virus, and human immunodeficiency virus (HIV-1)] are weak or absent, and repeated local intravaginal immunizations result in minimal humoral responses. In contrast to typical external secretions such as intestinal fluid that contain secretory immunoglobulin A (S-IgA) as the dominant isotype, semen and cervico-vaginal fluid contain more IgG than IgA. Furthermore, irrespective of the route of infection, humoral immune responses to HIV-1 are dominated by specific IgG and low or absent IgA antibodies in all external secretions. Because a significant proportion of IgG in genital tract secretions is derived from the circulation, systemic immunization may provide protective IgG antibody-mediated immunity in the genital tract. Furthermore, combined systemic and mucosal (oral, rectal, and especially intranasal) immunization may induce protective humoral responses in both the systemic and mucosal compartments of the immune system. Copyright Blackwell Munksgaard, 2005.
Ouedraogo, Itengre; McConley, Regina; Payne, Christopher; Heller, Alison; Wall, L Lewis
The objective was to determine the contribution of female genital cutting to genital fistula formation in Niger from the case records of a specialist fistula hospital. A retrospective review was undertaken of the records of 360 patients seen at the Danja Fistula Center, Danja, Niger, between March 2014 and September 2016. Pertinent clinical and socio-demographic data were abstracted from the cases identified. A total of 10 fistulas resulting from gurya cutting was obtained: 9 cases of urethral loss and 1 rectovaginal fistula. In none of the cases was genital cutting performed for obstructed labor or as part of ritual coming-of-age ceremonies, but all cutting procedures were considered "therapeutic" within the local cultural context as treatment for dyspareunia, lack of interest in or unwillingness to engage in sexual intercourse, or female behavior that was deemed to be culturally inappropriate by the male spouse, parents, or in-laws. Clinical cure (fistula closed and the patient continent) was obtained in all 10 cases, although 3 women required more than one operation. Gurya cutting is an uncommon, but preventable, cause of genital fistulas in Niger. The socio-cultural context which gives rise to gurya cutting is explored in some detail.
Hypospadias is a developmental defect of urethral tube closure that has a complex etiology. Here, we describe a multicellular agent-based model of genital tubercle development that simulates urethrogenesis from the urethral plate stage to urethral tube closure in differentiating ...
Background In several species with external fertilization, including frogs, laid unfertilized eggs were found to die by apoptosis outside of the animal body. However, there is no apparent reason for the externally laid eggs to degrade by this process, considering that apoptosis developed as a mechanism to reduce the damaging effect of individual cell death to the whole organism. Results Here, we demonstrate that a number of eggs are retained in the genital tract of the African clawed frog Xenopus laevis after gonadotropin-induced ovulation. The majority of these eggs exit meiotic arrest within 24 hours of hormone administration. Subsequently, post-meiotic eggs die in the frog genital tract by a well-defined apoptotic process. The hallmarks of egg degradation include prominent morphological changes, cytochrome c release, caspase activation, increase in ADP/ATP ratio, progressive intracellular acidification, egg swelling and all-out proteolysis of egg proteins. The sustained presence of post-apoptotic eggs in the genital tract of ageing frogs evidenced age-associated worsening of apoptotic clearance. Conclusions The direct observation of egg degradation in the Xenopus genital tract provides a clue to the physiological relevance of frog egg apoptosis. It works to eliminate the mature unlaid eggs retained in the animal body after ovulation. Our findings establish egg apoptosis as a major physiological process accompanying ovulation in frogs. PMID:23452868
Boardman, L A; Peipert, J F; Brody, J M; Cooper, A S; Sung, J
To determine the clinical utility of transvaginal sonography for the diagnosis of upper genital tract infection. Fifty-five women who either met the Centers for Disease Control and Prevention's minimal criteria for acute pelvic inflammatory disease or were being seen for non-classic signs of upper genital tract infection were evaluated. During abdominal and endovaginal ultrasound testing, fluid in the cul-de-sac, discrete tubes with or without tubal fluid, multicystic ovaries, and adnexal masses were noted. Upper genital tract infection was confirmed by laparoscopic visualization or histologic or microbiologic evidence of salpingitis of endometritis. The specificity of identifying fallopian tubes with or without intraluminal fluid on ultrasound was 97% (35 of 36); the sensitivity, however, was only 32% (six of 19). Calculated using Bayes theorem and based on a prevalence rate of 50%, the positive predictive value of visualizing fallopian tubes was 91%. The sensitivities associated with the visualization of a multicystic ovary or tubo-ovarian abscess were 42% (eight of 19) and 32% (six of 19), with specificities of 86% (31 of 36) and 97%, (35 of 36), and positive predictive values of 75% and 91%, respectively. Cul-de-sac fluid was associated with low sensitivity (37%; seven of 19), low specificity (58%; 21 of 36), and the lowest positive predictive value (47%). Endovaginal sonography has limited clinical utility in the diagnosis of upper genital tract infection due to its low sensitivity.
Fouéré, Sébastien; Chaine, Bénédicte; Maylin, Sarah; Minier, Marine; Vallée, Pascale; Scieux, Catherine; Lassau, François; Legoff, Jérôme; Janier, Michel
First HSV-1 genital episodes in HSV-2 infected patients however, had never been demonstrated until the 2 cases we observed. This scarcity could reflect the lower impact of HSV-2 on western populations but questions the existence of cross-protection between viral types.
Wagner, Aaron P; Frank, Laurence G; Creel, Scott; Coscia, Elizabeth M
The highly masculinized genitalia of female spotted hyenas Crocuta crocuta is unique among mammals: Crocuta have no external vagina so urination, penile intromission and parturition take place through the clitoris, which mimics a fully erectile male penis. Among hyenids, virilization of external female genitalia has previously been observed only in Crocuta, so functional explanations of masculinization have focused on aspects of social ecology unique to the species. Here we first show that the striped hyena Hyaena hyaena exhibits both unusual similarity in male and female androgen concentrations and transient genital anomalies characterized by a convergence in genital appearance among young males and females. We then evaluate hypotheses regarding the evolution of genital masculinization in the Hyaenidae and other taxa. Hyaena are behaviorally solitary, so discovery of unusual genital development patterns in this species does not support any current evolutionary models for masculinization in Crocuta, which all rely on the trait originating within a highly social species. Some hypotheses can be modified so that masculinization in Crocuta represents an extreme elaboration of a preexisting trait, shared as a homology with Hyaena.
Zikry, Joseph; Chapman, Lance W; Korta, Dorota Z; Smith, Janellen
Full-body skin exams (FBSE) play an integral role inearly detection and treatment of skin cancer. Promptdetection of melanoma is especially importantas survival outcomes decrease significantly withpresentation of advanced disease. Given thatmelanoma may grow in areas of skin with little to nosun exposure, genital melanomas are a recognizedentity in cutaneous oncology.
Méndez-Martínez, Socorro; García-Carrasco, Mario; Cedillo-Ramírez, María L; Mendoza-Pinto, Claudia; Etchegaray-Morales, Ivet; Gil-Juárez, Constantino; Montiel-Jarquín, Álvaro J; Taboada-Cole, Alejandro; Jiménez-Herrera, Erick A; Muñóz-Guarneros, Margarita; Cervera, Ricard
To assess the prevalence of genital Mycoplasma spp. among women with systemic lupus erythematosus (SLE) and to identify factors associated with such infection. A cross-sectional study was conducted among patients with SLE and healthy women who attended a hospital in Puebla, Mexico, between July 29, 2014, and January 4, 2015. All participants were aged 18 years or older and sexually active. A structured interview assessed sociodemographic, obstetric, gynecologic, and clinical characteristics. Disease activity was evaluated using the Mexican SLE Disease Activity Index. Polymerase chain reaction was used to detect the presence of Mycoplasma spp. in genital samples. Ureaplasma urealyticum was the only genital mycoplasma detected; it was present in 32 (24.6%) of 130 patients with SLE and 12 (12.8%) of 94 healthy women. Patients with SLE had increased odds of infection (odds ratio 2.120, 95% confidence interval 1.046-4.296). Among patients with SLE, multiparity was more common in those with U. urealyticum infection (P=0.043). One-quarter of women with SLE had genital infection with U. urealyticum. An association was found between infection and multiparity among women with SLE. © 2017 International Federation of Gynecology and Obstetrics.
Mónaco, M; Verdugo, F; Bodell, M; Avendaño, E; Til, L; Drobnic, F
The purpose of genital examination (GE) during the Pre-participation Physical Examination (PPE) is to identify the state of maturity, and rule out any genital pathology. To describe genital anomalies (GA) and estimate the awareness of GE in young football players. A descriptive, cross-sectional study was conducted in 280 elite football players from the results of PPE over two seasons. There was a detection rate of 5.4% GA, with varicocele being 3.2%, and of which only 13% were aware of their condition. Although this study shows a low incidence of genital abnormality in the study population, only 13% were aware of the GE prior to assessment. These findings demonstrate a low incidence of GA in this population. While GE is recommended during PPE, it is not a routine practice performed by family doctors or sports medicine specialists. This article attempts to raise awareness of the importance of GE in PPE as a preventive health strategy. Copyright © 2014 Asociación Española de Pediatría. Published by Elsevier Espana. All rights reserved.
Shelmidine, Nichole; Borries, Carola; Koenig, Andreas
The occurrence of genital swellings was examined in adult female silvered langurs (Trachypithecus cristatus). In contrast to the exaggerated swellings found in cercopithecines and apes, genital swellings in silvered langurs are confined to the vulva and the surrounding perineum, but they may nevertheless convey information similar to that of exaggerated swellings (i.e., correlate with the receptive period and fertility). If so, genital swellings would be expected to occur most frequently in cycling females, and sexual behavior and male interest should most frequently involve females with swellings. Swellings during gestation, if they occur at all, should be most pronounced at the beginning. Swelling sizes (in three size categories) in nine adult females were examined throughout different reproductive states (cycling, pregnant, and lactating), and in relation to proceptivity, receptivity, and attractivity. Data were collected from November 2002 through March 2004 (on 500 of the 502 calendar days) at the Wildlife Conservation Society's Bronx Zoo. Female sexual behavior (proceptivity and receptivity) and male inspection (attractivity) were recorded each day for 6 hr by video camera (2,948 hr total) and analyzed as present or absent for each female day. Swellings were assessed directly (not from videotapes). In contrast to the predictions, swellings occurred significantly less frequently in cycling females (compared to pregnant females) and no regular, cyclic pattern could be detected. Some females conceived without a swelling. Female attractivity was independent of swellings but coincided with proceptive behavior. Swellings occurred most frequently in pregnant females, especially toward the end of the gestation period. Therefore, genital swellings in silvered langurs are not similar to exaggerated swellings or the smaller genital swellings that have been described for some other primates. It is currently not clear what they signal to conspecifics. Male behavior needs
Belay, Tesfaye; Eko, Francis O; Ananaba, Godwin A; Bowers, Samera; Moore, Terri; Lyn, Deborah; Igietseme, Joseph U
Current design strategies for vaccines against certain microbial pathogens, including Chlamydia trachomatis, require the induction and targeting of specific immune effectors to the local sites of infection known as the mucosal effector sites. Chemokines and their receptors are important mediators of leukocyte trafficking and of the controlled recruitment of specific leukocyte clonotypes during host defense against infections and during inflammation. We analyzed the dynamics of chemokine and chemokine receptor expression in genital mucosae during genital chlamydial infection in a murine model to determine how these molecular entities influence the development of immunity and the clearance of infection. A time course study revealed an increase of up to threefold in the levels of expression of RANTES, monocyte chemotactic protein 1 (MCP-1), gamma-interferon-inducible protein 10 (IP-10), macrophage inflammatory protein 1alpha (MIP-1alpha), and intercellular adhesion molecule type 1 (ICAM-1) after genital infection with the C. trachomatis agent of mouse pneumonitis. Peak levels of expression of RANTES, MCP-1, and MIP-1alpha occurred by day 7 after primary infection, while those of IP-10 and ICAM-1 peaked by day 21. Expression levels of these molecules decreased by day 42 after primary infection, by which time all animals had resolved the infection, suggesting an infection-driven regulation of expression. A rapid upregulation of expression of these molecules was observed after secondary infection. The presence of cells bearing the chemokine receptors CCR5 and CXCR3, known to be preferentially expressed on Th1 and dendritic cells, was also synchronous with the kinetics of immune induction in the genital tract and clearance of infection. Results demonstrated that genital chlamydial infection is associated with a significant induction of chemokines and chemokine receptors that are involved in the recruitment of Th1 cells into the site of infection. Future studies will focus
Angulo, Javier C; García-Díez, Marcos; Martínez, Marc
The primitive anthropological meaning of genital ornamentation is not clearly defined and the origin of penile intervention for decorative purposes is lost in time. Corporeal decoration was practiced in the Upper Paleolithic period. We discuss the existing evidence on the practice of phallic piercing, scarring and tattooing in prehistory. We studied the archaeological and artistic evidence regarding explicit genital male representations in portable art made in Europe approximately 38,000 to 11,000 years ago with special emphasis on decorations suggesting genital ornamentation. Archaeological evidence that has survived to our day includes 42 phallic pieces, of which 30 (71.4%) show intentional marks to a different extent with a probable decorative purpose. Of these ornamental elements 18 (60%) were recovered from the upper Magdalenian period (11,000 to 12,700 years ago) in France and Spain, and 23 (76.7%) belong to the category of perforated batons. Decorations show lines (70% of objects), plaques (26.7%), dots/holes (23.3%) or even human/animal forms (13.3%). These designs most probably represent skin scarification, cutting, piercing and tattooing. Notably there are some technical similarities between the motifs represented and some designs present in symbolic cave wall art. This evidence may show the anthropological origin of current male genital piercing and tattooing. European Paleolithic art shows decoration explicitly represented in a high proportion of portable art objects with a phallic form that have survived to our day. Decorative rituals of male genital tattooing, piercing and scarification may have been practiced during Paleolithic times. Copyright Â© 2011 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.
Eady, Paul E; Hamilton, Leticia; Lyons, Ruth E
Antagonistic sexual coevolution stems from the notion that male and female interests over reproduction are in conflict. Such conflicts appear to be particularly obvious when male genital armature inflicts damage to the female reproductive tract resulting in reduced female longevity. However, studies of mating frequency, genital damage and female longevity are difficult to interpret because females not only sustain more genital damage, but also receive more seminal fluid when they engage in multiple copulations. Here, we attempt to disentangle the effects of genital damage and seminal fluid transfer on female longevity in the beetle Callosobruchus maculatus (Coleoptera: Bruchidae). Males copulating for the sixth time in succession inflicted greater levels of genital damage, but transferred smaller ejaculates in comparison with virgin males. The number of copulations performed by males was negatively related to female fecundity and positively related to female longevity, suggesting a trade-off between fecundity and longevity. However, inclusion of fecundity as a covariate revealed sperm and/or seminal fluid transfer to have a negative impact on female longevity above that caused by the fecundity–longevity trade-off. The consequences of multiple copulations on female longevity were examined. Females that mated twice laid more eggs and died sooner than those that mated once. However, incorporation of fecundity as a covariate into our statistical model removed the effect of female mating frequency on female longevity, indicating that double-mated females suffer greater mortality owing to the trade-off between fecundity and longevity. Males of this species are known to transfer very large ejaculates (up to 8% of their body weight), which may represent a significant nutritional benefit to females. However, the receipt of large ejaculates appears to carry costs. Thus, the interpretation of multiple mating experiments on female longevity and associated functional
Eady, Paul E; Hamilton, Leticia; Lyons, Ruth E
Antagonistic sexual coevolution stems from the notion that male and female interests over reproduction are in conflict. Such conflicts appear to be particularly obvious when male genital armature inflicts damage to the female reproductive tract resulting in reduced female longevity. However, studies of mating frequency, genital damage and female longevity are difficult to interpret because females not only sustain more genital damage, but also receive more seminal fluid when they engage in multiple copulations. Here, we attempt to disentangle the effects of genital damage and seminal fluid transfer on female longevity in the beetle Callosobruchus maculatus (Coleoptera: Bruchidae). Males copulating for the sixth time in succession inflicted greater levels of genital damage, but transferred smaller ejaculates in comparison with virgin males. The number of copulations performed by males was negatively related to female fecundity and positively related to female longevity, suggesting a trade-off between fecundity and longevity. However, inclusion of fecundity as a covariate revealed sperm and/or seminal fluid transfer to have a negative impact on female longevity above that caused by the fecundity-longevity trade-off. The consequences of multiple copulations on female longevity were examined. Females that mated twice laid more eggs and died sooner than those that mated once. However, incorporation of fecundity as a covariate into our statistical model removed the effect of female mating frequency on female longevity, indicating that double-mated females suffer greater mortality owing to the trade-off between fecundity and longevity. Males of this species are known to transfer very large ejaculates (up to 8% of their body weight), which may represent a significant nutritional benefit to females. However, the receipt of large ejaculates appears to carry costs. Thus, the interpretation of multiple mating experiments on female longevity and associated functional
Calla, Nirk E Quispe; Miguel, Rodolfo D Vicetti; Boyaka, Prosper N; Hall-Stoodley, Luanne; Kaur, Balveen; Trout, Wayne; Pavelko, Stephen D; Cherpes, Thomas L
Depot-medroxyprogesterone acetate (DMPA) is a hormonal contraceptive especially popular in areas with high prevalence of HIV and other sexually transmitted infections (STI). While observational studies identify DMPA as an important STI risk factor, mechanisms underlying this connection are undefined. Levonorgestrel (LNG) is another progestin used for hormonal contraception, but its effect on STI susceptibility is much less explored. Using a mouse model of genital HSV-2 infection, we herein found DMPA and LNG similarly reduced genital expression of the desmosomal cadherin desmoglein-1α (DSG1α), enhanced access of inflammatory cells to genital tissue by increasing mucosal epithelial permeability, and increased susceptibility to viral infection. Additional studies with uninfected mice revealed DMPA-mediated increases in mucosal permeability promoted tissue inflammation by facilitating endogenous vaginal microbiota invasion. Conversely, concomitant treatment of mice with DMPA and intravaginal estrogen restored mucosal barrier function and prevented HSV-2 infection. Evaluating ectocervical biopsy tissue from women before and 1 month after initiating DMPA remarkably revealed inflammation and barrier protection were altered by treatment identically to changes seen in progestin-treated mice. Together, our work reveals DMPA and LNG diminish the genital mucosal barrier; a first-line defense against all STI, but may offer foundation for new contraceptive strategies less compromising of barrier protection. PMID:27007679
Quispe Calla, N E; Vicetti Miguel, R D; Boyaka, P N; Hall-Stoodley, L; Kaur, B; Trout, W; Pavelko, S D; Cherpes, T L
Depot-medroxyprogesterone acetate (DMPA) is a hormonal contraceptive especially popular in areas with high prevalence of HIV and other sexually transmitted infections (STI). Although observational studies identify DMPA as an important STI risk factor, mechanisms underlying this connection are undefined. Levonorgestrel (LNG) is another progestin used for hormonal contraception, but its effect on STI susceptibility is much less explored. Using a mouse model of genital herpes simplex virus type 2 (HSV-2) infection, we herein found that DMPA and LNG similarly reduced genital expression of the desmosomal cadherin desmoglein-1α (DSG1α), enhanced access of inflammatory cells to genital tissue by increasing mucosal epithelial permeability, and increased susceptibility to viral infection. Additional studies with uninfected mice revealed that DMPA-mediated increases in mucosal permeability promoted tissue inflammation by facilitating endogenous vaginal microbiota invasion. Conversely, concomitant treatment of mice with DMPA and intravaginal estrogen restored mucosal barrier function and prevented HSV-2 infection. Evaluating ectocervical biopsy tissue from women before and 1 month after initiating DMPA remarkably revealed that inflammation and barrier protection were altered by treatment identically to changes seen in progestin-treated mice. Together, our work reveals DMPA and LNG diminish the genital mucosal barrier; a first-line defense against all STI, but may offer foundation for new contraceptive strategies less compromising of barrier protection.
Lee, Jae-Bong; Kim, Byung-Soo; Kim, Moon-Bum; Oh, Chang-Keun; Jang, Ho-Sun; Kwon, Kyung-Sool
Genital odor is an uncommon condition characterized by an offensive and malodorous smell in the genital area. Although the etiology of foul genital odor is multifactorial, an important cause is sweat secretion and decomposition of sweat components by bacteria. Different methods are effective in reducing body odor secondary to bromhidrosis. Conservative methods only act for a short period of time, and more invasive surgical methods carry risk of complications or are inapplicable for the genital region. A patient with localized foul odor in the genital hair bearing area was treated with botulinum toxin A. Botulinum toxin A was effective in creating an odorless and anhydrous response in the genital region, and no major adverse effects were noted during a follow-up of 9 months after injection. Local injection of botulinum toxin A appears to be a useful treatment for foul genital odor related to sweat glands activity.
Rob, Filip; Tachezy, Ruth; Pichlík, Tomáš; Rob, Lukáš; Kružicová, Zuzana; Hamšíková, Eva; Šmahelová, Jana; Hercogová, Jana
We conducted a cross-sectional study on the occurrence of a specific type of genital human papillomavirus (HPV) among long-term monogamous male partners of women with cervical dysplasia and genital warts. The purpose of the study was to improve knowledge with regards to the management of these couples. The presence of genital HPV-DNA was detected by PCR with broad spectrum primers followed by hybridization. 82 males met the study criteria, 41 in each group. Genital HPV-DNA prevalence was 67.5% in the genital warts group and 72.2% in the cervical dysplasia group. The prevalence of high risk HPVs was higher in the cervical dysplasia group, while low risk HPVs were more prevalent in the genital warts group (p < .05). The prevalence of HPV in males was independent of the duration of the relationship (73.5% for 6-24 months and 66.7% for longer relationships). In conclusion, our results suggest that the prevalence of the genital HPV infection in both groups of male partners is comparable and very high, but the spectrum of HPV types varies significantly. The presence of the genital HPV infection in male sexual partners seems to be independent of the duration of the relationship. Applying the HPV vaccination to boys may prevent this phenomenon. © 2016 Wiley Periodicals, Inc.
Baker, C. M. Kaliko
This dissertation explores genitive class selection of genitive case subjects in nominalizations and relative clauses in Hawaiian. The amount of research in the area of Hawaiian's "a"- and "o"-class is far from sufficient. Since Wilson (1976a), there has been minimal critical new inquiry to "a"- and…
Baker, C. M. Kaliko
This dissertation explores genitive class selection of genitive case subjects in nominalizations and relative clauses in Hawaiian. The amount of research in the area of Hawaiian's "a"- and "o"-class is far from sufficient. Since Wilson (1976a), there has been minimal critical new inquiry to "a"- and…
Sasabe, M; Takami, Y; Sota, T
Marked diversification of genital morphology is common in internally fertilizing animals. Although sexual selection may be the primary process controlling genital evolution, factors promoting genital evolution are controversial, and the genetic background of genital morphology is poorly understood. We analyzed the genetic basis of species-specific genital morphologies in carabid beetles of the subgenus Ohomopterus (genus Carabus, Carabidae) using two parapatric species with hybrid zones. Biometric analyses on experimental F(1) and backcross populations revealed that inheritance of genital morphology is polygenic. Applying Lande's modification of the Castle-Wright estimator to population means and variances to estimate the minimum number of genes involved, we found that a relatively small number of loci is responsible for species differences in genital morphology. In addition, joint-scaling tests indicated that the additive genetic effect accounts for most interspecific differences in genital traits, but dominance and epistatic genetic effects also play roles. Overall, the genetic basis of male and female genitalia is fairly simple, enabling these traits to respond quickly to selection pressures and to diverge rapidly. Our results provide insight into the diversification of genital morphology in carabid beetles, and will hopefully stimulate further studies on the genetic basis of genitalia, such as mapping of quantitative trait loci affecting species-specific genital morphology.
Laan, Ellen; Martoredjo, Daphne K; Hesselink, Sara; Snijders, Nóinín; van Lunsen, Rik H W
Many women have doubts about the normality of the physical appearance of their vulvas. This study measured genital self-image in a convenience sample of college-educated women, and assessed whether exposure to pictures of natural vulvas influenced their genital self-image. Forty-three women were either shown pictures of natural vulvas (N = 29) or pictures of neutral objects (N = 14). Genital self-image was measured before and after exposure to the pictures and two weeks later. Sexual function, sexual distress, self-esteem and trait anxiety were measured to investigate whether these factors influenced genital self-image scores after vulva picture exposure. A majority of the participants felt generally positively about their genitals. Having been exposed to pictures of natural vulvas resulted in an even more positive genital self-image, irrespective of levels of sexual function, sexual distress, self-esteem and trait anxiety. In the women who had seen the vulva pictures, the positive effect on genital self-image was still present after two weeks. The results of this study seem to indicate that even in young women with a relatively positive genital self-image, exposure to pictures of a large variety of natural vulvas positively affects genital self-image. This finding may suggest that exposure to pictures of natural vulvas may also lead to a more positive genital self-image in women who consider labiaplasty.
Nahmias, A J; Naib, Z M; Josey, W E
Epidemiological studies relating genital herpetic infection to cervical carcinoma are reviewed. The high frequency of herpes simplex virus type 2 (HSV-2) antibodies in young women (21 years or younger) with cervical carcinoma in situ and in women with dysplasia or carcinoma in situ, matched for various sexual attributes to control women, provide support for a causal relation. However, various laboratory, histopathological, and statistical problems associated with all epidemiological studies do not yet permit a firm conclusion as to the etiological role to the genital virus in cervical carcinogenesis. With the use of herpes-related cancer antigens or purified HSV-2 type-specific antigens, and with the possible development of protective HSV-2 vaccines, the application of epidemiological approaches may be necessary to provide the most finite evidence of causality.
The accurate description and interpretation of non-genital injuries may be crucial in cases of alleged sexual assault, and may be important in corroborating a victim's statement of events. In many cases of sexual assault, non-genital injuries may be either absent or trivial; nevertheless, even minor injuries may be of significance and need to be recorded. Injuries may be result from attempts to restrain the victim, whereas others (e.g. bite marks) may have a sexual motive or be part of a sado-masochistic ritual. A standard nomenclature for injuries (i.e. using the terms 'bruises', 'abrasions', 'lacerations', 'incisions and 'stab wounds') should avoid ambiguity between medical examiners. Copyright © 2012 Elsevier Ltd. All rights reserved.
Nikkels, A F; Piérard, G E
Genital herpes is a sexually transmitted disease. After the primary infection, the virus establishes a life-long latency in the sacral dorsal root ganglia. Recurrences may occur at an unpredictable rate. The clinical signs are not always easy to recognize and viral identification techniques may be helpful such as immunohistochemistry and in situ hybridization on Tzanck smears and muco-cutaneous biopsies. The treatment of genital herpes can follow one of three strategies using antiviral drugs, non-specific immunomodulators, and vaccination. The new oral antiviral drugs decrease the severity of clinical manifestations without, however, providing a definitive cure. In this article recent knowledge about the clinical aspects, differential diagnosis, diagnostic methods, treatment options and management is reviewed.
Narovlyansky, A N; Ivanova, A M; Shevlyagina, N V; Didenko, L V; Borovaya, T G; Izmest'eva, A V; Sanin, A V; Pronin, A V; Ershov, F I
An experimental model of the primary genital herpes (herpes simplex type 2, HSV-2) in the female guinea pigs was suggested to study the infectious process activity of polyprenyl phosphates (PPP) and PPP+acyclovir (AC) complex treatment. The morphofunctional features of the guinea pig ovaries were studied in the control and experimental groups (the latter were inoculated with PPP and/or AC as a primary infection treatment) at the stage of the recurrent genital herpes aggravation. It was shown that in the case of combined PPP +AC use significant changes in the disease symptoms were observed, as well as a decrease in the infectious process activity and duration, and positive remote effect on the ovarian morphophysiology.
Iglesia, Cheryl B; Yurteri-Kaplan, Ladin; Alinsod, Red
The aesthetic and functional procedures that comprise female genital cosmetic surgery (FGCS) include traditional vaginal prolapse procedures as well as cosmetic vulvar and labial procedures. The line between cosmetic and medically indicated surgical procedures is blurred, and today many operations are performed for both purposes. The contributions of gynecologists and reconstructive pelvic surgeons are crucial in this debate. Aesthetic vaginal surgeons may unintentionally blur legitimate female pelvic floor disorders with other aesthetic conditions. In the absence of quality outcome data, the value of FGCS in improving sexual function remains uncertain. Women seeking FGCS need to be educated about the range and variation of labia widths and genital appearance, and should be evaluated for true pelvic support disorders such as pelvic organ prolapse and stress urinary incontinence. Women seeking FGCS should also be screened for psychological conditions and should act autonomously without coercion from partners or surgeons with proprietary conflicts of interest.
Howitt, Brooke E; Kelly, Paul; McCluggage, W Glenn
Neuroendocrine tumours are uncommon or rare at all sites in the female genital tract. The 2014 World Health Organisation (WHO) Classification of neuroendocrine tumours of the endometrium, cervix, vagina and vulva has been updated with adoption of the terms low-grade neuroendocrine tumour and high-grade neuroendocrine carcinoma. In the endometrium and cervix, high-grade neoplasms are much more prevalent than low-grade and are more common in the cervix than the corpus. In the ovary, low-grade tumours are more common than high-grade carcinomas and the term carcinoid tumour is still used in WHO 2014. The term ovarian small-cell carcinoma of pulmonary type is included in WHO 2014 for a tumour which in other organs is termed high small-cell neuroendocrine carcinoma. Neuroendocrine tumours at various sites within the female genital tract often occur in association with other neoplasms and more uncommonly in pure form.
Heinrich, I; Heinrich, J
Infection of the genital organs by human papillomavirus (HPV) is the most commonly diagnosed sexually transmitted disease. Papillomaviruses lead to a contact infection of the epithelium and present with different clinical and histological signs. With the exception of the best known clinical manifestation Condylomata acuminata, subclinical infections can be only diagnosed from a stepwise examination. Physiological results from both men and women may be falsely explained as being caused by viruses, and can lead to an incorrect therapy. Genital papilla (Papillae coronae vulvae et glandis) present as atavistic cutaneous papilla a normal situation but with functional significance. Differences in clinical symptoms as well as the possibilities of further differentiation can be obtained by means of pictures taken during colposcopy.
Adekunle, A O; Fakokunde, F A; Odukogbe, A A; Fawole, A O
Female genital mutilation is a cultural practice that can adversely affect the health of women. Vulval complications of female circumcision in 39 patients managed at the University College Hospital, Ibadan, Nigeria over a period of 10 years were reviewed. The complications were: labial adhesions of varying degrees (51.3%) and clitoral retention cysts (48.7%). However, both types of complications occurred concurrently in two (5.1%) patients. All patients were treated surgically with good outcome. The only immediate complication of treatment was secondary haemorrhage in one patient with clitoral cyst. Regrettably, one patient with labial adhesion required a repeat surgical procedure 2 months later. The histological examination of all the retention cysts revealed epidermal inclusion cysts. Emphasising the reproductive health implications of female genital mutilation may prove an effective strategy towards eradication of the practice.
Gyekis, Joseph; Anthony, Kate; Foreman, Jennifer E; Klein, Laura Cousino; Vandenbergh, David J
Smoking has well-recognized endocrine disrupting effects in humans that have been linked specifically to nicotine in animal models. Nicotine's perinatal effects on genital development in mice, which is interpreted as a measure of endocrine disrupting activity, were evaluated in this report. Pregnant C57B/6J dams were administered 50 microg/ml nicotine in drinking water from gestational day 9 until pups were weaned. Their pups' anogenital distances and weights were measured at birth and at weaning. A subset of the pups was weighed again in adulthood. Female and male mice had significantly reduced anogenital distance at birth; however, by 34 days of age, differences in anogenital distance were no longer apparent, while body weight, which had been equal at birth and weaning, was significantly reduced in mice exposed to perinatal nicotine. Perinatal nicotine exposure significantly delayed genital development and altered adolescent body weight in this model. Copyright 2010 Elsevier Inc. All rights reserved.
Kuhn, L; Sun, X W; Wright, T C
The risk of lower genital tract neoplasia is increased in women infected with HIV. This has been best demonstrated in cervical squamous intraepithelial lesions, but has also been observed in vulvar and perianal intraepithelial lesions in some studies. Alterations in the prevalence and natural history of human papillomavirus infections of the lower genital tract appear to account for much of the increase. HIV-infected women are approximately four times more likely to be infected with human papillomavirus (including infection with high oncogenic risk human papillomavirus types) than are HIV-uninfected women, and these infections are more likely to be persistent. Human papilomavirus-associated lesions may be more difficult to treat in HIV-infected women. These data highlight the need to develop effective cervical cancer prevention programs for HIV-infected women.
Rampersaud, Ryan; Randis, Tara M.; Ratner, Adam J.
Summary Our understanding of the bacterial species inhabiting the female genital tract has been limited primarily by our ability to detect them. Early investigations using microscopy and culture-based techniques identified lactobacilli as the predominant members of the vaginal microbiota and suggested that these organisms might serve a protective function at the mucosal surface. Improvements in cultivation techniques and the development of molecular-based detection strategies validated these early findings and enabled us to recognize that the microbiota of the female genital tract is much more complex than previously suspected. Disruption of the vaginal microbial community due to invasion of exogenous organisms or by overgrowth of one or more endogenous species has important health implications for both the mother and newborn. PMID:21920833
Ekenze, S O; Ezegwui, H U; Adiri, C O
Despite the global outcry against female genital cutting (FGC), the practice continues in many African communities. The morbidity of this practice on the girl child deserves more attention. To determine the genital lesions complicating childhood FGC and the underlying factors that sustain this practice among the Igbos in south-east Nigeria. Prospective evaluation of girls with genital complications of FGC between January 2003 and June 2005 at the Federal Medical Centre, Owerri, south-east Nigeria. The girls' mothers were interviewed at presentation and subsequent visits to determine their perception and attitudes towards FGC. The average age at presentation was 3.5 years (range 1-5) and the genital cutting procedures were performed 8-90 days after birth. The procedure was undertaken by traditional practitioners in 14 (66.7%) girls and by nurses in 7 (33.3%) girls. Twelve girls (57.1%) had type I genital cutting and nine (42.9%) type II. Inclusion clitoral dermoid cyst and labial fusion were the complications in 13 (61.9%) and eight (38.1%), respectively. Treatment involved complete excision of the cysts and operative division of the labial fusion. Post-operative complications were wound infection (5) and labial adhesion (2). With duration of admission ranging from 3 to 5 days, the average cost of managing each child was $120. Of the girls' mothers, 15 (71.4%) had been educated to secondary level and 17 (80.1%) were aware of the campaign against FGC. Regrettably, all the mothers had genital cutting themselves during childhood and 13 (61.9%) stated that they would like to perpetuate the practice for socio-cultural reasons. Despite this, they all volunteered that FGC is enforced by the child's paternal relations. Childhood FGC contributes to appreciable morbidity among girls, a large proportion of whom are not managed in a hospital setting. The cost of managing these complications can be enormous, especially in low-resource settings. Girl child education to tertiary
Fonder, Margaret A; Hunter-Yates, Jennifer; Lawrence, W Dwayne; Telang, Gladys H
Vestibular papillomatosis (VP) is a benign condition of the female genitalia that may be mistaken for condyloma acuminatum (genital warts). In contrast to condylomata, lesions of VP each grow from a distinct mucosal insertion; match the color of the surrounding mucosa; and are symmetrically distributed, limited to the inner labia minora and vaginal introitus. Recognition of this entity will help to prevent unnecessary stress, testing, and discomfort.
Koban, I; Bender, C P; Assadian, O; Kramer, A; Hübner, N-O
In clinical practice, treatment of genital tract infections is based on administration of either antibiotics or antiseptics. While antibiotics may be applied systemically or topically, antiseptics may be applied only topically. In case of bacterial vaginosis (BV), antibiotic therapy may often be limited and side effects due to systemic administration may develop. Polihexanide (PHMB) is a promising option for the topical treatment of genital tract infections, in particular BV and vaginitis. A systematic search for publications on the use of PHMB for the treatment of genital infections in two electronic databases was performed. Titles, abstracts and citations were imported into a reference database. Duplicates were removed and two reviewers assessed each identified publication separately. Among a total of 204 references, 3 prospective randomized trials were identified. Two trials treated BV infections with PHMB in comparison to clindamycin as antibiotic standard therapy with no significant differences either in safety or in efficacy. The third controlled trial investigated the clinical efficacy of PHMB compared to placebo in the treatment of human papilloma virus. Patients treated with PHMB daily for up to 16-weeks showed significantly higher (52%) clearance of genital warts as compared to patients treated with placebo (4%). PHMB may be a clinically effective alternative for the treatment of BV and human papilloma virus. Although PHMB-based antiseptics are available since the late 90s, controlled trials to investigate its clinical potential for antiseptic treatment are scant. Clinical use of antiseptics for the treatment of infectious diseases should be explored and supported further. Copyright © 2012 S. Karger AG, Basel.
Matsuo, Koji; Eno, Michele L; Im, Dwight D; Rosenshein, Neil B
We conducted a literature review to determine the clinical characteristics of genital sarcoma during pregnancy. The systematic literature search was conducted using the search engines PubMed and MEDLINE with keywords "sarcoma" and "pregnancy" and was limited to female genital organs such as ovary, uterus, cervix, vagina, vulva, and retroperitoneal sarcoma. Kaposi's sarcoma, metastatic sarcoma, history of sarcoma, bone sarcoma located in pelvis, and fetal sarcoma were excluded in this study. There were 40 cases of genital sarcoma during pregnancy between 1955 and 2007. The majority of the cases were uterine sarcoma (37.5%), followed by retroperitoneal sarcoma (27.5%), vulvar sarcoma (22.5%), and vaginal sarcoma (12.5%). Mean age of the patient was 27.8 +/- 7.0. The distribution in the onset of symptoms had two peaks: first trimester (27.5%) and third trimester (50.0%). Growing mass (42.5%), abdominal pain (30.0%), and vaginal bleeding (22.5%) were the three most common symptoms. Incidental diagnosis was made in 22.5% and included during cesarean section (12.5%) and routine pelvic exam (7.5%). The cases initially not suspicious for malignancy were 42.5%. Thirty-three (82.5%) cases had live-born infants with term delivery in 55.2%. Mean birth weight was 2843 +/- 791 g, and male infants were more common (66.7%). Intrauterine growth retardation was seen in 12.5% of cases. Preterm labor was a common complication. Median survival period was 2.5 years (95% confidence, 1.9 to 3.1). The 2-, 3-, and 5-year cumulative survival rates were 60%, 38%, and 17%, respectively. Genital sarcomas in pregnancy are rare. There is a delay in diagnosis due to low index of suspicion. A majority had live births, and the 5-year survival is similar to that of advanced-stage sarcoma in nonpregnant women.
Sohrabi, Amir; Hajia, Masoud; Jamali, Firouzeh; Kharazi, Faranak
Frequency of cervical cancer related to Human Papilloma Virus (HPV) has increased remarkably in less-developed countries. Hence, applying capable diagnostic methods is urgently needed, as is having a therapeutic strategy as an effective step for cervical cancer prevention. The aim of this study was to investigate the prevalence of various multi-type HPV infection patterns and their possible rising incidence in women with genital infections. This descriptive study was conducted on women who attended referral clinical laboratories in Tehran for genital infections from January 2012 until December 2013. A total of 1387 archival cervical scraping and lesion specimens were collected from referred women. HPV genotyping was performed using approved HPV commercial diagnostic technologies with either INNO-LiPA HPV or Geno Array Test kits. HPV was positive in 563 cases (40.59%) with mean age of 32.35±9.96. Single, multiple HPV genotypes and untypable cases were detected in 398 (70.69%), 160 (28.42%) and 5 (0.89%) cases, respectively. Multiple HPV infections were detected in 92 (57.5%), 42 (26.2%), 17 (10.6%) and 9 (5.7%) cases as two, three, four and five or more genotypes, respectively. The prevalence of 32 HPV genotypes was determined one by one. Seventeen HPV genotypes were identified in 95.78% of all positive infections. Five dominant genotypes, HPV6, 16, 53, 11 and 31, were identified in a total of 52.35%of the HPV positive cases. In the present study, we were able to evaluate the rate of multiple HPV types in genital infections. Nevertheless, it is necessary to evaluate the role of the dominant HPV low-risk types and the new probably high-risk genotypes, such as HPV53, in the increasing incidences of genital infections.
Shweder, Richard A
Doctoring the genitals is compatible with a recognizable conception of social medicine. This commentary critically examines the distinction between medical and nonmedical procedures; presents an alternative account of Sohaila Bastami's personal reaction to the anonymous caller's request for referral information concerning hymen reconstruction surgery; and makes use of Yelp to simulate the caller's procedure for locating a helpful practitioner. Yelp is a very useful informational search engine that does not subject its users to a moral examination.
Gbery, I P; Djeha, D; Kacou, D E; Aka, B R; Yoboue, P; Vagamon, B; Sangare, A; Kanga, J M
Genital ulcers are common manifestations of infectious disease. The incidence of genital ulcers featuring a chronic course has increased since the beginning of the AIDS epidemic. The purpose of this 18-month cross-sectional study was to determine the main infectious causes of chronic genital ulcers (CGU) and their correlation with HIV infection. A total of 29 patients with CGU defined as an ulcer showing no sign of healing after more than one month were studied. Mean age ranged from 24 to 54 years. The male-to-female sex ratio was 1:5. The etiology was herpes in 19 cases (65.5 p. 100), chancroid in 6 cases (20.6 p. 100), streptococcal infection in 2 cases (6.8 p. 100), Pseudomonas aeruginosa infection in 1 case (3.4 p. 100) and cutaneous amibiasis in 1 case (3.4 p. 100). Twenty-two patients (75.8 p. 100) presented HIV infection including 16 with HIV1 and 6 with HIV1 and HIV2. All patients with herpes were HIV-positive. Eighteen of these patients were in stage C3 of HIV infection. Genital herpes was the main etiology of UGC in patients with HIV infection (p < 0.001). Conversely chancroid was the main etiology in patients without HIV infection (p < 0.05). This finding suggests that herpetic CGU is highly suggestive of AIDS whereas chancroid CGU is not. Although syphilis is widespread in Africa, it was not a cause of CGU in this study. Search for herpes simplex virus or Haemophilus ducreyi in patients with CGU is an important criteria for presumptive diagnosis of AIDS in Africa.
de Lima, Mário Maciel; de Lima, Mário Maciel; Granja, Fabiana
Genital warts caused by human papillomavirus (HPV) infection are the most common sexually transmitted disease leading to anogential lesions. Although the laser therapy has been shown to be effective in a number of conditions, the use of laser diode vaporization in urological applications and the understanding on its effectiveness as a treatment for various urological conditions is limited. Therefore, the aim of this study was to evaluate the efficacy of diode laser vaporization as a treatment for genital lesions. Patients presenting with genital lesions at the urology outpatient clinic at Coronel Mota Hospital, between March 2008 and October 2014, were enrolled into the study. Data collected included age, gender, duration of the lesion, site of the lesion and numbers of the lesions, length of follow-up, recurrence of lesions after treatment and whether there were any complications. A total of 92 patients were enrolled in the study; 92.4% (n = 85) male; mean age (± SD) 27.92 ± 8.272 years. The patients presented with a total of 296 lesions, with a median of 3 lesions each, including penis (n = 78), urethra (n = 4) lesions, and scrotum (n = 2) lesions. Lesions ranged in size from 0.1 to 0.5 cm(2), most commonly 0.3 cm(2) (n = 38; 41.3%), 0.4 cm(2) (n = 21; 22.8%) or 0.5 cm(2) (n = 20; 21.7%). Patients most commonly reported that they had their lesions for a duration of 12 (n = 29; 31.5%) or 6 months (n = 23; 25.0%). Eighteen patients (19.6%) had a recurrence after their 1(st)/conventional treatment. There were no incidences of post-operative infection or complications from the laser diode vaporization. Laser diode vaporization can be considered as an alternative method for treating genital lesions in urology, with satisfactory results in terms of pain, aesthetic and minimal recurrence.
Badaracco, G; Venuti, A; Di Lonardo, A; Scambia, G; Mozzetti, S; Benedetti Panici, P; Mancuso, S; Marcante, M L
Screening for human papillomavirus (HPV) types was performed by a PCR-based assay on 29 women (mean age 34.0 years, range 21-48 years). HPV-DNA was demonstrated in 16 women (55.2%), with a detection rate of 37.9% in the oral cavity and 34.5% in the genital tract. HPV-16 was the most prevalent genotype (53.8%), followed by HPV-6, which was present in 34.6% of the positive samples. Other types were more rarely detected. Five subjects showed concurrent genital tract and oral cavity infections but HPV type-specific concordance was detected in only 3 patients. Multiple HPV infections were found in 9 of the 26 positive samples, where HPV-6 appeared frequently associated with the other types. These data confirm the occurrence of mixed HPV infections and the wide diffusion of different types of HPV in the genital mucosa and in the oral cavity; they also stress the need to utilize diagnostic methods with a wide typing capacity.
Anic, Gabriella M; Giuliano, Anna R
Human papillomavirus (HPV) is highly prevalent in men and there is an interest in further understanding the relationship between HPV infection and disease in men, including the development of genital warts, penile intraepithelial neoplasia and invasive penile carcinomas. Genital warts are caused by HPV 6/11 and are the most common clinical manifestation of HPV in men. Though they are benign and not associated with mortality, they are a source of psychosocial distress and physical discomfort. HPV infection can also develop into invasive penile carcinoma which is associated with morbidity and mortality. Approximately 40% of invasive penile carcinomas are attributable to HPV with HPV 16, 18, and 6/11 being the genotypes most commonly detected in penile tumors. Penile carcinomas of the basaloid and warty histologic subtypes are most likely to test positive for HPV. In addition to HPV infection, the risk factors most strongly associated with penile cancer are lack of neonatal circumcision, phimosis (the inability of uncircumcised men to fully retract the foreskin), and anogenital warts. Male vaccination with the quadrivalent HPV vaccine that protects against HPV 6/11/16/18 has been shown to significantly reduce HPV-associated anogenital infection and disease in men. If the quadrivalent vaccine is successfully disseminated to large segments of the young male population, there is the potential for substantial reduction in genital HPV infection and related lesions in men. Copyright © 2011. Published by Elsevier Inc.
Matsushita, Hiroshi; Watanabe, Kazushi; Wakatsuki, Akihiko
Metastases to the female genital tract from gastric cancer are rare, but they significantly worsen the prognosis of such patients. The potential routes for metastasis to the female genital tract from gastric cancer include hematogenous spread, lymphatic spread and surface implantation. The rate of lymphatic metastasis to the ovary from gastric cancer has been reported to be higher compared with that from colorectal cancer. Uterine or Fallopian tube metastases are usually secondary to ovarian metastases, which are typically identified prior to the detection of gastric cancer in half of all synchronous cases, with complaints of abdominal distention, pain, palpable mass, or abnormal uterine bleeding. The prognosis of patients with female genital tract metastases from gastric cancer is extremely poor, and is worse compared with that of other primary sites, such as the breast and colorectum. In the past, surgical intervention in such patients consisted mainly of palliative resection to relieve the symptoms associated with a sizeable pelvic mass. However, recent retrospective studies based on a relatively small number of patients have reported that surgical tumor debulking plus chemotherapy may improve the prognosis of patients with metastatic ovarian cancer originating from gastric cancer. PMID:27882232
The prevalence of genital piercing among women is increasing. As the popularity increases, the number of complications from infection, injury, and retained jewelry is likely to rise. Techniques to remove embedded jewelry are not well described in the literature. The purpose of this report was to describe a case of a patient with a retained clitoral glans piercing, discuss a simple technique for outpatient removal, and review current evidence regarding associated risks of clitoral piercings. A 24-year-old female presented to the emergency department with an embedded clitoral glans piercing. Local anesthetic was injected into the periclitoral skin and a small superficial vertical incision was made to remove the ball of the retained barbell safely. In conclusion, among patients with retained genital piercing, outpatient removal of embedded jewelry is feasible. While the practice of female genital piercing is not regulated, piercing of the glans of the clitoris is associated with increased injury to the nerves and blood supply of the clitoris structures leading to future fibrosis and diminished function compared to piercing of the clitoral hood. PMID:28299217
In Kenya, a new ceremony known as "Ntanira Na Mugambo," or "circumcision through words," is being offered in some rural communities as an alternative to the harmful practice of female genital mutilation. This new ceremony includes a week-long program of counseling, training, and provision of information to young women ending with a "coming of age" celebration that involves music, dancing, presents, and feasting. Since its initiation in August 1996, about 300 young women have accepted this alternative rite. Kenya is among the countries where the practice of female genital mutilation is slowly diminishing, but the mutilation is still common in at least 26 African countries and among immigrants in some developed countries. The new Kenyan rite has the advantage of requiring the cooperation and support of the communities where it is practiced. It was developed as a cooperative effort of the Kenyan Maendeleo Ya Wanawake Organization and the Program for Appropriate Technology in Health after years of research. An important aspect of Ntanira Na Mugambo is the flexibility that arises from the ability to stress various components in response to community characteristics. Its success is also linked to the fact that it involves the entire family and community and has a male motivation component. It is hoped that this nonjudgmental rite will become a widely successful strategy to eliminate female genital mutilation and improve women's health throughout the world.
Amichetti, M; Chiappe, E; Mussari, S; Busana, L; Caffo, O; Botto, F; Galligioni, E; Tomio, L
Genital tract lymphoma is a rare disease; information on diagnosis, treatment and outcome are limited. We report on eight patients affected by non-Hodgkin's lymphoma of the genital tract, five from the cervix, two from the vagina and one from the vulva collected between 1987 and 1998. Age at presentation ranged from 36 to 82 (median 67) years. The commonest initial symptom was vaginal bleeding, post coital in 1 patient. Three patients complained of vescical symptoms. Ann Arbor classification was stage IAE for 6 patients. Histology, according to the IWF, was either intermediate grade (4 patients), or high grade (3 patients), not evaluable in one case. Seven patients were treated with chemotherapy (anthracycline based in four) followed by pelvic radiotherapy in five; one patient received irradiation alone. Five patients are currently alive and free of disease with follow-up ranging from 8 to 126 months. Based on our experience in this series, we support a management scheme of combination chemotherapy and radiotherapy for patients with non-Hodgkin's lymphoma of the genital tract.
Flores-Díaz, Ema; Sereday, Karen A; Ferreira, Silvaneide; Sirak, Bradley; Sobrinho, João Simão; Baggio, Maria Luiza; Galan, Lenice; Silva, Roberto C; Lazcano-Ponce, Eduardo; Giuliano, Anna R; Villa, Luisa L; Sichero, Laura; The Him Study Group
HPV-11 and HPV-6 are the etiological agents of about 90 % of genital warts (GWs). The intra-typic variability of HPV-11 and its association with infection persistence and GW development remains undetermined. Here, HPV infection in men (HIM) participants who had an HPV-11 genital swab and/or GW, preceded or not by a normal skin genital swab were analysed. Genomic variants were characterized by PCR-sequencing and classified within lineages (A, B) and sublineages (A1, A2, A3, A4). HPV-11 A2 variants were the most frequently detected in the genital swab samples from controls and in both genital swabs and GW samples from cases. The same HPV-11 variant was detected in the GW sample and its preceding genital swab. There was a lack of association between any particular HPV-11 variant and the increased risk for GW development.
Suschinsky, Kelly D; Lalumière, Martin L
Men's genital arousal occurs in response to a limited number of sexual stimuli, whereas women's genital arousal occurs in response to a wide range of sexual stimuli, including those depicting nonpreferred cues. Researchers have hypothesized that women's nonspecific pattern of genital arousal prepares the body for sexual activity, thus functioning to protect the genital organs against injury. If this hypothesis is correct, women should show genital responses to any cues suggesting sexual activity, even unappealing cues that involve nonconsensual sex and extreme violence. Fifteen men and 15 women listened to fourteen 2-min audiotaped narratives that depicted an interaction between a man and a woman and that varied factorially according to the presence of consent, violence, and sexual activity. The results support the preparation hypothesis: Men showed the greatest genital arousal in response to narratives depicting consensual, nonviolent sex, whereas women showed similar responses to all the narratives involving sexual activities, including those describing a sexual assault.
Sharma, Shimpa; Gulbake, Arvind
Introduction Ano-Genital Warts (AGW) like other Sexually Transmitted Diseases (STD) is associated with Human Immunodeficiency Virus (HIV) infection. This study of AGW was done in HIV positive and HIV negative patients. Aim To study the risk factors and clinical presentations of ano-genital warts in HIV positive and negative patients. Materials and Methods A comparative, cross-sectional, descriptive study of 25 HIV positive and 25 HIV negative (n=50) AGW patients between 15-60 years of both sex was conducted in Dr. D. Y. Patil Hospital and Research Centre from July 2014 to July 2016. Results Significant association of HIV positivity (p<0.05) was observed between age group of 15-30 years and HIV negative status (p<0.05) in age group of 31-45 years. HIV positive status significantly higher in patients with self-admitted multiple sexual partners (p<0.01), homosexuality (p<0.05) and presentation with anal warts (p<0.01). HIV negative status correlated significantly with single sexual partner admission (p<0.01) and hetero-sexuality (p<0.05). Gender did not show significant association with number of sexual partners or HIV positivity. Extra-genital or only genital warts had no association with HIV status. Co-STDs though more in number in ser-positive group, did not show any significant association with HIV positivity (p>0.05). No patient presented with changes of malignancy. Four were adolescents below 19 years. Two patients had atypical presentations of giant condylomata i.e., Buschke-Lowenstein Tumour (BLT). Conclusion HIV positivity was significantly associated with the risk factors of age below 30 years, homo sexuality and multiple sexual partners. Anal warts were significantly common in HIV positive patients. Four adolescents with AGW underline the need for high risk behaviour counselling. No patient had malignant ano-genital warts. Follow up of these patients with Human Papilloma Virus (HPV) sub-typing is necessary. PMID:28274028
Saigal, Karnika; Dhawan, Benu; Rawre, Jyoti; Khanna, Neena; Chaudhry, Rama
Limited data are available on the prevalence of genital mycoplasmas and Chlamydia trachomatis (CT) among Indian patients with genital tract infections. The objectives of the study were to determine the prevalence of Ureaplasma urealyticum (UU), Mycoplasma hominis (MH), Mycoplasma genitalium (MG), and CT in patients with genital tract infections. The antimicrobial susceptibilities of UU and MH were also assessed. Endocervical swabs/urethral swabs and first void urine samples of patients (n = 164) were collected. UU and MH were detected by culture and multiplex polymerase chain reaction (PCR). MG and CT were identified by PCR. Ureaplasma isolates were further biotyped and serotyped. Antimicrobial susceptibility was done by microbroth dilution method. UU, MH, MG, and CT were detected in 15.2%, 5.4%, 1.2%, and 6% patients, respectively. Ureaplasma parvum serovar 3/14 was the most prevalent. All isolates of UU and MH were uniformly susceptible to doxycycline and josamycin. Routine screening for these pathogens and antimicrobial susceptibility testing is warranted to prevent sequel of infections and formulate treatment guidelines.
Maraux, B; Ricbourg, A; Brugier, C; Chagnaud, S; Fargeaudou, Y; Rossignol, M; Barranger, E
Genital tract lacerations are responsible for potentially serious postpartum hemorrhage (PPH), and are often underestimated. The objective of this study was to analyze the characteristics of genital tract lacerations associated with severe PPH in a reference center. All women transferred for treatment of PPH due to genital tract lacerations between January 2008 and April 2011 were included in this observational study. Two populations of patients with genital tract lacerations were defined : patients with "complex" lesions and patients with "simple" genital tract laceration. Forty-four patients were treated for PPH associated with genital tract lacerations. The average age of patients was 30.6 years (17-41 years). All the patients had a vaginal delivery, combined with an instrumental in 70.5% of cases. With the exception of one patient, all patients had a revision of the cervix and vagina before the transport in our Institution. Twenty nine patients (70.7%) had received a suture of genital tract in their maternity. In our Hospital, the patient having a "simple" genital tract lesion received in 54.5% of cases medical drugs alone against 33.3% for patients with complex genital tract lacerations. In 39.4% of cases an embolization was necessary for the group of patients with complex genital tract lacerations against 9.1% in the simple genital tract lesion group. Genital tract lacerations are a serious cause of HDD. Their management should be multidisciplinary combining appropriate and timely decisions (resuscitation, embolization and/or surgery). The sequence of these treatments depends on the clinical condition of the patient and justifies a transfer to a referral center. Copyright © 2013. Published by Elsevier SAS.
Tseng, Diane; Kim, Julie; Warrick, Andrea; Nelson, Dylan; Pukay, Marina; Beadling, Carol; Heinrich, Michael; Selim, Maria Angelica; Corless, Christopher L; Nelson, Kelly
The genetic heterogeneity of melanomas and melanocytic nevi of the female genital tract is poorly understood. We aim to characterize the frequency of mutations of the following genes: BRAF, NRAS, KIT, GNA11, and GNAQ in female genital tract melanomas. We also characterize the frequency of BRAF mutations in female genital tract melanomas compared with melanocytic nevi. Mutational screening was performed on the following female genital tract melanocytic neoplasms: 25 melanomas, 7 benign melanocytic nevi, and 4 atypical melanocytic nevi. Of the 25 female genital tract melanoma specimens queried, KIT mutations were detected in 4 (16.0%), NRAS mutations in 4 (16.0%), and BRAF mutations in 2 (8.0%) samples. Two of the tumors with KIT mutations harbored double mutations in the same exon. No GNAQ or GNA11 mutations were identified among 11 melanomas screened. BRAF V600E mutations were detected in 7 of 7 benign melanocytic genital nevi (100%) and 3 of 4 atypical genital nevi (75%). Our study is limited by the small sample size of this rare subset of melanomas. KIT, NRAS, and BRAF mutations are found in a subset of female genital tract melanomas. Screening for oncogenic mutations is important for developing and applying clinical therapies for melanomas of the female genital tract. Copyright © 2014 American Academy of Dermatology, Inc. Published by Mosby, Inc. All rights reserved.
This review presents and discusses the reasons for the currently employed anatomical terminology relating to the genital peritoneum of various domestic species, based upon its prenatal development. When reviewing the development of genital organs, attention must be paid to changes in the related peritoneum in order to define currently used terminology more clearly. The relevance of some terms such as Caudal genital ligament, Plica gubernaculi, Plica iguinalis and genital fold is considered. A system of serosal folds, the Plica gonadoinguinalis or genitoinguinalis, seems to be a useful term to be added to the Nomina Embryologica Veterinaria.
Chatterjee, R N; Chatterjee, P; Kuthe, S; Acharyya-Ari, M; Chatterjee, R
In Drosophila melanogaster, the intersex (ix) is a terminally positioned gene in somatic sex determination hierarchy and function with the female specific product of double sex (DSX(F)) to implement female sexual differentiation. The null phenotype of ix is to transform diplo-X individuals into intersexes while leaving haplo-X animals unaffected. This study on the effect of different intersex mutations on genital disc development provides the following major results: (i) similar range of a characteristic array of morphological structures (from almost double sex terminalia to extreme reduction of terminal appendages) was displayed by the terminalia of XX ix(1)/ix(1) , XX ix(2)/ix(2) and XX ix(5)/ix(5) individuals; (ii) an increased number of apoptotic cells were found to occur in a localized manner in mature third instar larval genital discs of ix individuals; (iii) ix mutations can induce high frequency of neoplastic tumours in genitals in the presence of decapentaplegic (dpp(disk)) mutations; and (iv) heteroallelic combinations of dpp(disk) mutations can also induce tumours in intersex genitals with variable expressivity. On the basis of these findings, we suggest that: (i) loss of function of ix causes massive cell death in both male and female genital primordia of genital discs, resulting phenotype mimicking in male and female characteristics in genitals; and (ii) at the discs, the apoptotic cells persist as 'undead' cells that can induce oncogenic transformation in the neighbouring disc cells when dpp signalling is blocked or reduced by dpp(disk) mutations.
Jackowich, Robyn A; Vale, Rachel; Vale, Kayla; Wassersug, Richard J; Johnson, Thomas W
Introduction Some healthy males voluntarily seek castration without a recognized medical need. There are currently no standards of care for these individuals, which cause many of them to obtain surgery outside of a licensed medical setting. We seek to understand who performs these surgeries. Aim This study aims to characterize individuals who perform or assist in genital ablations outside of the healthcare system. Methods A cross-sectional Internet survey posted on eunuch.org received 2,871 responses. We identified individuals who had performed or assisted in human castrations (“cutters”; n = 98) and compared this group with all other survey respondents (n = 2,773), who had not assisted in castrations. Next we compared the cutters with the voluntary eunuchs. Lastly, because many of the cutters have themselves been castrated, we also divided the physically castrated population (n = 278) into cutters (n = 44) and noncutters (n = 234) and compared them. Main Outcome Measures Self-reported questionnaires were used to collect demographic information, gender identity and presentation, selected childhood experiences, and history of aggressive behaviors, self-harming behaviors, and hospitalization. Results Distinguishing characteristics of cutters included: (i) presenting themselves as very masculine, (ii) having had their longest sexual relationship with a man, (iii) growing up on a farm, (iv) witnessing animal castrations, (v) having a history of sexually inappropriate behavior, (vi) having been threatened with genital mutilation as a child, (vii) having a history of self-harm, (viii) being raised in a devoutly Christian household, (ix) having had an underground castration themselves, and (x) having body piercings and/or tattoos. Conclusions This study may help identify individuals who are at risk of performing illegal castrations. That information may help healthcare providers protect individuals with extreme castration ideations from injuring themselves or others
Jaishankar, Dinesh; Shukla, Deepak
Etiology, transmission and protection: Herpes simplex virus-2 (HSV-2) is a leading cause of sexually transmitted infections with recurring manifestations throughout the lifetime of infected hosts. Currently no effective vaccines or prophylactics exist that provide complete protection or immunity from the virus, which is endemic throughout the world. Pathology/Symptomatology: Primary and recurrent infections result in lesions and inflammation around the genital area and the latter accounts for majority of genital herpes instances. Immunocompromised patients including neonates are susceptible to additional systemic infections including debilitating consequences of nervous system inflammation. Epidemiology, incidence and prevalence: More than 500 million people are infected worldwide and most reported cases involve the age groups between 16-40 years, which coincides with an increase in sexual activity among this age group. While these numbers are an estimate, the actual numbers may be underestimated as many people are asymptomatic or do not report the symptoms. Treatment and curability: Currently prescribed medications, mostly nucleoside analogs, only reduce the symptoms caused by an active infection, but do not eliminate the virus or reduce latency. Therefore, no cure exists against genital herpes and infected patients suffer from periodic recurrences of disease symptoms for their entire lives. Molecular mechanisms of infection: The last few decades have generated many new advances in our understanding of the mechanisms that drive HSV infection. The viral entry receptors such as nectin-1 and HVEM have been identified, cytoskeletal signaling and membrane structures such as filopodia have been directly implicated in viral entry, host motor proteins and their viral ligands have been shown to facilitate capsid transport and many host and HSV proteins have been identified that help with viral replication and pathogenesis. New understanding has emerged on the role of
Jackowich, Robyn A; Vale, Rachel; Vale, Kayla; Wassersug, Richard J; Johnson, Thomas W
Some healthy males voluntarily seek castration without a recognized medical need. There are currently no standards of care for these individuals, which cause many of them to obtain surgery outside of a licensed medical setting. We seek to understand who performs these surgeries. This study aims to characterize individuals who perform or assist in genital ablations outside of the healthcare system. A cross-sectional Internet survey posted on eunuch.org received 2,871 responses. We identified individuals who had performed or assisted in human castrations ("cutters"; n = 98) and compared this group with all other survey respondents (n = 2,773), who had not assisted in castrations. Next we compared the cutters with the voluntary eunuchs. Lastly, because many of the cutters have themselves been castrated, we also divided the physically castrated population (n = 278) into cutters (n = 44) and noncutters (n = 234) and compared them. Self-reported questionnaires were used to collect demographic information, gender identity and presentation, selected childhood experiences, and history of aggressive behaviors, self-harming behaviors, and hospitalization. DISTINGUISHING CHARACTERISTICS OF CUTTERS INCLUDED: (i) presenting themselves as very masculine, (ii) having had their longest sexual relationship with a man, (iii) growing up on a farm, (iv) witnessing animal castrations, (v) having a history of sexually inappropriate behavior, (vi) having been threatened with genital mutilation as a child, (vii) having a history of self-harm, (viii) being raised in a devoutly Christian household, (ix) having had an underground castration themselves, and (x) having body piercings and/or tattoos. This study may help identify individuals who are at risk of performing illegal castrations. That information may help healthcare providers protect individuals with extreme castration ideations from injuring themselves or others. Jackowich RA, Vale R, Vale K, Wassersug RJ, and Johnson TW. Voluntary
Jardine, David; Lu, Jieqiang; Pang, James; Palmer, Cheryn; Tu, Quanmei; Chuah, John; Frazer, Ian H.
Aim To determine whether immunotherapy with HPV6 L1 virus like particles (VLPs) without adjuvant (VLP immunotherapy) reduces recurrence of genital warts following destructive therapy. Trial design A randomized placebo controlled blinded study of treatment of recurrent genital warts amenable to destructive therapy, conducted independently in Australia and China. Methods Patients received conventional destructive therapy of all evident warts together with intramuscular administration of 1, 5 or 25 µg of VLP immunotherapy, or of placebo immunotherapy (0.9% NaCl), as immunotherapy at week 0 and week 4. Primary outcome, assessed at week 8, was recurrence of visible warts. Results Of 33 protocol compliant Brisbane recipients of placebo immunotherapy, 11 were disease free at two months, and a further 9 demonstrated reduction of > 50% in total wart area. Wart area reduction following destructive treatment correlated with prior duration of disease. Among 102 protocol compliant Brisbane recipients of VLP immunotherapy, disease reduction was significantly greater than among the placebo immunotherapy (50% ± s.e.m. 7%) recipients for subjects receiving 5 µg or 25 µg of VLP immunotherapy/dose (71% ± s.e.m.7%) but not for those receiving 1 µg VLP immunotherapy/dose (42% ± 7%). Of 52 protocol compliant placebo immunotherapy recipients in Wenzhou, 37 were disease free at two months, and a further 8 had > 50% disease reduction. Prior disease duration was much shorter in Wenzhou subject (8.1 ± 1.1 mo) than in Brisbane subjects (53.7 ± 5.5 mo). No significant reduction in mean wart area was observed for the 168 Wenzhou protocol compliant subjects who also received VLP immunotherapy. Conclusions This study confirms the findings in a previous open label trial that administration of VLP immunotherapy may assist in clearance of recurrent genital warts in patients for whom destructive therapy is unsuccessful and that unsuccessful destructive therapy is more common with increasing
Werunga, Jane; Reimer-Kirkham, Sheryl; Ewashen, Carol
In this article, critical perspectives including postcolonial feminism, African feminism, and intersectionality are presented as having decolonizing methodological potential whereby the Western narrative surrounding the practice of female genital cutting, particularly in the context of migration, is reexamined. In addition, multiple intersecting influences on affected women's realities are accounted for and a critical consciousness that serves to inform praxis, address social determinants of health, and promote health equity is encouraged. The inclusion of an African feminist perspective, a traditionally marginalized critical perspective, serves to further decolonize some long-held erroneous beliefs about the sexuality, subjectivity, and embodiment of the African woman.
Kulchavenya, E; Dubrovina, S
Tuberculosis is a disease with myriad presentations and manifestations; it can affect any organ or tissue, excluding only hair and nails. Doctors who are not familiar with extrapulmonary tuberculosis often overlook this disease. Urogenital tuberculosis (UGTB) is the second most common form of TB in countries with severe epidemic situation and the third most common form in regions with low incidence of TB. The term "Urogenital tuberculosis" includes kidney tuberculosis; male and female tuberculosis and urinary tract tuberculosis as complication of kidney tuberculosis. We describe rarest case of tuberculosis of a placenta in young woman, suffered from genital tuberculosis, which was overlooked before delivery, as well as typical tubo-ovarian tuberculomas.
Sweileh, Waleed M
Female genital mutilation/cutting (FGM/C) is a common harmful traditional practice in many communities in Africa and to a lesser extent in Middle East and other regions in the world. In order to better understand publishing on this topic, we conducted a bibliometric study on FGM/C. Bibliometric analyses can be used as an indicator of the extent of interaction of researchers, health authorities, and communities with a particular health issue. Scopus database was used to retrieve data on FGM/C. Keywords used were "female genital mutilation", "female genital circumcision", "female genital cutting" and "female circumcision". Specifically, the number of publications, top productive countries and institutions, highly cited articles, citation analysis, co-authorships, international collaboration, role of African countries, top active authors, and journals involved in publishing articles on FGM/C were reviewed and analyzed. We indirectly assessed the impact of publications using total number of citations received, average number of citations per article, Hirsch-index, percentage of highly cited articles, and journal's impact factor. One thousand and thirty-five publications on FGM/C were retrieved. The h-index of retrieved articles was 37. A steep rise in number of publications was noticed in mid-1990s and again in 2012. More than half of retrieved articles were published from 2006 - 2015. A total of 65 countries contributed. The top ten productive countries included ones from Northern America, Europe and Africa. Nigeria and Egypt were the most active African countries in FGM/C publications. At least nine African academic institutions were actively involved on FGM/C publications. Articles on FGM/C that received the highest number of citations were those that focused on negative physical and psychosexual consequences of FGM/C. Journal topic areas were obstetrics/gynecology, public health, and psychological sociology. Collaboration between African and European countries on
In 1973 approximately 1 million girls will be victimized by female genital mutilation (FGM), widely practiced in more than 20 African nations from Mauritania to the Ivory Coast in the west, to Egypt and North Tanzania in the east, as well as in Oman, Bahrain, North and South Yemen, and the United Arab Emirates. FGM takes place among the Moslem populations of the Philippines, Indonesia, and Malaysia and the Jewish Falashas in Ethiopia. FGM is practiced on babies just a few days old to girls right before marriage or young women pregnant with their first child. The most extreme mutilation is called infibulation. In Somalia, almost 100% of the women are infibulated, and so are more than 80% of the women in north and central Sudan. In Ethiopia/Eritrea, Mali, and Sierra Leone, 90% of the women have undergone some form of genital mutilation. The rate reaches 70% in Burkina Faso; 60% in Kenya, Gambia, and the Ivory Coast; and 50% in Senegal, Egypt, Guinea Bissau, and Nigeria. The mutilation often results in accumulation of menstrual blood and pelvic inflammatory disease often leading to infertility. Between 20% and 25% of infertility in Sudan has been attributed to female genital mutilation. The practice of FGM has existed for centuries, and some claim it originated in the Nile Valley during the Pharaonic era. On the other hand, Muslim countries like Iraq, Syria, and Tunisia do not practice FGM. The London Black Women's Health Action Project set up an educational network to prevent mutilations and to dispel the myth of religion about FGM. FORWARD convened the First Study Conference on Genital Mutilation of Girls in Europe in 1992 and deemed FGM a form of child abuse. Local campaigns in Africa, Asia, and the Arab world educate against FGM. The Inter-Africa Committee on Traditional Practices Affecting the Health of Women and Children, based in Addis Ababa, Ethiopia, has offices in more than 20 African nations to sensitize the public about the harmful effects of FGM. In
Rouzi, Abdulrahim A
Female genital mutilation (FGM) is a very ancient traditional and cultural ritual. Strategies and policies have been implemented to abandon this practice. However, despite commendable work, it is still prevalent, mainly in Muslim countries. FGM predates Islam. It is not mentioned in the Qur'an (the verbatim word of God in Islam). Muslim religious authorities agree that all types of mutilation, including FGM, are condemned. 'Sensitivity' to cultural traditions that erroneously associate FGM with Islam is misplaced. The principle of 'do no harm', endorsed by Islam, supersedes cultural practices, logically eliminating FGM from receiving any Islamic religious endorsement.
... gov/news/fullstory_162650.html Routine Testing for Genital Herpes of Little Benefit: U.S. Experts Early diagnosis won' ... 2016 (HealthDay News) -- Routine blood test screening for genital herpes is not recommended for teens and adults -- including ...
Vriend, Henrike J; Nieuwkerk, Pythia T; van der Sande, Marianne A B
To assess gender-specific impact of genital warts on health-related quality of life (HRQoL), and to explore to what extent sexual characteristics and clinical symptoms influenced the impact on emotional and sexual well-being of both sexes. We conducted a survey of sexual and clinical characteristics from persons diagnosed with genital warts at STI clinics. HRQoL was measured using two measurement tools: 1) the generic EQ-5D; and 2) the genital warts-specific CECA-10 including an emotional well-being and a sexual activity dimension. The EQ-5D scores were compared with scores of the general population. Descriptive analyses were used to explore characteristics associated with HRQoL scores stratified for gender. The HRQoL-measurement tools showed that genital warts have especially an emotional impact. The impact of genital warts on HRQoL was greater for women than for men. In addition, the CECA-10 showed that in women the impact of genital warts on sexual activity was influenced by age, relationship status and number of warts. No related factors were seen in men. Genital warts have a greater impact on women than on men. In women, sexual and clinical factors influenced the impact of genital warts on well-being, whereas in men no such factors were found.
Casey, Jessica T.; Bjurlin, Marc A.; Cheng, Earl Y.
Objective To describe the characteristics of pediatric genital injuries presenting to United States emergency departments (EDs). Methods A retrospective cohort study utilizing the U.S. Consumer Product Safety Commission (CPSC) National Electronic Injury Surveillance System (NEISS) from 1991-2010 to evaluate pediatric genital injuries was performed. Results Pediatric genital injuries represented 0.6% of all pediatric injuries with the incidence of injuries rising through the period studied, 1991-2010. The mean age at injury was 7.1 years old and was distributed 56.6% girls and 43.4% boys. A total of 43.3% had lacerations and 42.2% had contusions/abrasions. The majority of injuries occurred at home (65.9%), and the majority of patients (94.7%) were treated and released from the hospital. The most common consumer products associated with pediatric genital trauma were: bicycles (14.7% of all pediatric genital injuries), bathtubs (5.8%), daywear (5.6%), monkey bars (5.4%), and toilets (4.0%). Conclusion Although pediatric genital injuries represent a small proportion of overall injuries presenting to the ED, genital injuries continue to rise despite public health measures targeted to decrease childhood injury. Our results can be used to guide further prevention strategies for pediatric genital injury. PMID:23953603
Olin, Laura; Wald, Anna
A 42-year-old bisexual man with a history of recurrent oral herpes and no history of genital herpes was noted to have antibody to herpes simplex virus type 2 (HSV-2) only. During a symptomatic oral recurrence, HSV-2 was found in a perioral lesion as well as in the genital area.
Kenny, Maureen C.; Wurtele, Sandy K.
Preschoolers' knowledge of genital names facilitates disclosure of sexual abuse and provides the foundation for subsequent sex education. Surveys of preschoolers in the early 1990s found that few children knew proper names for the genitals. To determine knowledge among a current cohort of culturally diverse children, 128 preschool children were…
Rowe, Locke; Arnqvist, Göran
Animal genitalia show two striking but incompletely understood evolutionary trends: a great evolutionary divergence in the shape of genitalic structures, and characteristic structural complexity. Both features are thought to result from sexual selection, but explicit comparative tests are hampered by the fact that it is difficult to quantify both morphological complexity and divergence in shape. We undertake a comparative study of multiple nongenitalic and male genital traits in a clade of 15 water strider species to quantify complexity and shape divergence. We show that genital structures are more complex and their shape more divergent among species than nongenital traits. Further, intromittent genital traits are more complex and have evolved more divergently than nonintromittent genital traits. More importantly, shape and complexity of nonintromittent genital traits show correlated evolution with indices of premating sexual selection and intromittent genital traits with postmating sexual selection, suggesting that the evolution of different components of genital morphology are shaped independently by distinct forms of sexual selection. Our quantitative results provide direct comparative support for the hypothesis that sexual selection is associated with morphological complexity in genitalic traits and highlight the importance of quantifying morphological shape and complexity, rather than size in studies of genital evolution. © 2011 The Author(s). Evolution © 2011 The Society for the Study of Evolution.
Mullinax, Margo; Herbenick, Debby; Schick, Vanessa; Sanders, Stephanie A.; Reece, Michael
Research increasingly shows that genital attitudes have an impact on sexual well-being and health-seeking behaviours. This study explored what women and men like and dislike about women's genitals. Data are from open-ended items, part of a cross-sectional internet-based survey anonymously completed by 496 women and 198 men. Overall, both women and…
Mullinax, Margo; Herbenick, Debby; Schick, Vanessa; Sanders, Stephanie A.; Reece, Michael
Research increasingly shows that genital attitudes have an impact on sexual well-being and health-seeking behaviours. This study explored what women and men like and dislike about women's genitals. Data are from open-ended items, part of a cross-sectional internet-based survey anonymously completed by 496 women and 198 men. Overall, both women and…
Background The objective of this study is to estimate the incidence of genital warts in Hong Kong and explore a way to establish a surveillance system for genital warts among the Hong Kong general population. Methods A total of 170 private doctors and all doctors working in the 5 local Social Hygiene Clinics (SHC) participated in this study. During the 14-day data collection period (January 5 through18, 2009), the participating doctors filled out a log-form on a daily basis to record the number of patients with genital warts. The total number of new cases of genital warts presented to private and public doctors in Hong Kong was projected using the stratification sampling method. Results A total of 721 (0.94%) adults presented with genital warts to the participating doctors during the two-week study period, amongst them 73 (10.1%) were new cases. The projected number of new cases of genital warts among Hong Kong adults was 442 (297 male and 144 female) during the study period. The incidence of genital warts in Hong Kong was estimated to be 203.7 per 100,000 person-years (respectively 292.2 and 124.9 per 100,000 person-years for males and females). Conclusions The incidence of genital warts is high among adults in Hong Kong. The study demonstrates the importance of collecting surveillance data from both private and public sectors. PMID:20849578
Igwegbe, A O; Egbuonu, I
Three hundred and twenty-five consecutive live female deliveries at Nnamdi Azikiwe University Teaching Hospital, Nnewi were followed up for 9 months for evidence of any genital mutilation. Their mothers were examined for genital mutilation and a questionnaire based on face-to-face interview of the mothers was also administered. There was no genital mutilation observed among the 200 female babies whose mothers completed the 9 months follow up, The prevalence of genital mutilation among the mothers was 48%. The prevalence of female genital mutilation among the mothers increased with age. The circumcision index C.I. was zero and 3.0 at 16-20 years and 31-35 years age groups, respectively. Also the prevalence decreased with increasing level of education. The circumcision index was 1.0 for mothers at primary level education and least 0.33 at tertiary level of education. There was no relationship with parity. None of the mothers was willing to allow genital mutilation to be performed on her baby but 36% applied local treatment to the clitoris especially powder (28%). Dystocia was the commonest complication in the mothers and the knowledge about female genital mutilation was acquired informally from fellow women. Female education is paramount in the campaign and advocacy against female genital mutilation.
Gully, Kevin J.; Britton, Helen; Hansen, Karen; Goodwill, Kristopher; Nope, Joni L.
A study (n=242) investigated the effectiveness of a simple seven-item scale designed to quantify indices of emotional distress during the rectal-genital phase of a child sexual-abuse examination. The Genital Examination Distress Scale found increased distress was associated with positive physical findings. (CR)
Peripheral Female Genital Arousal as Assessed by Thermography Following Topical Genital Application of Alprostadil vs Placebo Arousal Gel: A Proof-of-Principle Study Without Visual Sexual Stimulation.
Goldstein, Sue W; Gonzalez, Joshua R; Gagnon, Catherine; Goldstein, Irwin
Female sexual arousal disorder is a pathophysiologic state characterized clinically by persistent or recurrent inability to attain or maintain an adequate lubrication-swelling response of sexual excitement until completion of sexual activity. Prior clinical experience with alprostadil products for men with erectile dysfunction supports its use in women with female sexual arousal disorder. To compare the effect of topical alprostadil with over-the-counter (OTC) lubricant on female genital arousal in the absence of visual sexual stimuli. Healthy premenopausal women without sexual dysfunction were recruited from the community to participate in the study. Of 17 women who consented, 10 were enrolled and completed the trial. The mean age of subjects was 32 years (range = 27-43). Study drug or placebo was applied topically to the genitals. Continuous temperature monitoring was performed. Participants completed questionnaires assessing genital sensation, effect, intensity, and duration. Change in temperature from baseline in vestibule, clitoris and vulva. In all 10 subjects, topical alprostadil induced a statistically significant increase in temperature of the vestibule, clitoris, and vulva compared with the OTC lubricant. The most rapid difference in genital temperature between placebo and alprostadil was seen on the vulva, which demonstrated a significant difference at approximately 9 minutes. There was a significant difference in temperature seen for the vestibule and clitoris at 11 and 19 minutes, respectively. Sixty percent of women reported being aware or conscious of genital sensations with topical alprostadil, but not with OTC lubricant. Discordance was noted in 30% of subjects who reported being aware or conscious of genital sensations with the two treatments and 10% who reported not being aware or conscious of genital sensations with either treatment. Topical alprostadil administered to healthy premenopausal women induced statistically significant, sustained
Jiménez-Ruiz, Ismael; Almansa Martínez, Pilar; Pastor Bravo, María Del Mar
To explore men's knowledge of the negative consequences of female genital mutilation (FGM) to women's health in countries where this practice is performed. A qualitative methodology was used with an ethnomethodological approach. Both individual and group semi-structured interviews concerning FGM were conducted with 25 men, selected by triple sampling. A study presentation letter was provided to participants, together with an informed consent declaration. Permission was also procured to record the interviews in audio format. Data analysis was performed using the Atlas Ti7 software. Those participants against FGM are aware of the range of complications this practice can cause, being able to identify physical, obstetric, psychological, sexuality and social consequences in women subjected to FGM. However, those men who are in favour display a general ignorance of the problems resulting from this practice. Participants from countries where FGM is performed who are against this practice are more aware of the negative consequences than those who claim to be in favour. The design of awareness-raising programmes and other tools to combat female genital mutilation must highlight the implications for women's and girls' health, and include family-targeted campaigns which involve men in the process of eradicating this practice. Copyright © 2016 SESPAS. Published by Elsevier Espana. All rights reserved.
Spadacini, B; Nichols, P
In Ethiopia, the Italian Association for Women in Development (AIDOS) has been working with Ethiopia's National Committee on Traditional Practices Affecting the Health of Women and Children for 5 years. AIDOS began working on female genital mutilation in the early 1980s and rejects charges of cultural imperialism that are applied to Northern organizations attempting to help African organizations address this violation of universal human rights. In Ethiopia, 85% of women are mutilated, with most undergoing Sunna, or removal of the prepuce of the clitoris. The joint project seeks to increase awareness about the health consequences of female genital mutilation in the target group. The primary technique used is provision of training of trainers courses and presentation of four modular units and audiovisual materials specifically designed for use with socially influential women, male and female secondary school students, community leaders, and health workers. In addition, an information/education campaign uses videos and sound and slide shows with accompanying story books. A second category of communication tools was developed for a mass information campaign, including radio spots, posters, information leaflets, and a newsletter. When the project was ready for expansion into the southern region of the country, it became clear that a new participatory communication strategy was required to stimulate discussion, such as the use of role playing and theater. Working together, the two organizations have successfully confronted project constraints such as the difficulty in assessing project impact, scheduling problems, and gender-biased assess to information.
Hypospadias is a developmental defect of urethral tube closure that has a complex etiology involving genetic and environmental factors, including anti-androgenic and estrogenic disrupting chemicals; however, little is known about the morphoregulatory consequences of androgen/estrogen balance during genital tubercle (GT) development. Computer models that predictively model sexual dimorphism of the GT may provide a useful resource to translate chemical-target bipartite networks and their developmental consequences across the human-relevant chemical universe. Here, we describe a multicellular agent-based model of genital tubercle (GT) development that simulates urethrogenesis from the sexually-indifferent urethral plate stage to urethral tube closure. The prototype model, constructed in CompuCell3D, recapitulates key aspects of GT morphogenesis controlled by SHH, FGF10, and androgen pathways through modulation of stochastic cell behaviors, including differential adhesion, motility, proliferation, and apoptosis. Proper urethral tube closure in the model was shown to depend quantitatively on SHH- and FGF10-induced effects on mesenchymal proliferation and epithelial apoptosis??both ultimately linked to androgen signaling. In the absence of androgen, GT development was feminized and with partial androgen deficiency, the model resolved with incomplete urethral tube closure, thereby providing an in silico platform for probabilistic prediction of hypospadias risk across c
Magnowski, Piotr; Wolski, Hubert; Magnowska, Magdalena; Nowak-Markwitz, Ewa
Nowadays, women with genital cancers live longer due to early diagnosis and better treatment schemes. Only few studies assessed bone mass in patients with genital cancer Osteoporosis is a condition characterized by progressive loss of bone mass, weakening of the spatial structure of the bone, and increased susceptibility to fractures. Osteopenia is a condition of reduced, but not yet reaching the pathological values, bone density in relation to norms for age and sex. Metastases are the primary cause of death in cancer patients. It is estimated that approximately half of people dying due to cancer have bone metastases. Osteoporosis in neoplastic disease may occur due to bone metastases or therapy-related adverse effects, i.e. reduced bone mineral density (BMD). Bone microenvironment provides a good medium for the growth of cancer cells. BMD of the femur and spine should be measured by DXA. Computed tomography (CT) and magnetic resonance imaging (MRI) are the techniques used to detect bone metastases. Lifestyle is the key to improving the quality of life and maximize any pharmacological treatment in cancer patients. It is proposed that treatment of cancer without bone metastases does not require therapy increasing bone mass. Further studies in women treated for gynecological malignancies undergoing oophorectomy and adjuvant treatment are needed to elucidate the mechanisms associated with bone loss.
Knipscheer, Jeroen; Vloeberghs, Erick; van der Kwaak, Anke; van den Muijsenbergh, Maria
Aims and method To study the mental health status of 66 genitally mutilated immigrant women originating from Africa (i.e. Somalia, Sudan, Eritrea and Sierra Leone). Scores on standardised questionnaires (Harvard Trauma Questionnaire-30, Hopkins Symptom Checklist-25, COPE-Easy, Lowlands Acculturation Scale) and demographic and psychosocial correlates were analysed. Results A third of the respondents reported scores above the cut-off for affective or anxiety disorders; scores indicative for post-traumatic stress disorder were presented by 17.5% of women. Type of circumcision (infibulation), recollection of the event (a vivid memory), coping style (avoidance, in particular substance misuse) and employment status (lack of income) were significantly associated with psychopathology. Clinical implications A considerable minority group, characterised by infibulated women who have a vivid memory of the circumcision and cope with their symptoms in an avoidant way, reports to experience severe consequences of genital circumcision. In terms of public healthcare, interventions should target these groups as a priority. PMID:26755984
Lapoint, Paul G.; Monif, Gilles R. G.
Analysis of 240 consecutive vaginal swabs using the compatibility profile technique revealed that only 2 bacteria have the ability to be a sole isolate and as such a candidate to be a major aerobic regulator of the bacterial flora of the female genital tract (BFFGT). Compatibility profiles of Lactobacillus and Gardnerella vaginalis have shown that these organisms shared compatibility profiling for the majority of the normal bacterial constituents of the female genital tract. Dominance disruption appears to come from the addition of compatible co-isolates and presumed loss of numerical superiority. These phenomena appear to be the keys to reregulation of BFFGT. Lactobacillus appears to be the major regulator of both G. vaginalis and anaerobic bacteria. When additional organisms are added to the bacterial flora, they may add to or partially negate the inhibitory influence of Lactobacillus on the BFFGT. Inhibitor interrelationships appear to exist between coagulase-negative staphylococci and Staphylococcus aureus and the group B streptococci (GBS) and other beta hemolytic streptococci. Facilitating interrelationships appear to exist between S. aureus and the GBS and selected Enterobacteriaceae. PMID:18476156
Birge, Ozer; Ozbey, Ertugrul Gazi; Arslan, Deniz; Erkan, Mustafa Melih; Demir, Feyza; Akgor, Utku
About 100 million women are estimated to be circumcised globally. Various rates of complications have been encountered, especially after circumcision, such as bleeding, infection, shock, menstrual irregularity, difficulty in urination or common urinary tract infections, inguinal pain, difficulty in sexual intercourse, and genital circumcision scar especially at the vulvar region, and cystic or solid character mass in short and long term. Furthermore, the maternal-fetal morbidity and mortality increase due to bleeding and fistula, which develop after prolonged labor, travail, and difficult labors. Our aim in this paper was to discuss a 42-year-old multiparous female case who had undergone type 2 radical genital mutilation (circumcision) when she was 7 years of age, along with the literature, which has been evaluated for the gradually growing mass at the left inguinal canal region in the last 10 years and diagnosed as epidermoid inclusion cyst developing secondary to postcircumcision surgical ground trauma, since there was no other case found in the literature search that had been circumcised at such an early age and developing after circumcision at such advanced age, and, therefore, this is suggested to be the first case on this subject. PMID:26682078
Alo, Olubunmi Akinsanya; Gbadebo, Babatunde
The practice of female genital cutting (FGC) is widespread in Nigeria and varies from one ethnic group to another. In 1994, Nigeria joined members of the 47th World Health Assembly in a resolution to eliminate the practice, and since then, several steps has been taken to achieve this objective. Nigeria joined members of the 47th World Health Assembly sixteen years ago in a resolution to eliminate female genital mutilation. This study uses data from 420 women aged 15?49 years who had at least one surviving daughter to investigate changes in FGC prevalence among mothers and daughters. The sample was systematically selected through stratified random sampling across the six states of southwest Nigeria. Focus group discussion, and an in-depth interview with fourteen women considered to be specialist in FGC were also held to compliment data generated from the interview. The analysis indicated an FGC prevalence rate of 75% and 71% for mothers and daughters, respectively. It further indicated that the practice is rooted in tradition despite the fact that 52% of the respondents are aware of the health hazards of FGC. Educated mothers were found to be less likely to favor the cutting of their daughters. It is suggested that educational campaigns aimed toward parents should be intensified. Legal recourse, prohibition of operations, improvement in women's status, and sex education are also suggested as means of eradicating the practice.
Langevin, R; Paitich, D; Ramsay, G; Anderson, C; Kamrad, J; Pope, S; Geller, G; Pearl, L; Newman, S
Several studies are reported which examine the critical stimuli and responses as well as personality factors important in genital exhibitionism. Using penile volume measurement, sex history questionnaires, personality tests, and behavioral observations, it was found that (1) exhibitionists responded most to mature females and were comparable to normals in reactions to children and men; (2) while exhibitionists indicated narcissistic desires in exposing, in a laboratory study they did not differ from controls in reactions to exposing with various reactions of the female, from sexual arousal and admiration to fear and anger; (3) the only strong features distinguishing exhibitionists from controls and other sexually anomalous subjects were peeping associated with orgasm and outdoor solitary masturbation; (4) exhibitionists seemed to be less assertive and less feminine than controls, but results were weak and inconsistent; (5) exhibitionists and controls did not differ in separation and divorce or marital satisfaction; (6) blood testosterone and penile reactivity of exhibitionists were within normal limits. Overall, the results suggest that most major theories of genital exhibitionism are wanting. It is suggested that narcissism and pedophilia be examined further in connection with exhibitionism.
Beder Ribeiro, Camila Maria; Ferrer, Iracema; Santos de Farias, Andreza Barkokebas; Fonseca, Débora Diniz; Morais Silva, Igor Henrique; Monteiro Gueiros, Luiz Alcino; Carvalho, Alessandra Tavares; Porter, Stephen Ross; Leao, Jair Carneiro
The aim of this study was to verify human papillomavirus (HPV) transmission and genotype concordance among heterosexual couples. Thirty-one married couples were evaluated. All male subjects presented with clinically diagnosed HPV-related malignant or potentially malignant lesions and underwent peniscopy and penile swab. Their female counterparts underwent swabs of the uterine cervix and oral mucosa. HPV-DNA detection was performed by polymerase chain reaction and restriction fragment length polymorphism. HPV-DNA was detected in the penis, vagina/cervix, and oral cavity of 16 couples (51.61%). Of these, HPV-DNA concordance was observed in 14 couples (87.5%). HPV-DNA was amplified in penile and oral sites of 14 couples. Of these, 13 couples reported fellatio (92.85%), most of them (10 couples, 76.9%) without condom use. HPV-DNA concordance was observed in 7/10 of these couples (70%). The three couples (100%) who reported use of condom during fellatio were HPV-DNA discordant (p = 0.025). Lifetime number of female sexual partners and detection of HPV-DNA in the penile mucosa are surrogate markers of exposure to HPV during marriage. Consistent use of condoms may reduce the risk of HPV transmission. Oral acquisition of HPV from oro-genital contact is influenced by lack of condom use and previous sexual behavior of the male partner. In addition, oral transmission of the virus due to fellatio is as common as genital transmission.
Morfin-Maciel, Blanca María; Sotelo-Ortiz, Julieta Margarita
Human papillomavirus (HPV) is one of the most common sexually transmitted infections worldwide. Most HPV infections are cleared within two years by the immune system. Only in 5% to 10% of infected women the infection persists determining a high risk of developing cervical intraepithelial neoplasia. The transfer factor (TF) or dialyzable leukocyte extract is an immunomodulator that has been successfully used as an adjuvant in the treatment of intracelular infections such as recurrent herpes virus diseases. One daily dose of transfer factor was given for five days and subsequently each week for five weeks to a group of women with persistent genital papillomavirus infection. We included 13 patients, aged 19 to 45 years, with first intercourse between the ages of 14 to 23, and a mean of three sexual partners in their lifetime. All of them had persistent HPV that had been treated before with local and ablative therapeutic options, including cervical freezing, cervical conization, cauterizing loop, imiquimod and podophyllin. Transfer factor was administered daily for 5 days, and subsequently at 7-day intervals for 5 weeks. We found a clinical significant improvement in the gynaecological evaluation of cervical, vaginal, vulvar and perineal lesions. No recurrences have developed for at least 1 year of follow-up. The use of transfer factor in women with HPV showed resolution of genital lesions, without recurrences for at least one year after the treatment was ended.
The ritual genital mutilation of females is widely practiced across the greater part of the African continent affecting an estimated 100 million women in more than 25 countries. The practice also exists to a lesser extent along the Arab peninsula and in parts of Asia. Approximately 200,000 immigrants have come to the US over the past decade from such countries. Many of the women among this immigrant population are severely disabled by social constraints, chronic pain, and impaired mobility. They only rarely present, however, at conventional medical facilities because they are prevented by men and/or they do not expect their specialized medical problems to be understood or handled compassionately. The author spent 32 months between 1979 and 1984 in Sudan, Kenya, and Egypt researching female genital mutilation. She describes the immediate and long-term medical consequences of the process and condition, especially with regard to menstruation and childbirth. The significance of the procedure as a social phenomenon is explained in historical terms and in terms of the values of the societies in which it is established, with consideration given to how a working relationship may be established with the immigrant women.
Mackern-Oberti, Juan Pablo; Motrich, Rubén Darío; Damiani, Maria Teresa; Saka, Héctor Alex; Quintero, Cristian Andrés; Sánchez, Leonardo Rodolfo; Moreno-Sosa, Tamara; Olivera, Carolina; Cuffini, Cecilia; Rivero, Virginia Elena
Chlamydia trachomatis is the most commonly reported agent of sexually transmitted bacterial infections worldwide. This pathogen frequently leads to persistent, long-term, subclinical infections, which in turn may cause severe pathology in susceptible hosts. This is in part due to the strategies that Chlamydia trachomatis uses to survive within epithelial cells and to evade the host immune response, such as subverting intracellular trafficking, interfering signaling pathways and preventing apoptosis. Innate immune receptors such as toll-like receptors expressed on epithelial and immune cells in the genital tract mediate the recognition of chlamydial molecular patterns. After bacterial recognition, a subset of pro-inflammatory cytokines and chemokines are continuously released by epithelial cells. The innate immune response is followed by the initiation of the adaptive response against Chlamydia trachomatis, which in turn may result in T helper 1-mediated protection or in T helper 2-mediated immunopathology. Understanding the molecular mechanisms developed by Chlamydia trachomatis to avoid killing and host immune response would be crucial for designing new therapeutic approaches and developing protective vaccines. In this review, we focus on chlamydial survival strategies and the elicited immune responses in male genital tract infections. © 2017 Society for Reproduction and Fertility.
Booksmythe, Isobel; Head, Megan L.; Keogh, J. Scott; Jennions, Michael D.
Male genitalia often show remarkable differences among related species in size, shape and complexity. Across poeciliid fishes, the elongated fin (gonopodium) that males use to inseminate females ranges from 18 to 53% of body length. Relative genital size therefore varies greatly among species. In contrast, there is often tight within-species allometric scaling, which suggests strong selection against genital–body size combinations that deviate from a species' natural line of allometry. We tested this constraint by artificially selecting on the allometric intercept, creating lines of males with relatively longer or shorter gonopodia than occur naturally for a given body size in mosquitofish, Gambusia holbrooki. We show that relative genital length is heritable and diverged 7.6–8.9% between our up-selected and down-selected lines, with correlated changes in body shape. However, deviation from the natural line of allometry does not affect male success in assays of attractiveness, swimming performance and, crucially, reproductive success (paternity). PMID:27188478
Morrone, Aldo; Hercogova, Jana; Lotti, Torello
Female genital mutilation (FGM) is a traditional cultural practice, but also a form of violence against girls, which affects their lives as adult women. FGM comprises a wide range of procedures: the excision of the prepuce; the partial or total excision of the clitoris (clitoridectomy) and labia; or the stitching and narrowing of the vaginal orifice (infibulation). The number of girls and women who have been subjected to FGM is estimated at around 137 million worldwide and 2 million girls per year are considered at risk. Most females who have undergone mutilation live in 28 African countries. Globalization and international migration have brought an increased presence of circumcised women in Europe and developed countries. Healthcare specialists need to be made aware and trained in the physical, psychosexual, and cultural aspects and effects of FGM and in the response to the needs of genitally mutilated women. Health education programs targeted at immigrant communities should include information on sexuality, FGM, and reproduction. Moreover, healthcare workers should both discourage women from performing FGM on their daughters and receive information on codes of conduct and existing laws. The aim is the total eradication of all forms of FGM.
Valacyclovir, the metabolic precursor of acyclovir, is now approved for treatment and prevention of genital infection with herpes simplex viruses. The clinical file is bulky and methodologically sound. For treatment of a first episode of genital herpes, a large comparative trial has shown that valacyclovir (1 g twice a day) is as effective as acyclovir (200 mg five times a day) when given for 10 days. For treating recurrences, two trials show that valacyclovir is as effective as acyclovir (200 mg five times a day) with a treatment period of 5 days. A daily dose of 1 g of valacyclovir is as effective as 2 g daily. Valacyclovir can be administered once a day. For prevention among patients with frequent recurrences, the efficacy of valacyclovir (500 mg/d in a single dose) has been proven in a placebo-controlled trial lasting 4 months. In these trials, valacyclovir and acyclovir were both well tolerated, with no major differences between the two drugs. PMID:10424269
Green, J; Ferrier, S; Kocsis, A; Shadrick, J; Ukoumunne, O; Murphy, S; Hetherton, J
Objective: To identify factors which determine whether and when patients will disclose infection with genital herpes to sexual partners. Methods: The sample was 26 women and 24 men attending a herpes clinic in a sexually transmitted disease clinic. Semistructured interviews yielded quantitative data and also qualitative data which were subjected to content analysis. Results: Characteristics of partners were very important in determining whether disclosure occurred. Respondents were less likely to tell partners regarded as casual. Perception of the likely reaction of partners was important in deciding whether to tell. Many respondents assumed that they were not infectious if they were not currently having an attack or if they were taking antiviral medication. The decision whether to tell tended to be based on considerations of likely discovery and of honesty towards the partner rather than control of transmission. Of patient characteristics only self rated depressed mood was related to disclosure to the most recent partner. Conclusions: Perception of the partner and anticipated partner response is crucially important in determining whether and when disclosure of genital herpes infection occurs. PMID:12576613
Margraf, A; Costa-Ayub, C L S; Okada, M A; Gomes, J R; Ortolani-Machado, C F; Soares, M A M
We examined the post-embryonic development of the male and female genital apparatus of the brown spider, Loxosceles intermedia. The development of the genital apparatus for both sexes begins with the appearance of inner structures. In the male genital apparatus, formation of the testes occurs first, followed by differentiation of the duct, ampulla and vas deferens, and finally the formation of the genital opening and differentiation of the copulatory organ (secondary sexual characteristic). Similarly, the development of the female genital apparatus begins with the formation of the ovaries, followed by the appearance of oocytes in vitellogenesis, then the development of oviducts and uterus internus and, finally, the spermatheca. These data may be very important in further comparative studies on the development of the reproductive system of spiders.
Tammaro, A; Parisella, F R; Cavallotti, C; Persechino, S; Cavallotti, C
In human genital skin the majority of superficial sensory corpuscles is represented by glomerular corpuscles. These corpuscles show an own morphology. Our aim is to compare the ultra-structure of superficial sensory corpuscles in the penis skin of younger and older subjects. In this report the ultra-structure of the sensitive corpuscle in the penis skin of the younger and older subjects was compared, showing that the genital skin of the older humans contains more simple complexes than the younger ones. Our findings support the view that the age-related changes that can be observed in human glomerular genital corpuscles are consistent with an increase of the simple complexes and a strong decrease of the poly-lamellar one in the older people. These findings demonstrate that human genital corpuscles underwent age-related changes. Moreover our morphological findings can be correlated in relation to the clinical evolution of the sensitivity in the genital skin.
Genital surgery is one of the most controversial and contested practices, yet it is frequently described and referred to with little or no attention to cultural and social context. This article examines the practice, performed on both men and women, and the extent to which it clashes with issues of consent and capacity, as well as multicultural concepts of toleration for minority group practices. It then questions why female genital surgery, unlike male genital surgery, is legally prohibited in Australia. It argues that such legal gender bias stems from a liberal conception of "tolerance" and the limits of consent in Australia, placing female genital surgery in an "unacceptable" category and male genital surgery in an "acceptable" category.
Cengiz, Fatma Pelin; Emiroglu, Nazan; Wellenhof, Rainer Hofmann
BACKGROUND The dermoscopic features of vulvar melanosis lesions are well known. To our knowledge, there are only a few case reports about dermoscopic features of pigmented genital lesions in male patients. OBJECTIVE To evaluate dermoscopic and clinical characteristics of benign lesions of the genital area in both males and females, and to assess the distinguishing dermoscopic criteria of vulvar melanosis and atypical melanocytic nevi of the genital type. METHODS 68 patients with pigmented genital lesions were included in this observational study (28 male and 40 female). A punch biopsy was taken from all pigmented lesions and histopathological examination was performed on all specimens. RESULTS We histopathologically diagnosed: genital melanosis in 40 lesions, atypical melanocytic nevi of the genital type in 15 lesions, melanocytic nevi in 9 lesions, seborrheic keratosis in 4 lesions. The most frequent locations were the glans penis (19 patients, 67.9%) in males and the labia minora (19 patients, 47.5%) in females. The mean age of patients with atypical nevi (28,6 ± 11,36) was significantly lower than the mean age of patients with genital melanosis (47,07 ± 15,33). CONCLUSIONS Parallel pattern is prominent in genital melanosis, ring-like pattern is only observed in genital melanosis. Most pigmented lesions on the genital area are solitary. Blue-white veil and irregular dots are only observed in AMNGT. According to these results, we propose that histopathological examination is performed, especially if blue-white veil and irregular dots are found by dermoscopy. PMID:25830986
Vanderstraeten, Eva; Bogaert, Lies; Bravo, Ignacio G; Martens, Ann
Squamous cell carcinoma (SCC) represents the most common malignant tumour of the eye and external genitals in horses. Comparable to humans, papillomaviruses (PV) have been proposed as etiological agents of cancer in horses and recently, Equine papillomavirus type 2 (EcPV2) has been identified in genital SCCs. Hitherto it had never been demonstrated in ocular SCCs. The first goal of this study was to determine the prevalence of EcPV2 DNA in tissue samples from equine genital and ocular SCCs, genital papillomas and penile intraepithelial neoplasia (PIN) lesions, using EcPV2-specific PCR. The second goal was to investigate the possibility of latent EcPV2 infection in the genital and ocular mucosa of healthy horses on swabs obtained from the eye, penis, vulvovaginal region and cervix. EcPV2 DNA was detected in all genital SCCs (17/17), genital papillomas (8/8), PIN lesions (11/11) and ocular SCCs (9/9). In healthy horses, EcPV2 DNA was detected in 43% (17/40) of penile swabs, 53% (9/17) of vulvovaginal swabs, 47% (8/17) of cervical swabs and 57% (32/56) of ocular swabs. This study confirms the presence of EcPV2 DNA in equine genital SCCs. Moreover, we demonstrate for the first time its involvement in other genital lesions and in ocular SCCs and latent EcPV2 infections in normal genital (including cervical) and ocular equine mucosa. The close relatives of EcPV2 are associated to cutaneous lesions, and this virus is not related to high-risk human papillomaviruses causing cervical cancer. Thus, similar viral tropism does not imply close evolutionary relationship. Copyright Â© 2010 Elsevier B.V. All rights reserved.
Ghosh, Mimi; Rodriguez-Garcia, Marta; Wira, Charles R.
Studies on HIV acquisition and transmission in women exposed to sexual trauma throughout their life cycle are lacking but some findings suggest that rates of HIV acquisition through coercive sex are significantly higher than that seen in consensual sex. Sexual trauma can also occur as a result of female genital mutilation, which makes sex extremely painful and can cause increased abrasions, lacerations and inflammation, which enhances the risk of HIV acquisition. This review presents an overview of the immune system in the human female reproductive tract from adolescence, through puberty to pregnancy and menopause. What is clear is that the foundation of information on immune protection in the female reproductive tract throughout the life cycle of women is extremely limited and at some stages such as adolescence and menopause are grossly lacking. Against this back backdrop, forced or coercive sexual intercourse as well as genital mutilation further complicates our understanding of the biological risk factors that can result in transmission of HIV and other sexually transmitted infections. PMID:23034063
Ghosh, Mimi; Rodriguez-Garcia, Marta; Wira, Charles R
Studies on HIV acquisition and transmission in women exposed to sexual trauma throughout their life cycle are lacking, but some findings suggest that rates of HIV acquisition through coercive sex are significantly higher than that seen in consensual sex. Sexual trauma can also occur as a result of female genital mutilation, which makes sex extremely painful and can cause increased abrasions, lacerations, and inflammation, which enhances the risk of HIV acquisition. This review presents an overview of the immune system in the human female reproductive tract (FRT) from adolescence, through puberty to pregnancy and menopause. What is clear is that the foundation of information on immune protection in the FRT throughout the life cycle of women is extremely limited and at some stages such as adolescence and menopause are grossly lacking. Against this backdrop, forced or coercive sexual intercourse as well as genital mutilation further complicates our understanding of the biological risk factors that can result in transmission of HIV and other sexually transmitted infections. © 2012 John Wiley & Sons A/S.
Spear, Gregory T; Kersh, Ellen; Guenthner, Patricia; Vishwanathan, Sundaram Ajay; Gilbert, Douglas; Zariffard, M Reza; Mirmonsef, Paria; Landay, Alan; Zheng, Luyang; Gillevet, Patrick
Vaginal bacterial communities play an important role in human health and have been shown to influence HIV infection. Pigtailed macaques (Macaca nemestrina) are used as an animal model of HIV vaginal infection of women. Since the bacterial microbiota could influence retrovirus infection of pigtailed macaques, the genital microbiota in 10 cycling macaques was determined by pyrosequencing. The microbiota of all macaques was polymicrobial with a median of 13 distinct genera. Strikingly, the genera Sneathia and Fusobacterium, both in the phylum Fusobacteria, accounted for 18.9% and 13.3% of sequences while the next most frequent were Prevotella (5.6%), Porphyromonas (4.1%), Atopobium (3.6%), and Parvimonas (2.6%). Sequences corresponding to Lactobacillus comprised only 2.2% of sequences on average and were essentially all L. amylovorus. Longitudinal sampling of the 10 macaques over an 8-week period, which spanned at least one full ovulatory cycle, showed a generally stable presence of the major types of bacteria with some exceptions. These studies show that the microbiota of the pigtailed macaques is substantially dissimilar to that found in most healthy humans, where the genital microbiota is usually dominated by Lactobacillus sp. The polymicrobial makeup of the macaque bacterial populations, the paucity of lactobacilli, and the specific types of bacteria present suggest that the pigtailed macaque microbiota could influence vaginal retrovirus infection.
Kersh, Ellen; Guenthner, Patricia; Vishwanathan, Sundaram Ajay; Gilbert, Douglas; Zariffard, M. Reza; Mirmonsef, Paria; Landay, Alan; Zheng, Luyang; Gillevet, Patrick
Abstract Vaginal bacterial communities play an important role in human health and have been shown to influence HIV infection. Pigtailed macaques (Macaca nemestrina) are used as an animal model of HIV vaginal infection of women. Since the bacterial microbiota could influence retrovirus infection of pigtailed macaques, the genital microbiota in 10 cycling macaques was determined by pyrosequencing. The microbiota of all macaques was polymicrobial with a median of 13 distinct genera. Strikingly, the genera Sneathia and Fusobacterium, both in the phylum Fusobacteria, accounted for 18.9% and 13.3% of sequences while the next most frequent were Prevotella (5.6%), Porphyromonas (4.1%), Atopobium (3.6%), and Parvimonas (2.6%). Sequences corresponding to Lactobacillus comprised only 2.2% of sequences on average and were essentially all L. amylovorus. Longitudinal sampling of the 10 macaques over an 8-week period, which spanned at least one full ovulatory cycle, showed a generally stable presence of the major types of bacteria with some exceptions. These studies show that the microbiota of the pigtailed macaques is substantially dissimilar to that found in most healthy humans, where the genital microbiota is usually dominated by Lactobacillus sp. The polymicrobial makeup of the macaque bacterial populations, the paucity of lactobacilli, and the specific types of bacteria present suggest that the pigtailed macaque microbiota could influence vaginal retrovirus infection. PMID:22264029
Cuburu, Nicolas; Kweon, Mi-Na; Hervouet, Catherine; Cha, Hye-Ran; Pang, Yuk-Ying S; Holmgren, Jan; Stadler, Konrad; Schiller, John T; Anjuère, Fabienne; Czerkinsky, Cecil
We have recently reported that the sublingual (s.l.) mucosa is an efficient site for inducing systemic and mucosal immune responses. In this study, the potential of s.l. immunization to induce remote Ab responses and CD8(+) cytotoxic responses in the female genital tract was examined in mice by using a nonreplicating Ag, OVA, and cholera toxin (CT) as an adjuvant. Sublingual administration of OVA and CT induced Ag-specific IgA and IgG Abs in blood and in cervicovaginal secretions. These responses were associated with large numbers of IgA Ab-secreting cells (ASCs) in the genital mucosa. Genital ASC responses were similar in magnitude and isotype distribution after s.l., intranasal, or vaginal immunization and were superior to those seen after intragastric immunization. Genital, but not blood or spleen, IgA ASC responses were inhibited by treatment with anti-CCL28 Abs, suggesting that the chemokine CCL28 plays a major role in the migration of IgA ASC progenitors to the reproductive tract mucosa. Furthermore, s.l. immunization with OVA induced OVA-specific effector CD8(+) cytolytic T cells in the genital mucosa, and these responses required coadministration of the CT adjuvant. Furthermore, s.l. administration of human papillomavirus virus-like particles with or without the CT adjuvant conferred protection against genital challenge with human papillomavirus pseudovirions. Taken together, these findings underscore the potential of s.l. immunization as an efficient vaccination strategy for inducing genital immune responses and should impact on the development of vaccines against sexually transmitted diseases.
Brennan, Patricia L R; Prum, Richard O
Genital coevolution between the sexes is expected to be common because of the direct interaction between male and female genitalia during copulation. Here we review the diverse mechanisms of genital coevolution that include natural selection, female mate choice, male-male competition, and how their interactions generate sexual conflict that can lead to sexually antagonistic coevolution. Natural selection on genital morphology will result in size coevolution to allow for copulation to be mechanically possible, even as other features of genitalia may reflect the action of other mechanisms of selection. Genital coevolution is explicitly predicted by at least three mechanisms of genital evolution: lock and key to prevent hybridization, female choice, and sexual conflict. Although some good examples exist in support of each of these mechanisms, more data on quantitative female genital variation and studies of functional morphology during copulation are needed to understand more general patterns. A combination of different approaches is required to continue to advance our understanding of genital coevolution. Knowledge of the ecology and behavior of the studied species combined with functional morphology, quantitative morphological tools, experimental manipulation, and experimental evolution have been provided in the best-studied species, all of which are invertebrates. Therefore, attention to vertebrates in any of these areas is badly needed. Copyright © 2015 Cold Spring Harbor Laboratory Press; all rights reserved.
Brennan, Patricia L.R.; Prum, Richard O.
Genital coevolution between the sexes is expected to be common because of the direct interaction between male and female genitalia during copulation. Here we review the diverse mechanisms of genital coevolution that include natural selection, female mate choice, male–male competition, and how their interactions generate sexual conflict that can lead to sexually antagonistic coevolution. Natural selection on genital morphology will result in size coevolution to allow for copulation to be mechanically possible, even as other features of genitalia may reflect the action of other mechanisms of selection. Genital coevolution is explicitly predicted by at least three mechanisms of genital evolution: lock and key to prevent hybridization, female choice, and sexual conflict. Although some good examples exist in support of each of these mechanisms, more data on quantitative female genital variation and studies of functional morphology during copulation are needed to understand more general patterns. A combination of different approaches is required to continue to advance our understanding of genital coevolution. Knowledge of the ecology and behavior of the studied species combined with functional morphology, quantitative morphological tools, experimental manipulation, and experimental evolution have been provided in the best-studied species, all of which are invertebrates. Therefore, attention to vertebrates in any of these areas is badly needed. PMID:26134314
Oseso, Linda; Magaret, Amalia S; Jerome, Keith R; Fox, Julie; Wald, Anna
Current treatment of genital herpes is focused on ameliorating signs and symptoms but is not curative. However, as potential herpes simplex virus (HSV) cure approaches are tested in the laboratory, we aimed to assess the interest in such studies by persons with genital herpes and the willingness to assume risks associated with experimental therapy. We constructed an anonymous online questionnaire that was posted on websites that provide information regarding genital herpes. The questions collected demographic and clinical information on adults who self-reported as having genital herpes, and assessed attitudes toward and willingness to participate in HSV cure clinical research. Seven hundred eleven participants provided sufficient responses to be included in the analysis. Sixty-six percent were women; the median age was 37 years, and the median time since genital HSV diagnosis was 4.7 years. The willingness to participate in trials increased from 59.0% in phase 1 to 68.5% in phase 2, and 81.2% in phase 3 trials, and 40% reported willingness to participate even in the absence of immediate, personal benefits. The most desirable outcome was the elimination of risk for transmission to sex partner or neonate. The mean perceived severity of receiving a diagnosis of genital HSV-2 was 4.2 on a scale of 1 to 5. Despite suppressive therapy available, persons with genital herpes are interested in participating in clinical research aimed at curing HSV, especially in more advanced stages of development.
Lunde, Ingvild Bergom; Sagbakken, Mette
According to several sources, little progress is being made in eliminating the cutting of female genitalia. This paper, based on qualitative interviews and observations, explores perceptions of female genital cutting and elimination of the phenomenon in Hargeisa, Somaliland. Two main groups of participants were interviewed: (1) 22 representatives of organisations whose work directly relates to female genital cutting; and (2) 16 individuals representing different groups of society. It was found that there is an increasing use of medical staff and equipment when a girl undergoes the procedure of female genital cutting; the use of terminology is crucial in understanding current perceptions of female genital cutting; religion is both an important barrier and facilitator of elimination; and finally, traditional gender structures are currently being challenged in Hargeisa. The findings of this study suggest that it is important to consider current perceptions on practices of female genital cutting and on abandonment of female genital cutting, in order to gain useful knowledge on the issue of elimination. The study concludes that elimination of female genital cutting is a multifaceted process which is constantly negotiated in a diversity of social settings. Copyright © 2014 Reproductive Health Matters. Published by Elsevier Ltd. All rights reserved.
Brotto, Lori A; Gorzalka, Boris B
The current study was aimed at comparing genital and subjective sexual arousal in pre- and postmenopausal women and exploring the effects of heightened sympathetic nervous system (SNS) activity on these parameters. Seventy-one women (25 young and premenopausal, 25 postmenopausal, and 21 age-matched premenopausal women) participated in two counterbalanced sessions consisting of genital arousal assessment with vaginal photoplethysmography and subjective arousal assessment with self-report questionnaires. SNS activity was enhanced using laboratory-induced hyperventilation. Results demonstrated no significant differences between pre- and postmenopausal women on genital and subjective measures of arousal in response to neutral and erotic films. SNS manipulation increased genital excitement only in young, premenopausal women. These data suggest that prior SNS enhancement can differentiate pre- from postmenopausal genital arousal. Data also revealed significant correlations between genital and subjective sexual arousal in older pre- and postmenopausal women, but not in young premenopausal women. These data are the first to directly compare genital-subjective correlations between pre- and postmenopausal women.
Kavanaugh, Barbara E.; Odem-Davis, Katherine; Jaoko, Walter; Estambale, Benson; Kiarie, James N.; Masese, Linnet N.; Deya, Ruth; Manhart, Lisa E.; Graham, Susan M.; McClelland, R. Scott
Background Our goal in the present study was to investigate the prevalence and correlates of genital warts in a population of female sex workers in Mombasa, Kenya. Because of the high prevalence of HIV-1 in this population, we were particularly interested in the association between HIV-1 infection and genital warts. Methods We conducted a cross-sectional study of the prevalence and correlates of genital warts among high-risk women in Mombasa, Kenya. Between 2001 and 2007, 1182 women were enrolled, of whom 613 (51.4%) were HIV-1-seropositive. Chi square tests and logistic regression were used to examine the associations between genital warts and potential correlates. Results Genital warts were identified on clinical examination in 27 (2.3%) women. Women who were HIV-1-seropositive were nearly 8 times as likely to have genital warts compared to HIV-1-seronegative women (OR 7.69, 95% CI 2.30–25.6). Conclusion Understanding the prevalence and correlates of genital warts will help to determine whether coverage for the wart-inducing subtypes 6 and 11 in an HPV vaccine is an important consideration in resource-limited countries. PMID:23060082
Navarro-Illana, Esther; López-Lacort, Mónica; Navarro-Illana, Pedro; Vilata, Juan José; Diez-Domingo, Javier
To assess the effectiveness of the HPV vaccines in preventing genital warts in young women. Population-based study using health databases. Valencian Community (Spain). All girls and women aged 14-19years who were registered in the Valencian Community between January 2009 and December 2014 (n=279,787). Incident cases of genital warts were defined as the first activation of diagnosis code ICD-9-CM 078.11 (Condyloma acuminatum) in primary care and outpatient clinics during the study period. There were 612 cases of genital warts. The overall incidence rate was 75.8/100,000 person-years (95% CrI 69.7-81.8). There was a decrease in genital warts when female candidates to be vaccinated with quadrivalent HPV vaccine reached the age of 18 (in 2012), compared to previous years. Incidence of genital warts in unvaccinated women and those who received the bivalent vaccine was higher than in girls and women who received the quadrivalent HPV vaccine. The effectiveness of a three-dose regimen of the quadrivalent HPV vaccine was 77% (95 CrI: 66-85%), whereas that of a single dose was 61% (95 CrI: 20-87%). No effectiveness was seen with a full vaccination course with the bivalent HPV vaccine. Three doses of the quadrivalent HPV vaccine were effective against genital warts in our population. Moreover, with low vaccine coverage the incidence of genital warts decreased only in the vaccinated. Copyright © 2017 Elsevier Ltd. All rights reserved.
Evans, Jonathan P; Gasparini, Clelia; Holwell, Gregory I; Ramnarine, Indar W; Pitcher, Trevor E; Pilastro, Andrea
The role of sexual selection in fuelling genital evolution is becoming increasingly apparent from comparative studies revealing interspecific divergence in male genitalia and evolutionary associations between male and female genital traits. Despite this, we know little about intraspecific variance in male genital morphology, or how male and female reproductive traits covary among divergent populations. Here we address both topics using natural populations of the guppy, Poecilia reticulata, a livebearing fish that exhibits divergent patterns of male sexual behaviour among populations. Initially, we performed a series of mating trials on a single population to examine the relationship between the morphology of the male's copulatory organ (the gonopodium) and the success of forced matings. Using a combination of linear measurements and geometric morphometrics, we found that variation in the length and shape of the gonopodium predicted the success of forced matings in terms of the rate of genital contacts and insemination success, respectively. We then looked for geographical divergence in these traits, since the relative frequency of forced matings tends to be greater in high-predation populations. We found consistent patterns of variation in male genital size and shape in relation to the level of predation, and corresponding patterns of (co)variation in female genital morphology. Together, these data enable us to draw tentative conclusions about the underlying selective pressures causing correlated patterns of divergence in male and female genital traits, which point to a role for sexually antagonistic selection.
Glinšek Biškup, Urška; Uršič, Tina; Petrovec, Miroslav
Herpes simplex virus types 1 and 2 are the main cause of genital ulcers worldwide. Although herpes simplex virus type 2 is the major cause of genital lesions, herpes simplex virus type 1 accounts for half of new cases in developed countries. Herpes simplex virus type 2 seroprevalence rises with sexual activity from adolescence through adulthood. Slovenian data in a high-risk population shows 16% seroprevalence of HSV-2. HSV-1 and HSV-2 DNA in genital swabs was detected in 19% and 20.7%, respectively. In most cases, genital herpes is asymptomatic. Primary genital infection with herpes simplex virus types 1 and 2 can be manifested by a severe clinical picture, involving the vesicular skin and mucosal changes and ulcerative lesions of the vulva, vagina, and cervix in women and in the genital region in men. Direct methods of viral genome detection are recommended in the acute stage of primary and recurrent infections when manifest ulcers or lesions are evident. Serological testing is recommended as an aid in diagnosing genital herpes in patients with reinfection in atypical or already healed lesions. When herpes lesions are present, all sexual activities should be avoided to prevent transmission of infection. Antiviral drugs can reduce viral shedding and thus reduce the risk of sexual transmission of the virus.
Lichen planus (LP) is an inflammatory autoimmune disease that affects both glabrous and mucosal skin. Although pathophysiology has not yet been fully defined, LP is a T-cell mediated disorder that demonstrates an increased Th1 cytokine expression as well as T-cell reactivity against basement membrane zone components. In males, genital LP often takes its more classic form as pink, shiny, flat-topped papules on the glans and coronal sulcus. In women, erosive disease is most common and often leads to significant scarring and sexual dysfunction. Therapeutic management is challenging, and control rather than cure is the goal. Topical corticosteroids remain first-line therapy, but some women will require systemic immunosuppressants to achieve remission. Surgery is less common for women with significant scarring who wish to resume sexual activity. Further research is needed on pathogenesis, and randomized controlled trials are necessary to better define best treatments for this chronic disease. ©2015 Frontline Medical Communications.
The mission of the Cochrane Nursing Care Field (CNCF) is to improve health outcomes through increasing the use of the Cochrane Library and supporting Cochrane's role by providing an evidence base for nurses and healthcare professionals who deliver, lead or research nursing care. The CNCF produces Cochrane Corner columns, summaries of recent nursing-care-relevant Cochrane Reviews that are regularly published in collaborating nursing-related journals. Information on the processes CNCF has developed can be accessed at: cncf.cochrane.org/evidence-transfer-program-review-summaries. This is a Cochrane review summary of: Heslop R, Roberts H, Flower D et al ( 2016 ) Interventions for men and women with their first episode of genital herpes. Cochrane Database of Systematic Reviews. Issue 8. CD010684. doi: 10.1002/14651858.CD010684.pub2.
One of the most challenging issues in cross-cultural bioethics concerns the long-standing socio-cultural practice of female genital circumcision (FGC), which is prevalent in many African countries and the Middle East as well as in some Asian and Western countries. It is commonly assumed that FGC, in all its versions, constitutes a gross violation of the universal human rights of health, physical integrity, and individual autonomy and hence should be abolished. This article, however, suggests a mediating approach according to which one form of FGC, the removal of the clitoris foreskin, can be made compatible with the high demands of universal human rights. The argument presupposes the idea that human rights are not absolutist by nature but can be framed in a meaningful, culturally sensitive way. It proposes important limiting conditions that must be met for the practice of FGC to be considered in accordance with the human rights agenda. © 2017 John Wiley & Sons Ltd.
Zeitlin, L; Whaley, K J; Hegarty, T A; Moench, T R; Cone, R A
Microbicide candidates were selected that have demonstrated activity against sperm or sexually transmitted disease pathogens in vitro, and the efficacy of these agents for preventing vaginal transmission of genital herpes infection was evaluated in the progestin-treated mouse. Each agent was delivered to the vaginas of mice approximately 20 sec prior to delivering a highly infectious herpes simplex virus-2 inoculum. The following agents provided significant protection: anti-HSV monoclonal antibodies III-174 and HSV8, modified bovine beta-lactoglobulin (beta-69), carrageenan, concanavalin A, chlorhexidine, dextran sulfate (average molecular weight 8,000 and 500,000), fucoidan, neem, nonoxynol-9, polystyrene sulfonate, and povidone-iodine. Two agents, gramicidin and heparan sulfate, though highly effective in vitro, were not protective in vivo at the doses tested.
Harari, Ariana; Wood, Charles E; Van Doorslaer, Koenraad; Chen, Zigui; Domaingue, Marie Claire; Elmore, David; Koenig, Patricia; Wagner, Janice D; Jennings, Ryan N; Burk, Robert D
Genital condyloma-like lesions were observed on male and female cynomolgus macaque monkeys (Macaca fascicularis) originating from the island of Mauritius. Cytobrush and/or biopsy samples were obtained from lesions of 57 affected macaques. Primary histologic features included eosinophilic, neutrophilic, and lymphoplasmacytic penile and vulvar inflammation, epidermal hyperplasia with acanthosis, and increased collagenous stroma. Polymerase chain reaction-based assays to amplify viral DNA revealed the presence of macaque lymphocryptovirus (LCV) DNA but not papillomavirus or poxvirus DNA. Subsequent DNA analyses of 3 genomic regions of LCV identified isolates associated with lesions in 19/25 (76%) biopsies and 19/57 (33%) cytology samples. Variable immunolabeling for proteins related to the human LCV Epstein Barr Virus was observed within intralesional plasma cells, stromal cells, and epithelial cells. Further work is needed to characterize the epidemiologic features of these lesions and their association with LCV infection in Mauritian-origin macaques.
Elkins, Gary R; Ramsey, Derek; Yu, Yimin
Persistent genital arousal disorder (PGAD) is characterized by intrusive sexual arousal that is unresolvable via sexual activity and persists for an extended period of time. PGAD's etiology is unknown, and it has no established treatments. This case study reports on a 71-year-old female patient diagnosed with PGAD who received 9 sessions of hypnotherapy. The following measures were administered at baseline and follow-up: Hospital Anxiety and Depression Scale, Center for Epidemiologic Studies Depression Scale, Pittsburgh Sleep Quality Index, and visual analogue measurements of quality of life, intensity of symptoms, and marital interference. At follow-up, there were significant improvements in all measures. Given the currently limited alternatives for treatment, this case study suggests that hypnotherapy may be beneficial for some patients with PGAD.
Apers, Ludwig; Colebunders, Robert
A recent analysis of Egypt's first nationally representative survey of hepatitis C virus (HCV) infection found female genital cutting (FGC) to be an independent risk factor for HCV infection for women in urban areas. We use the same dataset to extend this analysis. In an ecological analysis, we find a strong association between FGC and HCV prevalence (Pearson R 2—74%; P < 0.0001). HCV prevalence is significantly higher if FGC is performed by a non-Doctor (15.4%) than a Doctor (4.2%; P < 0.001), and the calculated population attributable fraction of FGC for prevalent HCV seropositivity is high in women (79.8%). PMID:27335830
Akinsulure-Smith, Adeyinka M.
Although many African women immigrate to the United States from countries with high prevalence rates for Female Genital Cutting (FGC), there has been limited research exploring the incidence and impact of FGC among this growing immigrant population. This pilot study sought to examine the experiences of FGC among West African immigrant women in the US. Of the 23 participants, 7 reported a history of FGC, with Muslim participants reporting significantly higher rates of FGC than Christians (Fisher’s Exact=.045). Most of the women who had experienced FGC were from Sierra Leone (Fisher’s Exact=.027). Limitations of the study are discussed along with suggestions for future research aimed at understanding the impact of FGC, reducing the prevalence and demand for FGC among African immigrant women and improving the health and quality of life of women who have undergone the procedure. PMID:23264203
Surico, D; Amadori, R; Gastaldo, L B; Tinelli, R; Surico, N
This study aims to evaluate the knowledge of female genital cutting (FGC) in a tertiary teaching hospital in Italy. A survey questionnaire on FGC was given to paediatricians, nurses, midwives, gynaecologists and residents in paediatrics and gynaecology in a tertiary teaching hospital in Italy. The results of the survey were then analysed. The results showed that 71.5% (73/102) of healthcare professionals dealt with patients presenting with FGC. Gynaecologists (83%) and paediatric nurses (75%) were the only ones who declared to be aware of Italian law on FGC. In detail, 55% of midwives, 50% of paediatricians, 50% of paediatrician residents and 28.5% of gynaecological residents were aware of this law. The general knowledge of Italian National Guidelines on FGC is even worse: most professionals are not aware of protocols of action. Considering the increasing extension of FGC due to immigration, improvement of care through specialised education of healthcare providers is mandatory.
Akinsulure-Smith, Adeyinka M; Chu, Tracy
Though the practice of female genital cutting (FGC) has been framed as a form of gender-based torture, few studies have examined the prevalence and impact of the practice among documented survivors of torture. This article presents a secondary analysis of data from 514 African-born women at an interdisciplinary clinic for survivors of torture. Results indicate few demographic differences between those who experienced FGC and those who had not, though a larger proportion of the FGC group were West African and identified as Muslim. Many with FGC were in the process of applying for asylum, reported sexual and psychological torture, and cited gender as a basis for their persecution. The FGC group evidenced unique correlates related to immigration status and psychological and sexual torture experiences that the non-FGC group did not. Findings indicate that female survivors of torture with FGC represent a distinct group with specific mental health needs.
Akinsulure-Smith, Adeyinka M
Although many African women immigrate to the United States from countries with high prevalence rates for female genital cutting (FGC), there has been limited research exploring the incidence and impact of FGC among this growing immigrant population. This pilot study sought to examine the experiences of FGC among West African immigrant women in the US. Of the 23 participants, 7 reported a history of FGC, with Muslim participants reporting significantly higher rates of FGC than Christians (Fisher's Exact = .045). Most of the women who had experienced FGC were from Sierra Leone (Fisher's Exact = .027). Limitations of the study are discussed along with suggestions for future research aimed at understanding the impact of FGC, reducing the prevalence and demand for FGC among African immigrant women and improving the health and quality of life of women who have undergone the procedure.
Kandala, Ngianga-Bakwin; Nwakeze, Ngozi; Kandala, Shadrack Ngianga I I
The harmful effects of female genital mutilation (FGM) on women are recognized worldwide. Although it is practiced by persons of all socioeconomic backgrounds, there are differences within countries and between communities. The aim of this study was to use the 2003 Nigeria Demographic and Health Survey data to determine the spatial distribution of the prevalence of FGM and associated risk factors. Data were available for 7,620 women; 1,673 (22.0%) interviewed had had FGM and 2,168 women had living children, of whom 485 (22.4%) daughters had undergone FGM. Unmarried women were more likely to report a lower prevalence of FGM. Modernization (education and high socioeconomic status) had minimal impact on the likelihood of FGM, but education plays an important role in the mother's decision not to circumcise her daughter. It follows from these findings that community factors have a large effect on FGM, with individual factors having little effect on the distribution of FGM.
Maganhin, Carla C; Carbonel, Adriana Aparecida Ferraz; Hatty, Juliana Halley; Fuchs, Luiz Fernando Portugal; Oliveira-Júnior, Itamar Souza de; Simões, Manuel de Jesus; Simões, Ricardo S; Baracat, Edmund C; Soares-Jr, José Maria
Melatonin is secreted by the pineal gland and this is linked to the day/night cycle. It is an antioxidant and plays a fundamental role in the regulation of the jet-lag stage, in several physiological reactions and in control of the biologic rhythm. Human melatonin has an important influence on the female genital system. In fact, melatonin may influence production and action of steroids, modifying cellular signalization on the target tissue. There are many evidences that the melatonin therapy may be interfering with neoplasia development, mainly of the estrogen-dependent tumor. This paper aims to analyze the actions of melatonin on the neuroendocrine, immunological and cardiovascular systems, as well as on the reproductive function.
Kisu, Iori; Tanaka, Kyoko; Banno, Kouji; Okuda, Shigeo; Aoki, Daisuke
Congenital uterine anomaly is a female genital disorder caused by developmental anomaly of the Müllerian ducts. In this report, we present a case of repair of congenital 'disconnected uterus' between the cervix and the body of the uterus. The case did not correspond to the consensus classifications that have been proposed for congenital uterine anomaly. The patient was a young woman whose chief complaints were not having first menstruation and experiencing monthly severe lower abdominal pain. Magnetic resonance imaging showed that the uterine body was separated from the uterine cervix. Uteroplasty was conducted to anastomose the separated uterus. Periodic menstruation started 1 month after surgery and abdominal pain was improved. Performance of uteroplasty in this case was extremely significant and greatly improved the quality of life of the patient.
Hammarlund, Kina; Nystrom, Maria
Our aim in this study was to analyze and describe young Swedish women's experiences of living with genital warts. Interviews with 10 young women, aged 16-21 years, were interpreted within a lifeworld hermeneutic tradition. The women experience themselves as victims of a disgusting disease. Furthermore, they appear to disregard the fact that their own lifestyles could be a risk factor for contracting venereal infections. On the other hand they get to know their bodies better after the gynecological examinations where the treatment begins. Their loss of innocence is considerable; thus it seems fair to compare this experience with earlier epochs' ideas about loss of virginity due to the first intercourse. Consequently the young women also start looking at themselves as adults, and they take responsibility for the consequences of their sexuality.
Aslam, Mubeen; Kropp, Rhonda Y; Jayaraman, Gayatri; Dinner, Katherine; Wong, Thomas; Steben, Marc
Genital herpes (GH) is the most common cause of genital ulceration, but is not reportable in Canada. Research in the United States has found that less than 10% of seropositive persons reported a diagnosis of GH. The present article investigates the rates of diagnosed cases of GH in Canada from 2002 to 2007. Primary case diagnosis data on GH for the period between 2002 and 2007 were obtained from the Canadian Disease and Therapeutic Index, a proprietary database maintained by Intercontinental Medical Statistics (IMS) Health Canada. Of the 45,000 to 49,000 office-based physicians in Canada, IMS Health collected diagnosis-specific prescription diaries from a sample of 652, stratified according to geographic region and representing all major specialties, during this period. Between 2002 and 2007, there were approximately 84,398 to 122,456 medically attended GH cases annually in Canada. Approximately 74% to 93% of these diagnosed cases made one physician visit per year. The annual rate of medically attended GH cases ranged from 261.2 per 100,000 population to 386.6 per 100,000 population. The present report is the first time that administrative data have been used to estimate the annual rate of medically attended GH cases in Canada. The data include both incident and prevalent cases and are likely an underestimate of the actual number of cases because they only represent diagnosed cases presenting for medical care. Further seroepidemiological and clinical research studies would be helpful to assess the burden of infection and to plan appropriate diagnostic, treatment and preventive counselling services. Genital herpes (GH) is the most common cause of genital ulceration, but is not reportable in Canada. Research in the United States has found that less than 10% of seropositive persons reported a diagnosis of GH. The present article investigates the rates of diagnosed cases of GH in Canada from 2002 to 2007. Primary case diagnosis data on GH for the period between 2002
Franco-Sansaloni, A; Vizcaíno-Torres, J; Gaona-Morales, J; Estellés-Morant, D; Antonio-Serrano, J
In the last years has been an increase in cases of tu- berculosis, representing a global health problem that is also reflected in an increased of cases in pregnant population. Especially in developed countries has been observed a direct relation with VIH patients,and groups of immigrants from countries where the infection is endemic. Tuberculous disease during pregnancy presents good outcome if it is diagnosed and treated properly. We present the case of a romanian patient with uncon- trolled 23 weeks gestation that enters with the suspicion of chorioam- nionitis and after late septic miscarriage and clinical sepsis criteria, leaks out of the hospital reentering with signs of neurologic involvement and pelviperitonitis as a result of genital tuberculous. Diagnosed with tuber- culous meningitis and disseminated with a grim evolution until death.
Feigenbaum, Frank; Boone, Kaitlynn
To evaluate whether treatment of spinal meningeal cysts that compress sacral spinal nerve roots is associated with relief of persistent genital arousal disorder. In this case series we encountered a group of patients with persistent genital arousal disorder among a larger cohort undergoing a prospective outcomes study on the surgical treatment of symptomatic spinal meningeal cysts. Epidemiologic data were collected and the type, number, and location of the meningeal cysts in each patient were determined on magnetic resonance imaging. Postoperatively patients were asked to self-report whether their persistent genital arousal disorder was eliminated, significantly better, the same, or worse. In a cohort of 1,045 patients with symptomatic spinal meningeal cysts, we identified 11 with persistent genital arousal disorder; all were female and all had meningeal cysts in the sacral spinal canal causing sacral nerve root compression. In addition to persistent genital arousal disorder, all patients had other symptoms typical of sacral nerve root compression such as perineal, bladder, and bowel symptoms. Although multiple types of meningeal cysts were encountered, Tarlov cysts were the most common (8/11). Postoperatively, seven (64%) patients reported elimination of their persistent genital arousal disorder, three (27%) noted significant improvement, one (9%) said they were unchanged, and none experienced worsening with an average follow-up of 23 months ranging from 2 months to 6 years. Although Tarlov cysts were more numerous, the presence of persistent genital arousal disorder and the surgical outcomes appeared unrelated to the type of spinal meningeal cyst treated. Our case series suggests that sacral nerve root compression caused by spinal meningeal cysts can cause persistent genital arousal disorder. The presence of nerve root compression appears to be more important than the particular type of meningeal cyst involved. Microsurgical cyst treatment cured or significantly
Goodman, Michael P; Placik, Otto J; Matlock, David L; Simopoulos, Alex F; Dalton, Teresa A; Veale, David; Hardwick-Smith, Susan
Little prospective data exists regarding the procedures constituting female genital plastic/cosmetic surgery (FGPS). To evaluate whether the procedures of labiaplasty and vaginoperineoplasty improve genital self image, and evaluate effects on sexual satisfaction. Prospective cohort case-controlled study of 120 subjects evaluated at baseline, 6, 12, and 24 months postoperative, paired with a demographically similar control group. Interventions include labiaplasty, clitoral hood reduction, and/or aesthetic vaginal tightening, defined as perineoplasty + "vaginoplasty" (aka "vaginal rejuvenation."). Outcome measures include body image, genital self-image, sexual satisfaction, and body esteem. As a group, study patients tested at baseline showing body dissatisfaction, negative genital self-image, and poorer indices of sexual satisfaction. Preoperative body image of study patients were in a range considered to be mild to moderately dysmorphic, but matched controls at one and two years; genital self-image scores at entry were considerably lower than controls, but by 2-year follow-up had surpassed control value at entry. Similarly, sexual satisfaction values, significantly lower at entry, equaled at one, and surpassed control values, at 2 years. Postoperatively, at all points in time, these differences in body image and genital self-image disappeared, and sexual satisfaction markedly improved. Overall body esteem did not differ between study and control groups, with the exception of the genital esteem quotient, which improved after surgery. Women requesting and completing FGPS, when tested by validated instruments, at entry report sexual dissatisfaction and negative genital self-image. When tested at several points in time after surgery up to two years, these findings were no longer present. When performed by an experienced surgeon, FGPS appears to provide sexual and genital self-image improvement. 2 Therapeutic. © 2016 The American Society for Aesthetic Plastic Surgery
Darville, Toni; Hiltke, Thomas J
Although the pathologic consequences of C. trachomatis genital infection are well-established, the mechanism(s)that result in chlamydia-induced tissue damage are not fully understood. We reviewed in vitro, animal, and human data related to the pathogenesis of chlamydial disease to better understand how reproductive sequelae result from C. trachomatis infection. Abundant in vitro data suggest that the inflammatory response to chlamydiae is initiated and sustained by actively infected nonimmune host epithelial cells. The mouse model indicates a critical role for chlamydia activation of the innate immune receptor, Toll-like receptor 2, and subsequent inflammatory cell influx and activation, which contributes to the development of chronic genital tract tissue damage. Data from recent vaccine studies in the murine model and from human immunoepidemiologic studies support a role for chlamydia-specific CD4 Th1-interferon-g-producing cells in protection from infection and disease. However, limited evidence obtained using animal models of repeated infection indicates that, although the adaptive T cell response is a key mechanism involved in controlling or eliminating infection, it may have a double-edged nature and contribute to tissue damage. Important immunologic questions include whether anamnestic CD4 T cell responses drive disease rather than protect against disease and the role of specific immune cells and inflammatory mediators in the induction of tissue damage with primary and repeated infections. Continued study of the complex molecular and cellular interactions between chlamydiae and their host and large-scale prospective immunoepidemiologic and immunopathologic studies are needed to address gaps in our understanding of pathogenesis that thwart development of optimally effective control programs, including vaccine development.
Bowden, F J; Mein, J; Plunkett, C; Bastian, I
OBJECTIVES: To determine the effectiveness of azithromycin, an azalide antibiotic with long tissue half-life, in a pilot study of patients with genital donovanosis in the Northern Territory, Australia. DESIGN: Patients with histologically confirmed donovanosis were randomised to receive one of two open-label azithromycin dosage regimens: Regimen A--1.0 g once weekly for 4 weeks; or Regimen B--500 mg daily for 7 days. Patients were assessed at 6 weeks and classified as either "cured", "improved" or "failed". RESULTS: Seven patients received regimen A and 4 received regimen B. Six weeks after commencing treatment the genital ulcers of four patients receiving regimen A and one patient receiving regimen B had healed; the lesions of the other six patients (3 in each regimen) were "improved". No patient failed to respond and no significant adverse reaction was recognised. The eleven patients were reviewed after completing the six-week trial; all lesions had re-epithelialised without further antibiotic treatment, no relapses had occurred, the longest follow-up period being seven months. A further 17 patients with donovanosis who were unable to meet the entry criteria were also treated successfully with azithromycin during the study period. CONCLUSIONS: This is the first time that azithromycin has been shown to have clinical activity against donovanosis. Poor compliance with prolonged courses of antibiotics is one of the major barriers to control of the disease. Intermittent or short-course therapy, made possible by the long tissue half-life of the drug, could facilitate control of donovanosis in endemic populations if the high cost of medication can be addressed. PMID:8655160
Little, Cindy M
Female genital cutting/mutilation (FGC/M) is a procedure that involves physically altering a woman's/girl's genitals for no health benefits. This is a practice that is deeply rooted in culture, religion, and social tradition primarily in some African and Middle East countries. It is performed by a midwife, barber, traditional healer with no surgical training, or a physician. The practice of FGC/M has been gaining increased attention as women from those countries have been migrating to the United States and Western Europe. The World Health Organization (WHO) has estimated that 125 million women worldwide have undergone FGC/M. The practice has serious short-term and long-term physical, obstetric, and psychological complications. It has been proposed by some healthcare professionals that physicians or other healthcare providers should perform the cutting because it would be done under more sanitary conditions that would reduce complications. However, the WHO and other organizations have condemned the practice by any medical professional. The FGC/M procedure is a human rights violation and has been banned by WHO and other organizations and governments. This article provides an overview of the current issues related to FGC/M and addresses important cultural considerations for nurses caring for women with FGC/M. Nurses are in a unique position to provide holistic, culturally competent care in a respectful, nonjudgmental atmosphere. Nurses have a role in educating women with FGC/M about the complications and care, as education is necessary in the challenge to eradicate the practice of FGC/M.
Rosenblatt, Karin A.; Weiss, Noel S.; Cushing-Haugen, Kara L.; Wicklund, Kristine G.; Rossing, Mary Anne
Background We conducted a population-based, case–control study to examine the association between the use of genital powder and ovarian cancer risk, including measures of extent and timing of exposure. We also assessed the relationship of powder use with risk of disease subtypes according to histology and degree of malignancy. Methods Information was collected during in-person interviews with 812 women with epithelial ovarian cancer diagnosed in western Washington State from 2002 to 2005 and 1,313 controls. Logistic regression was used to calculate odds ratios (ORs) and 95% confidence intervals (CIs). Results Overall, the perineal use of powder after bathing was associated with a slightly increased ovarian cancer risk (OR = 1.27, 95% CI: 0.97–1.66), which was most evident among women with borderline tumors (OR = 1.55, 95% CI: 1.02–2.37). We noted no clear pattern of risk increase on the basis of the extent of use, assessed as years in which powder was used, or as lifetime number of applications for invasive or borderline tumors, or their histologic subtypes. There was no alteration in the risk of ovarian cancer associated with other types of powder exposure (e.g., on sanitary napkins or diaphragms). Conclusions The International Agency for Research on Cancer has designated perineal exposure to talc (via the application of genital powders) as a possible carcinogen in women. A modest association of ovarian cancer with this exposure was seen in our study and in some previous ones, but that association generally has not been consistent within or among studies. Therefore, no stronger adjective than “possible” appears warranted at this time. PMID:21516319
Naz, Rajesh K
The population explosion and unintended pregnancies, sexually transmitted diseases including human immunodeficiency virus, and cervical cancer, are major challenges to health worldwide. Their prevention might be achieved through vaccination-based approaches to activate specific immunity against pathogen- or fertility-associated antigens in the female genital tract (FGT). This article aims to review methodologies for enhancing adaptive immunity in the FGT to maximize the response to vaccination. Most components of the adaptive and innate mucosal immune system are present in the FGT and several features are common with the nasopharynx/bronchial and gastrointestinal tracts. In contrast to other mucosal sites, the FGT has minimal local lymphoid tissue. Other sites primarily produce IgA and IgM while in the FGT, especially the vaginocervix, IgG is the predominant immunoglobulin secreted. In rodents, data exist to substantiate a common mucosal immune system interconnecting the nasal/bronchial, gastrointestinal, and female genital tracts. The intranasal route seems the most efficacious to induce an immunity in the FGT especially when combined with a systemic or parenteral route. In humans, for induction of secretory IgA and IgG antibodies in the FGT, immunization by the nasal or the vaginal route is effective. In vaginal immunization, a strong and consistent antibody response is best achieved following vaccination during the follicular phase of the menstrual cycle. Antibodies administered systemically percolate into the FGT and can provide immunoprotection against target molecules or cells. Thus, as well as active immunization using selected routes, the passive immunization approach may provide a viable alternative to vaccinology for future development. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.
Cerbini, S; Greco, M; Lalli, P; Santucci, A; Pitzurra, M
Vaginal living organisms have been defined as the most complete in human ecology. As many as 100 million colonies of microorganisms can live in a single ml of vaginal liquid. More common are the anaerobic types, particularly the lactobacillus and bacteroides. The low pH of the vagina, normally 4, is due to the high lactic acid content of the lactobacillus. Pathogenic bacteria is inhibited at 4.5 pH. Conversely, it proliferates at a high pH. The slightest alteration of this delicate equilibrium allows potentially pathogenic bacteria to grow to a concentration high enough to produce symptoms. Researchers have sought to identify new pathological microorganisms, due to the increase in reported cases of vaginal infection in recent years. New strains such as microplasmas and chlamydia are assuming greater importance. Evidence of the numerous vaginal microbes comes from anamnestic, symptomatological data and from simple laboratory tests conducted in gynecological clinics with microscopes and Gram coloration. 663 women were examined in 6 laboratories. The computerized data revealed that only 29, or 4.37%, showed no symptoms at all and had gone to the lab for a mere check up; 175, or 26.40%, complained of pain, burning and itching; 361, or 54.45%, revealed symptoms associated with leukorrhea; 98, or 14.78%, showed only leukorrhea. The epidemiological study shows the importance of candida albicans in the infectious pathology of the female genital organ. Trichomonas vaginalis and grambacteria infection have been detected particularly when an IUD is used. The negative result of numerous bacterioscopic exams has shown the necessity of more in-depth study of genital infections, using analytical cultural methodology.
Soleilhavoup, Clement; Riou, Cindy; Tsikis, Guillaume; Labas, Valerie; Harichaux, Gregoire; Kohnke, Philippa; Reynaud, Karine; de Graaf, Simon P.; Gerard, Nadine; Druart, Xavier
The female genital tract includes several anatomical regions whose luminal fluids successively interact with gametes and embryos and are involved in the fertilisation and development processes. The luminal fluids from the inner cervix, the uterus and the oviduct were collected along the oestrous cycle at oestrus (Day 0 of the cycle) and during the luteal phase (Day 10) from adult cyclic ewes. The proteomes were assessed by GeLC-MS/MS and quantified by spectral counting. A set of 940 proteins were identified including 291 proteins differentially present along the cycle in one or several regions. The global analysis of the fluid proteomes revealed a general pattern of endocrine regulation of the tract, with the cervix and the oviduct showing an increased differential proteins abundance mainly at oestrus while the uterus showed an increased abundance mainly during the luteal phase. The proteins more abundant at oestrus included several families such as the heat shock proteins (HSP), the mucins, the complement cascade proteins and several redox enzymes. Other proteins known for their interaction with gametes such as oviductin (OVGP), osteopontin, HSPA8, and the spermadhesin AWN were also overexpressed at oestrus. The proteins more abundant during the luteal phase were associated with the immune system such as ceruloplasmin, lactoferrin, DMBT1, or PIGR, and also with tissue remodeling such as galectin 3 binding protein, alkaline phosphatase, CD9, or fibulin. Several proteins differentially abundant between estrus and the luteal phase, such as myosin 9 and fibronectin, were also validated by immunohistochemistry. The potential roles in sperm transit and uterine receptivity of the proteins differentially regulated along the cycle in the female genital tract are discussed. PMID:26518761
Ness, R B; Soper, D E; Holley, R L; Peipert, J; Randall, H; Sweet, R L; Sondheimer, S J; Hendrix, S L; Amortegui, A; Trucco, G; Bass, D C; Kelsey, S F
Among women diagnosed with pelvic inflammatory disease, we examined the associations between hormonal or barrier methods of contraception and upper genital tract infection or inflammation. Participants were 563 patients from a treatment trial for pelvic inflammatory disease. All had pelvic pain; pelvic organ tenderness; and leukorrhea, mucopurulent cervicitis, or untreated cervicitis. Contraceptive use within the prior 4 weeks was compared among women with baseline upper genital tract gonorrhea or chlamydia, women with endometritis without upper genital tract gonorrhea or chlamydia, and women with neither upper genital tract gonorrhea or chlamydia nor endometritis. Inconsistent condom use was significantly and independently associated with a 2 to 3 times elevated risk for upper genital tract infection. Upper genital tract gonorrhea or chlamydia was not significantly associated with use of oral contraceptives, use of medroxyprogesterone, condoms used consistently, nor other barrier methods. No hormonal or barrier contraceptive method was related to a reduction in upper genital tract disease among women with clinical pelvic inflammatory diseases.
Gupta, Vishal; Khute, Prakash; Patel, Anjali; Gupta, Somesh
Although atypical presentations of herpetic infection in immunocompetent individuals are common, they very rarely have the extensive, chronic and verrucous appearances seen in the immunocompromised host. We report a case of genital herpes manifesting as painless chronic non-healing genital ulcers with exuberant granulation tissue in an immunocompetent man. Owing to this morphology, the ulcers were initially mistaken for donovanosis. To the best of our knowledge, such a presentation of genital herpes in an immunocompetent individual has not been described previously. © The Author(s) 2015.
Suligoi, Barbara; Salfa, Maria Cristina; Mariani, Luciano
Overview of the impact of ano-genital warts in Italy. In Italy, the HPV infection is not subject to mandatory reporting, the available epidemiological data come from sentinel surveillance of STIs and show a high spread among young people under 25 years and an increase in reports after 2004. Although ano-genital warts are a benign disease, nonetheless they are characterized by a big relational and psycho-sexual impact, due also to high recurrence rates. It is extremely useful to promote information activities, education in safe sex, early diagnosis and treatment of genital warts. In this context, primary prevention through vaccination represents a valid tool of protection.
Sala, R; Manara, D
In this article we focus on female genital mutilation. We analyse this problem as one of the most important issues of multiculturalism, which is also coming to the attention of the public in Italy as a consequence of the growing number of immigrants from African countries. The fundamental problem is about the acceptability of this practice: can female genital mutilation be permitted and, if so, on what basis? We will try to cope with this as a genuine conflict between culture-relative values and universal values, such as human rights. Some attention will be drawn to Italian law. Finally, the impact on nurses of requests for genital mutilation will be described.
Liu, Bao-ying; Li, Yan; Zheng, Lei; Zhong, Mei; Yu, Yan-hong; Xiong, Meng-zhou
To establish an early diagnostic method for detecting female genital tuberculosis. Eighty-six women with genital tuberculosis during January 2005-September 2007 were examined by phage amplified biological assay, and the results were compared with those from leucorrhea culture, smear and PCR. Forty-five patients were tuberculosis positive with 100% of specificity identified by phage amplified biological assay. Twenty patients were tuberculosis positive by PCR. Five patients were culture-positive tuberculosis and no case had smear-positive tuberculosis. Phage amplified biologically assay is sensitive and specific, which could be used for the early diagnosis of female genital tuberculosis.
Okuzaki, Y; Sota, T
To identify factors leading to the correlated evolution of exaggerated male and female genitalia, we studied the effects of the variable dimensions of corresponding functional genital parts (male copulatory piece and female vaginal appendix) on copulatory performance in the polygamous carabid beetle Carabus (Ohomopterus) maiyasanus. We used mating pairs of individuals from two populations to increase the variances in genital dimensions and determined the copulation performance (insemination and spermatophore replacement, and copulation time) in single- and double-mating situations. In single mating, insemination success was not affected by genital dimensions, although the copulation time was significantly shorter when the male aedeagus was longer. In the double-mating experiment, insemination and replacement of spermatophores by the second male succeeded more frequently when the copulatory piece was shorter and the vaginal appendix was longer, and when the difference between the length of the copulatory piece and the vaginal appendix was smaller. Thus, a matching of the corresponding genital parts between the sexes increases the male's reproductive success in sperm competition, but elongation of the copulatory piece cannot be explained simply by the improvement in male reproductive success. We discuss possible factors for the elongation of genital parts in terms of sexual conflict and reproductive interference through interspecific copulation.
Beutner, K R; Reitano, M V; Richwald, G A; Wiley, D J
A consensus process was undertaken to describe and evaluate current information and practice regarding the diagnosis, treatment, and evaluation of patients with external genital warts (EGWs) and their sex partners. This process developed a number of key statements that were based on strong evidence in the literature or reasonable suppositions and opinions of experts. Key statements included the following. In most cases, EGWs can be diagnosed clinically by visual inspection. No one treatment is ideal for all patients or all warts. Women with EGWs and female sex partners of men with EGWs are at increased risk for human papillomavirus-related cervical disease and, like all women, should be screened for cervical cancer. The diagnosis of EGWs in children requires a sexual abuse evaluation. Clinicians who treat EGWs have a responsibility to counsel patients and to provide information about the infectivity, diagnosis, treatment, and natural history of EGWs and general information about sexual health and other sexually transmitted diseases.
Four individuals from three generations of a family had the Hand-Foot-Genital (Hand-Foot-Uterus) syndrome. Affected females had urologic abnormalities confirming that the latter are part of the syndrome.
Alcón Belchí, Carolina; Jiménez Ruiz, Ismael; Pastor Bravo, María del Mar; Almansa Martínez, Pilar
Create and implement a protocol for identifying and preventing female genital mutilation in a municipality of the Region of Murcia. A bibliographical review and significant databases were consulted for the creation of the algorithm performance. These include Cuiden, Dialnet, Medes, Medline, and other documentary sources of interest. The instrument for data collection was completed by interviewing parents of girls at risk. The multi-disciplinary team was formed; the female genital mutilation risk cases were collected, and were summoned to the nursing consulting room. Two girls had been mutilated, the rest were at risk of female genital mutilation, and in one case the risk was imminent. The algorithm designed guides practitioners in their performance, achieving an effective detection and prevention of genital mutilation of girls. This is a first approach to the development of a regional protocol. Copyright © 2015 Elsevier España, S.L.U. All rights reserved.
Usoro, Agnes; Batts, Alfreda; Sarria, Juan C
Few case reports have documented the use of topical cidofovir for refractory genital herpes simplex virus (HSV) ulcers in human immunodeficiency virus (HIV) infected patients. This drug formulation lacks a standardized concentration or even a procedural outline as to how it should be compounded. We aim to discuss the utilization of topical cidofovir in addition to presenting a procedural means of compounding it for treatment of refractory genital HSV ulcers. Our patient completed 21 days of intravenous foscarnet and 13 days of topical cidofovir with clinical improvement in the penile and scrotal ulcers. Genital herpes is a concern in patients with HIV because it generally manifests as a persistent infection. Physicians should be aware that when patients fail to respond to the conventional treatment regimens for genital HSV in a timely manner, other options are available, such as topical cidofovir as an adjuvant to systemic antivirals.
Narumi, Yoko; Kosho, Tomoki; Tsuruta, Goro; Shiohara, Masaaki; Shimazaki, Ei; Mori, Tetsuo; Shimizu, Ayako; Igawa, Yasuhiko; Nishizawa, Shuji; Takagi, Kimiyo; Kawamura, Rie; Wakui, Keiko; Fukushima, Yoshimitsu
We describe two patients with Pallister-Hall syndrome (PHS) with genital abnormalities: a female with hydrometrocolpos secondary to vaginal atresia and a male with micropenis, hypoplastic scrotum, and bilateral cryptorchidism. Nonsense mutations in GLI3 were identified in both patients. Clinical and molecular findings of 12 previously reported patients who had GLI3 mutations and genital abnormalities were reviewed. Genital features in the male patients included hypospadias, micropenis, and bifid or hypoplastic scrotum, whereas all the females had hydrometrocolpos and/or vaginal atresia. No hotspot for GLI3 mutations has been found. The urogenital and anorectal abnormalities associated with PHS might be related to dysregulation of SHH signaling caused by GLI3 mutations rather than hormonal aberrations. We recommend that clinical investigations of genital abnormalities are considered in patients with PHS, even those without hypopituitarism. © 2010 Wiley-Liss, Inc.
51 women with urinary schistosomiasis underwent gynecological examinations, including colposcopy and photographic documentation of lesions, in a study conducted in 1994 at Mangochi Hospital near Lake Malawi. Microscopy of genital biopsies determined that 33 women had S. haematobium eggs in their cervix, vagina, and/or vulva. A significant correlation was identified between the size of genital lesion and the number of ova counted. Women with genital pathology had significantly more tumors in the vulva than women with schistosomiasis of the urinary tract only. Most of the observed pathology could be seen with the unaided eye. Even though the sample was very small, significantly more cases of genital schistosomiasis were found in women who had fewer children than desired and whose husbands had children with other women. Reasons for that observation were not investigated. The findings of this pilot study indicate that more research is needed to provide a better understanding of the implications of the disease upon marital and sexual lives.
McDougall, Lindy Joan
In the West, a specific ideal has emerged for female genitalia. The ideal is one of absence, a clean slit that can be attained through the removal of pubic hair and, increasingly, through female genital cosmetic surgery. This ideal is largely created in the media, which generates contradictory messages for women. The popular press, backed by medical opinion, explicitly acknowledges that a wide range of variation is normal--female genitals vary in appearance 'about as much as snowflakes'--but by showing only altered minimalist clean slits, it carries an implicit message that women should be worried if their genitals do not match up to this exacting ideal. Consequently, some women feel their genitals are not satisfactory and choose surgery. Using biomedicine to fix normal body parts in order to fashion desirable femininity, releases medicine from its rigid scientific underpinnings exposing it as an increasingly cultural and commercial pursuit.
Ljubin-Sternak, Sunčanica; Meštrović, Tomislav
The most prevalent, curable sexually important diseases are those caused by Chlamydia trachomatis (C. trachomatis) and genital mycoplasmas. An important characteristic of these infections is their ability to cause long-term sequels in upper genital tract, thus potentially affecting the reproductive health in both sexes. Pelvic inflammatory disease (PID), tubal factor infertility (TFI), and ectopic pregnancy (EP) are well documented complications of C. trachomatis infection in women. The role of genital mycoplasmas in development of PID, TFI, and EP requires further evaluation, but growing evidence supports a significant role for these in the pathogenesis of chorioamnionitis, premature membrane rupture, and preterm labor in pregnant woman. Both C. trachomatis and genital mycoplasmas can affect the quality of sperm and possibly influence the fertility of men. For the purpose of this paper, basic, epidemiologic, clinical, therapeutic, and public health issue of these infections were reviewed and discussed, focusing on their impact on human reproductive health. PMID:25614838
Farage, Miranda A; Miller, Kenneth W; Tzeghai, Ghebre E; Azuka, Charles E; Sobel, Jack D; Ledger, William J
Female genital cutting affects over 140 million women worldwide. Prevalent in certain countries of Africa and the Middle East, the practice continues among immigrants to industrialized countries. Female genital cutting is a deeply rooted tradition that confers honor on a woman and her family, yet also a traumatic experience that creates significant dermatological, gynecological, obstetric and infectious disease complications. Little is known about postmenopausal health in cut women. The international community views this practice as a human rights violation. In addition to genital health complications, the medical community must confront an understudied concern of what happens as this population ages. These challenges must be addressed to provide optimal care to women affected by female genital cutting.
Lortkipanidze, G G; Vashakidze, L M; Mamaladze, T T; Gudzhabidze, N B
Diagnostics of genital TB among women is a serious challenge because of the absence of specific clinical manifestation and difficulty to obtain material for bacteriological verification of the pathogen. All the cases with ascites and masses in pelvic cavity must undergo thorough testing to exclude tuberculosis. The present article describes 14 suspect cases of genital TB, where along with the mandatory clinical diagnostic studies (including PCR of ascites and bacteriological testing for TB, also on carcinoma of CA-125 ovary) they have conducted laparoscopy, with further cytological and bacteriological testing of bioptic sample. This method allowed us to diagnose genital and abdominal tuberculosis among women in 85,7% of cases through cytologic and histologic testing and to exclude ovarian carcinoma. Effectiveness of laparoscopy has been confirmed in diagnostics of genital and abdominal TB.
Dou, Na; Li, Weiping; Zhao, Enfeng; Wang, Chan; Xiao, Zhaozhao; Zhou, Honghui
To investigate the risk factors associated with candida infection of the genital tract in the tropics. We performed questionnaire survey and experiments at the Hainan branch of General Hospital of People's Liberation Army, Hainan General Hospital and Sanya Maternity and Child Health Care Hospital in 2013. Controls were without Candida infection of genital tract, and cases had from Candida infection. We recruited 689 cases and 652 controls. The average age of cases with Candida infection of the genital tract was higher than that of controls. In the multivariate modeling, marriage (adjusted odds ratio: 2.49, 95% confidential interval: 1.09-5.67) and vaginal lavage (adjusted odds ratio: 4.41, 95% confidential interval: 1.13-5.14) were significantly associated with Candida infection of genital tract in tropics. Candida infection was related with age. Marriage and Vaginal lavage were significant risk factors. Attention should be paid to health education for the prevention of these infections.
Martinez-Díaz, Frances A
Genital aphthous ulcers can result from multiple conditions including febrile syndromes. Chikungunya infection manifests mainly as fever accompanied by polyarthralgia and pruritic rash. Nevertheless, healthcare providers should be alert to additional presentations. This is the case of a young woman presenting with painful genital ulcers after a three day prodome of fever and polyarthralgia. As a suspected case of Chikungunya infection and a clinical diagnosis of aphthae, treatment with oral prednisone for two weeks produced complete resolution of ulcers with no scarring. It is important to recognize that genital aphthous ulcers can develop in a febrile presentation such as that with Chikungunya. Although sexually transmitted diseases should be ruled out as a more common diagnosis in cases of genital lesions, knowledge about this unusual dermatological presentation would represent not only adequate prompt treatment but will minimize equivocal diagnosis as a sexually transmitted disease.
Wilkinson, S M
Rather than focus on the girl's phallic identification as a compensatory reaction to her femininity, I offer a conceptual framework through which to examine how the girl symbolically masters and elaborates her biologically unfolding sexuality. Presumably, because her genital inner space can be defined and filled only through the playful retention and expulsion of an external object, the girl's phallic identification paradoxically affords her the first experience of her genital femininity. Borne out of her genital stimulation at the oedipal threshold, the genital dress-rehearsal turns on outside gestures becoming registered as sensations inside her body. As a result of her dual experience, the girl is both phallic and vaginal, giver and receiver, father and mother. Through the magic of play, the girl renegotiates her oath of fidelity to her internal, pre-oedipal mother, while laying claim to the kind of sexual vibrancy that her external, oedipal mother shares with her oedipal father.
Pelletier, Fabien; Aubin, François; Puzenat, Eve; Deprez, Philippe; Blanc, Dominique; Estavoyer, Jean-Marie; Humbert, Philippe
In 1913, a distinctive clinical entity of acute genital ulcer occurring in an adolescent girl with a non-venereal infectious aetiology was described by Lipschütz. Since the initial description, several aetiologies have been discussed, and among them, paratyphoid fever is very uncommon. After her return from a trip, a 25-year-old girl developed high fever and diarrhoea. Examination of the vulva revealed a genital ulcer. The rest of the general examination was normal. Blood cultures identified Salmonella paratyphi A, and a diagnosis of Lipschütz's ulcer associated with paratyphoid fever was made. Bacteriaemia was then treated with antibiotics and the vulvar ulceration rapidly disappeared. Lipschütz described a distinctive clinical entity of acute genital ulcers occurring in adolescents. To our knowledge, we report herein the second case associated with proved paratyphoid fever. The authors thus recommend that typhoid or paratyphoid fever should be included in the differential diagnosis of genital ulcerations.
Background Understanding women’s perspectives of female genital cutting is particularly critical for understanding the roots of the problem and enhancing effectiveness of any prevention program. Very limited research has examined how people in Iraqi Kurdistan Region think about this practice. This study aimed to explore the perspectives of women of female genital cutting with the aim of uncovering discrepancies and commonalities between women of different socio-educational groups. Methods An explorative study using Q-methodology was conducted with 29 women from different educational and socio-economic statuses in Erbil, the main city of the Iraqi Kurdistan Region. Participants were asked to rank-order a set of 39 statements about different aspects of female genital cutting into a distribution on a scale of nine from “disagree most” to “agree most”. By-person factor analysis was performed with factors or latent viewpoints extracted through centroid method and varimax rotation. Results A four-factor solution and one consensus perspective provided the best conceptual fit for the women’s perspectives about female genital cutting. Factor 1, entitled “positive cultural tradition”, centers on recognizing female genital cutting as a positive cultural aspect and an essential part of the Kurdish culture. Factor 2, “active opponents”, positions around actively opposing the practice of female genital cutting and considering the practice a violation of human rights. Factor 3, “role of law”, stresses the importance of developing and enforcing law for combating female genital cutting. Factor 4, “health concerns and passive opposition”, represents the perspectives of recognizing the importance of health concerns resulting from female genital cutting and opposition of the practice but not in an active manner. A consensus perspective, “marital role”, centers primarily on lack of effect of female genital cutting on women’s marital role. Conclusions
Background Iraqi Kurdistan region is one of the areas where female genital mutilation is reportedly widely practiced but inadequately studied. The aim of this study was to determine (i) the prevalence of female genital mutilation among Muslim Kurdish women in Erbil city, (ii) the patterns and types of female genital mutilation, (iii) the factors associated with this practice and (iv) women’s knowledge and attitudes towards this practice. Methods A cross-sectional study was conducted in the primary health care centers and the Maternity Teaching Hospital in Erbil city, involving 1987 women aged 15–49 years. Data were obtained about female genital mutilation status and knowledge and perception towards this practice. The participants were clinically examined to verify the self-reported female genital mutilation status. Results The self-reported prevalence of female genital mutilation was 70.3%, while it was 58.6% according to clinical examination of the women’s genitalia. The most common type of female genital mutilation was type I (99.6%) and the most common age at which mutilation was performed was 4–7 years (60.2%). This practice was mostly performed by traditional birth attendants (72.5%). Only 6.4% of mutilated women reported having complications after mutilation, most commonly bleeding (3.6%). The practice was more reported among housewives (OR = 3.3), those women whose mothers were mutilated (OR = 15.1) or with unknown mutilation status (OR = 7.3) and those women whose fathers were illiterate (OR = 1.4) or could only read and write (OR = 1.6). The common reasons for practicing female genital mutilation were cultural tradition (46.7%) and dictate of religion (38.9%). Only 30% of the participants were aware about the health consequences of female genital mutilation. More than one third (36.6%) of the women support the practice and 34.5% have intention to mutilate their daughters. Conclusions Prevalence of female genital mutilation
Lorenzen, Emma; Follmann, Frank; Jungersen, Gregers; Agerholm, Jørgen S
Sexually transmitted diseases constitute major health issues and their prevention and treatment continue to challenge the health care systems worldwide. Animal models are essential for a deeper understanding of the diseases and the development of safe and protective vaccines. Currently a good predictive non-rodent model is needed for the study of genital chlamydia in women. The pig has become an increasingly popular model for human diseases due to its close similarities to humans. The aim of this review is to compare the porcine and human female genital tract and associated immune system in the perspective of genital Chlamydia infection. The comparison of women and sows has shown that despite some gross anatomical differences, the structures and proportion of layers undergoing cyclic alterations are very similar. Reproductive hormonal cycles are closely related, only showing a slight difference in cycle length and source of luteolysing hormone. The epithelium and functional layers of the endometrium show similar cyclic changes. The immune system in pigs is very similar to that of humans, even though pigs have a higher percentage of CD4(+)/CD8(+) double positive T cells. The genital immune system is also very similar in terms of the cyclic fluctuations in the mucosal antibody levels, but differs slightly regarding immune cell infiltration in the genital mucosa - predominantly due to the influx of neutrophils in the porcine endometrium during estrus. The vaginal flora in Göttingen Minipigs is not dominated by lactobacilli as in humans. The vaginal pH is around 7 in Göttingen Minipigs, compared to the more acidic vaginal pH around 3.5-5 in women. This review reveals important similarities between the human and porcine female reproductive tracts and proposes the pig as an advantageous supplementary model of human genital Chlamydia infection.
Park, Sung Jin; Seo, Juhyung; Ha, Seong-Heon
Purpose To evaluate the prevalence and type distribution of high-risk human papillomavirus (HPV) infection in genital warts of Korean men, and for the first time, to describe the risk factors associated with high-risk HPV infection in male genital warts. Materials and Methods In a single private clinic, 150 consecutive male patients with histopathologic-confirmed genital warts who underwent HPV genotyping by use of polymerase chain reaction (PCR) were included in this study. We detected HPV DNA in male genital warts and evaluated HPV type distribution, especially high-risk HPV types, by use of PCR. The associations between HPV prevalence and various characteristics, such as age, circumcision status, type of genital warts diagnosis (new vs. recurrent), number of lesions, site of lesions, and gross morphology, were assessed by use of unconditional multiple logistic regression. Results High-risk HPV types were detected in 31 cases (23.5%), and of these, 27 cases (20.5%) contained both high-risk and low-risk HPV types. The most frequently detected high-risk HPV types were HPV16 (6.8%), HPV33 (4.5%), HPV18 (2.3%), and HPV68 (2.3%). In particular, the prevalence of infection with HPV16 and/or HPV18 was 8.3% (11 of 132). In the multivariate analysis, lesions located at sites including the base of the penis or the pubic area, papular or mixed genital warts, and lack of circumcision significantly increased the association with high-risk HPV infection in male genital warts. Conclusions The prevalence of high-risk HPV infection was substantial in male genital warts. The site and morphology of lesions and circumcision status were significantly associated with the prevalence of high-risk HPV infection. PMID:24648877
Handy, Ariel B; Meston, Cindy M
In general, laboratory studies have shown low correlations between subjective (ie, self-report) and physiologic (ie, vaginal pulse amplitude) measurements of sexual arousal in women. One explanation for this presumed low concordance is that women might not be attending to their genital responses and/or might be unable to accurately perceive their genital responses. To examine the extent to which women can perceive their genital arousal sensations, the role that interoceptive awareness plays in this ability, and whether interoceptive awareness influences sexual concordance in women. Twenty-six sexually functional women viewed an erotic film while their physiologic and perceived genital sexual arousal levels were measured continuously. Self-report measurements of sexual function and bodily awareness also were administered. Physiologic sexual arousal was measured with a vaginal photoplethysmograph, and perception of genital arousal was measured with an arousometer. Degree of bodily awareness was measured with the Multidimensional Assessment of Interoceptive Awareness questionnaire. Women exhibited a significant degree of agreement between physiologic and perceived genital arousal (P < .05). Interoceptive awareness was found to significantly moderate this relation (P < 0.05), such that a greater degree of interoceptive awareness facilitated greater agreement between physiologic and perceived genital arousal. Interoceptive awareness also was found to facilitate greater concordance between subjective and physiologic sexual arousal (P < .05). Women can perceive their genital response, and interoceptive awareness influences this ability and the relation between subjective and physiologic sexual arousal. Increasing bodily awareness could be a plausible route for treatment development. Copyright Â© 2016 International Society for Sexual Medicine. Published by Elsevier Inc. All rights reserved.
Adinma, J I; Agbai, A O
Genital mutilation occurred in 296 (48.5%) of 610 pregnant Nigerian Igbo women attending antenatal clinics. The incidence was especially high in association with high maternal age, high parity and low social class. Female genital mutilation (FGM) class 1 occurred in 75 (25.3%) cases while FGM class 2 occurred in 221 (74.7%). There was no cases of FGM class 3 (infibulation). The majority, 322 (52.8%) of the women were positively aware of their true genital mutilation status, but 288 (47.2%) showed negative response being either unaware of their true genital mutilation status or had become confused. Female genital mutilation was no longer practised in the locality of 337 (55.3%) of the women, was occasionally practised in that of 55 (9.0%) and was still fully practised in that of 88 (14.4%) of the respondents. Most of the women, 324 (53.1%) had no knowledge of any advantages of female genital mutilation. However, 157 (25.7%) believed that it discourages infidelity while 56 (9.2%) believed that it facilitated delivery. Similarly, 336 (55.1%) of the women were not aware of any risks of female genital mutilation, although 164 (26.9%) believed that it would cause difficult labour. Eighty (13.1%) of the respondents would advocate FGM for their daughters, out of which 34 (42.5%) cited cultural reasons. Four hundred and sixty-six women (76.4%) would not wish their daughters to be circumcised. The eradication of female genital mutilation must involve the identification of issues sustaining the practice in different localities and subsequent action supported either by logical persuasion following aggressive health education and by legislation.
Nagarajan, Uma M; Prantner, Daniel; Sikes, James D; Andrews, Charles W; Goodwin, Anna M; Nagarajan, Shanmugam; Darville, Toni
Type I interferons (IFNs) induced during in vitro chlamydial infection exert bactericidal and immunomodulatory functions. To determine the precise role of type I IFNs during in vivo chlamydial genital infection, we examined the course and outcome of Chlamydia muridarum genital infection in mice genetically deficient in the receptor for type I IFNs (IFNAR(-/-) mice). A significant reduction in chlamydial shedding and duration of lower genital tract infection was observed in IFNAR(-/-) mice in comparison to the level of chlamydial shedding and duration of infection in wild-type (WT) mice. Furthermore, IFNAR(-/-) mice developed less chronic oviduct pathology in comparison to that in WT mice. Compared to the WT, IFNAR(-/-) mice had a greater number of chlamydial-specific T cells in their iliac lymph nodes 21 days postinfection. IFNAR(-/-) mice also exhibited earlier and enhanced CD4 T-cell recruitment to the cervical tissues, which was associated with increased expression of CXCL9 in the genital secretions of IFNAR(-/-) mice, but not with expression of CXCL10, which was reduced in the genital secretions of IFNAR(-/-) mice. These data suggest that type I IFNs exacerbate C. muridarum genital infection through an inhibition of the chlamydial-specific CD4 T-cell response.
Flores-Díaz, Ema; Sereday, Karen A; Ferreira, Silvaneide; Sirak, Bradley; Sobrinho, João Simão; Baggio, Maria Luiza; Galan, Lenice; Silva, Roberto C; Lazcano-Ponce, Eduardo; Giuliano, Anna R; Villa, Luisa L; Sichero, Laura
Human papillomavirus type 6 (HPV-6) and HPV-11 are the etiological agents of approximately 90% of genital warts (GWs). The impact of HPV-6 genetic heterogeneity on persistence and progression to GWs remains undetermined. HPV Infection in Men (HIM) Study participants who had HPV-6 genital swabs and/or GWs preceded by a viable normal genital swab were analyzed. Variants characterization was performed by polymerase chain reaction sequencing and samples classified within lineages (A, B) and sublineages (B1, B2, B3, B4, B5). Country- and age-specific analyses were conducted for individual variants; odds ratios and 95% confidence intervals for the risk of GWs according to HPV-6 variants were calculated. B3 variants were most prevalent. HPV-6 variants distribution differed between countries and case status. HPV-6 B1 variants prevalence was increased in GWs and genital swabs of cases compared to controls. There was difference in B1 and B3 variants detection in GW and the preceding genital swab. We observed significant association of HPV-6 B1 variants detection with GW development. HPV-6 B1 variants are more prevalent in genital swabs that precede GW development, and confer an increased risk for GW. Further research is warranted to understand the possible involvement of B1 variants in the progression to clinically relevant lesions.
Hirsch, Pierre; Leclerc, Mathieu; Rybojad, Michel; Petropoulou, Anna D; Robin, Marie; Ribaud, Patricia; de la Tour, Régis Peffault; Cavelier-Balloy, Bénédicte; Socié, Gérard; Vexiau-Robert, Dominique
Genital chronic graft-versus-host disease (GVHD) is a frequent but underdiagnosed complication of allogeneic stem-cell transplantation impairing quality of life. We identified 32 female patients with genital chronic GVHD (cGVHD) who underwent allogeneic hematopoietic stem-cell transplantation in our center between 2000 and 2010 and who were followed after transplantation in a specialized gynecological consultation. Pre- and posttransplantation clinical data and detailed acute and cGVHD data were collected. All patients received the same local treatment for genital lesions. At presentation, most patients complained about vaginal dryness and dyspareunia with impairment in sexual activity. Fifty percent of patients had grade I genital lesions and 50% had grade II or III lesions. Patients seen later in gynecological consultation had more severe lesions than patients seen early after transplantation. At the time of diagnosis, most patients had other cutaneous or mucous localizations of cGVHD. In most cases, lesions were stabilized or decreased with local steroids and estrogen treatment, and most patients could resume sexual activity. Treatment was more efficient in patients with mild lesions than in others. Genital cGVHD should be systematically searched for in women who have received allogeneic hematopoietic stem-cell transplantation in an early specialized consultation, especially in case of other cutaneous or mucous localizations of cGVHD. Local treatment associating steroids and estrogen seemed to prevent further evolution of grade I genital lesions and to avoid surgical treatment.
Cestaro, Giovanni; De Rosa, Michele; Gentile, Maurizio; Massa, Salvatore
Lymphatic malformation or lymphangioma is a benign proliferation of the lymphatics accounting for 4% of all vascular malformations and 26% of all benign vascular tumors. There are several reports about genital lymphangiomas mimicking venereal lesions, such as genital warts. Hereby we described a case of a 24 year old man affected by multiple vesicles and warts in genital area. All hematological and biochemical parameters, Human Immunodeficiency Virus (HIV) and Treponema Pallidum tests, C1-Inhibitor and C1-Q values were within limits. An accurate fulguration and wide excision of bigger lesions were performed. Histological examination showed numerous dilated lymphatic vessels in the superficial dermis with infiltration of inflammatory cells, that is a histopathological picture compatible with genital lymphangioma. Considering our clinical suspicion of condylomatosis, HPV (Human Papilloma Virus) Polimerase Chain Reaction (PCR) Genotyping, named INNOLiPA test, was performed, that revealed a genital infection by HPV - genotype 6. We think that our case can be considered an example of HPV infection and acquired genital lymphangioma overlap clinical syndrome. The patient presented any lesions one year after the procedure at follow-up examination.
It remains unclear why there is such marked variation in the severity of the human immunodeficiency virus (HIV) epidemic between African countries. The prevalence of HIV infection has reached high levels in many parts of southern Africa but in most countries of West Africa the levels are much lower. Although there is good evidence that sexually transmitted infections (STIs) and genital ulcers in particular facilitate heterosexual transmission of HIV, there is little comparative STI data from the African countries worst affected by HIV infection. A MEDLINE search covering the period 1966 to August 2000 using the keywords "sexually transmitted diseases", "genital ulcers" and "Africa" was performed to identify factors that might be relevant to the spread of HIV infection in countries with the highest prevalences of the virus. In the countries worst affected by HIV infection, the proportions of men and women with STI who had genital ulcers lay in the ranges 45-68% and 13-68%, respectively. The proportions were much lower in countries of West Africa than in those of southern Africa. The African countries worst affected by HIV infection should adopt a more specialized approach to STI control than hitherto and specifically target the high incidence of genital ulceration. Locally, technical STI committees should draw up country-specific guidelines taking into account the prevalence of the various causes of genital ulceration. In these countries, national AIDS control programmes and donor agencies should develop a specific focus for decreasing the incidence of genital ulcer disease. PMID:11436480
Male genitalia are more variable between species (and populations) than other organs, and are more morphologically complex in polygamous compared to monogamous species. Therefore, sexual selection has been put forward as the major explanation of genital variation and complexity, in particular cryptic female choice for male copulatory courtship. As cryptic female choice is based on differences between males it is somewhat paradoxical that there is such low within-species variation in male genitalia that they are a prime morphological identification character for animal species. Processes other than sexual selection may also lead to genitalia variation but they have recently become neglected. Here I focus on pleiotropy and natural selection and provide examples how they link genitalia morphology with genital environments. Pleiotropy appears to be important because most studies that specifically tested for pleiotropic effects on genital morphology found them. Natural selection likely favours certain genital morphology over others in various environments, as well as by reducing re-infection with sexually transmitted diseases or reducing the likelihood of fertilisation with aged sperm. Both pleiotropy and natural selection differ locally and between species so may contribute to local variation in genitalia and sometimes variation between monogamous and polygamous species. Furthermore, the multitude of genital environments will lead to a multitude of genital functions via natural selection and pleiotropy, and may also contribute to explaining the complexity of genitalia.
LeVasseur-Viens, Hélène; Polak, Michal; Moehring, Amanda J
Genitalia are one of the most rapidly diverging morphological features in animals. The evolution of genital morphology is proposed to be driven by sexual selection via cryptic female choice, whereby a female selectively uptakes and uses a particular male's sperm on the basis of male genital morphology. The resulting shifts in genital morphology within a species can lead to divergence in genitalia between species, and consequently to reproductive isolation and speciation. Although this conceptual framework is supported by correlative data, there is little direct empirical evidence. Here, we used a microdissection laser to alter the morphology of the external male genitalia in Drosophila, a widely used genetic model for both genital shape and cryptic female choice. We evaluate the effect of precision alterations to lobe morphology on both interspecific and intraspecific mating, and demonstrate experimentally that the male genital lobes do not affect copulation duration or cryptic female choice, contrary to long-standing assumptions regarding the role of the lobes in this model system. Rather, we demonstrate that the lobes are essential for copulation to occur. Moreover, slight alterations to the lobes significantly reduced copulatory success only in competitive environments, identifying precopulatory sexual selection as a potential contributing force behind genital diversification.
Bernstein, David I; Wald, Anna; Warren, Terri; Fife, Kenneth; Tyring, Stephen; Lee, Patricia; Van Wagoner, Nick; Magaret, Amalia; Flechtner, Jessica B; Tasker, Sybil; Chan, Jason; Morris, Amy; Hetherington, Seth
Genital herpes simplex virus type 2 (HSV-2) infection causes recurrent lesions and frequent viral shedding. GEN-003 is a candidate therapeutic vaccine containing HSV-2 gD2∆TMR and ICP4.2, and Matrix-M2 adjuvant. Persons with genital herpes were randomized into 3 dose cohorts to receive 3 intramuscular doses 21 days apart of 10 µg, 30 µg, or 100 µg of GEN-003, antigens without adjuvant, or placebo. Participants obtained genital swab specimens twice daily for HSV-2 detection and monitored genital lesions for 28-day periods at baseline and at intervals after the last dose. One hundred and thirty-four persons received all 3 doses. Reactogenicity was associated with adjuvant but not with antigen dose or dose number. No serious adverse events were attributed to GEN-003. Compared with baseline, genital HSV-2 shedding rates immediately after dosing were reduced with GEN-003 (from 13.4% to 6.4% for 30 μg [P < .001] and from 15.0% to 10.3% for 100 µg [P < .001]). Lesion rates were also significantly (P < .01) reduced immediately following immunization with 30 µg or 100 µg of GEN-003. GEN-003 elicited increases in antigen binding, virus neutralizing antibody, and T-cell responses. GEN-003 had an acceptable safety profile and stimulated humoral and cellular immune responses. GEN-003 at doses of 30 µg and 100 µg reduced genital HSV shedding and lesion rates. NCT01667341 (funded by Genocea).
Davarmanesh, M.; Samsami Dehaghani, A.; Deilami, Z.; Monabbati, A.; Dastgheib, L.
Background. Lichen Planus is a chronic mucocutaneous disease of immunological basis and unknown etiology. women with oral lichen planus may have concomitant manifestations in vulvovaginal areas. Objective. To determine the frequency and risk factors of genital involvement in a group of Iranian women affected by oral lichen planus. Methods. Thirty-six women with clinical and histopathological diagnosis of oral lichen planus were evaluated for demographic, historical, and clinical parameters of the oral disease. All the patients were referred for careful vulvovaginal examination, as well as histopathological assessment upon clinical indication. Results. Nineteen patients complained from genital symptoms but the number of women with the final diagnosis of genital lichen planus (n = 2) was too small to show any correlation with the parameters evaluated. Conclusion. In spite of low genital involvement possibly due to inadequate patient population, lack of follow-up visits, and contribution of genetic or ethnic factors, for conservative patient care, women with the oral lichen planus in particular those having some relevant genital symptoms, should preferably be referred for careful vulvovaginal examination. Multicenter cohort studies on women of different geographical regions or ethnicities who have genital lichen planus alone or in combination with other common sites are encouraged. PMID:22675343
Gasparini, Clelia; Pilastro, Andrea; Evans, Jonathan P
In internally fertilizing species male genitalia often show a higher degree of elaboration than required for simply transferring sperm to females. Among the hypotheses proposed to explain such diversity, sexual selection has received the most empirical support, with studies revealing that genital morphology can be targeted by both pre-and postcopulatory sexual selection. Until now, most studies have focused on these two episodes of selection independently. Here, we take an alternative approach by considering both components simultaneously in the livebearing fish, Poecilia reticulata. We allowed females to mate successively (and cooperatively) with two males and determined whether male genital length influenced the female's propensity to mate with a male (precopulatory selection, via female choice) and whether male genital size and shape predicted the relative paternity share of subsequent broods (postcopulatory selection, via sperm competition/cryptic female choice). We found no evidence that either episode of sexual selection targets male genital size or shape. These findings, in conjunction with our recent work exposing a role of genital morphology in mediating unsolicited (forced) matings in guppies, further supports our prior speculation that sexual conflict may be an important broker of genital evolution in this species.
Cayetano, L; Bonduriansky, R
Theory predicts that costly secondary sexual traits will evolve heightened condition dependence, and many studies have reported strong condition dependence of signal and weapon traits in a variety of species. However, although genital structures often play key roles in intersexual interactions and appear to be subject to sexual or sexually antagonistic selection, few studies have examined the condition dependence of genital structures, especially in both sexes simultaneously. We investigated the responses of male and female genital structures to manipulation of larval diet quality (new versus once-used mung beans) in the bruchid seed beetle Callosobruchus maculatus. We quantified effects on mean relative size and static allometry of the male aedeagus, aedeagal spines, flap and paramere and the female reproductive tract and bursal spines. None of the male traits showed a significant effect of diet quality. In females, we found that longer bursal spines (relative to body size) were expressed on low-quality diet. Although the function of bursal spines is poorly understood, we suggest that greater bursal spine length in low-condition females may represent a sexually antagonistic adaptation. Overall, we found no evidence that genital traits in C. maculatus are expressed to a greater extent when nutrients are more abundant. This suggests that, even though some genital traits appear to function as secondary sexual traits, genital traits do not exhibit heightened condition dependence in this species. We discuss possible reasons for this finding. © 2015 European Society For Evolutionary Biology. Journal of Evolutionary Biology © 2015 European Society For Evolutionary Biology.
Liu, Chenfang; Zhang, Yuehui; Yu, Yang; Han, Fengjuan
Genital infection is a common worldwide disease among females with clinical features such as bilateral lower abdominal tenderness, abnormal vaginal or cervical discharge, fever, abnormal vaginal bleeding, dyspareunia, vaginal itching, and adnexal tenderness, which can significantly impair women's health and quality of life. Genital infection is commonly treated with antibiotics, leading to an imbalance in gut flora due to prolonged use of antibiotics. Therefore, it is necessary to discover safe and efficacious alternative treatment strategies for patients with genital infection. Complementary and alternative medicine (CAM) is becoming increasingly prevalent among women with genital infection. CAM has interested the western mainstream medical community because of its less invasive, safe, effective, economical, and convenient therapies. CAM focuses on the prevention and treatment of disease and has become an important force in treating chronic disease. During the last few decades, the popularity of CAM has gradually increased. To further understand the efficacy of CAM in treating genital infection, our paper will review the current progress of treating genital infection including vulvitis, vaginitis, cervicitis, and pelvic inflammatory disease (PID) with CAM therapies. Several CAM strategies including traditional Chinese medicine (TCM), acupuncture, Psychology interference, and physical therapy are introduced in this review. PMID:24648850
Yang, Zhangsheng; Tang, Lingli; Shao, Lili; Zhang, Yuyang; Zhang, Tianyuan; Schenken, Robert; Valdivia, Raphael
Despite the extensive in vitro characterization of CPAF (chlamydial protease/proteasome-like activity factor), its role in chlamydial infection and pathogenesis remains unclear. We now report that a Chlamydia trachomatis strain deficient in expression of CPAF (L2-17) is no longer able to establish a successful infection in the mouse lower genital tract following an intravaginal inoculation. The L2-17 organisms were cleared from the mouse lower genital tract within a few days, while a CPAF-sufficient C. trachomatis strain (L2-5) survived in the lower genital tract for more than 3 weeks. However, both the L2-17 and L2-5 organisms maintained robust infection courses that lasted up to 4 weeks when they were directly delivered into the mouse upper genital tract. The CPAF-dependent chlamydial survival in the lower genital tract was confirmed in multiple strains of mice. Thus, we have demonstrated a critical role of CPAF in promoting C. trachomatis survival in the mouse lower genital tracts. It will be interesting to further investigate the mechanisms of the CPAF-dependent chlamydial pathogenicity. PMID:27382018
Background Anogenital warts (AGWs) are a common, highly infectious disease caused by the human papillomavirus (HPV), whose high recurrence rates contribute to direct medical costs, productivity loss and increased psychosocial impact. Because of the lack of a systematic review of the epidemiology of AGWs in the literature, this study reviewed the published medical literature on the incidence and prevalence of AGWs. Methods A comprehensive literature search was performed on the worldwide incidence and prevalence of AGWs between 2001 and 2012 using the PubMed and EMBASE databases. An additional screening of abstracts from relevant sexual health and infectious disease conferences from 2009 to 2011 was also conducted. Only original studies with general adult populations (i.e., at least including ages 20 through 40 years) were included. Results The overall (females and males combined) reported annual incidence of any AGWs (including new and recurrent) ranged from 160 to 289 per 100,000, with a median of 194.5 per 100,000. New AGW incidence rates among males ranged from 103 to 168 per 100,000, with a median of 137 per 100,000 and among females from 76 to 191 per 100,000, with a median of 120.5 per 100,000 per annum. The reported incidence of recurrent AGWs was as high as 110 per 100,000 among females and 163 per 100,000 among males. Incidence peaked before 24 years of age in females and between 25 and 29 years of age among males. The overall prevalence of AGWs based on retrospective administrative databases or medical chart reviews or prospectively collected physician reports ranged from 0.13% to 0.56%, whereas it ranged from 0.2% to 5.1% based on genital examinations. Conclusions The literature suggests that AGWs are widespread and the prevalence depends on study methodology as suggested by higher rates reported from routine genital examinations versus those from treatment records. However, there remains a need for more population-based studies from certain regions
Abdulcadir, Jasmine; Rodriguez, Maria I; Petignat, Patrick; Say, Lale
Clitoral reconstruction following female genital mutilation/cutting (FGM/C) is a new surgical technique reported to be a feasible and effective strategy to reduce clitoral pain, improve sexual pleasure, and restore a vulvar appearance similar to uncircumcised women. However, data on safety, care offered, and evaluation of sexual and pain outcomes are still limited. This study aims to present the care offered and clinical outcomes of two women who received multidisciplinary care, including psychosexual treatment, with clitoral reconstruction. We report their long-term outcomes, and the histology of the removed periclitoral fibrosis. We report the cases of two women with FGM/C types II and III who requested clitoral reconstruction for different reasons. One woman hoped to improve her chronic vulvar pain, as well as improve her sexual response. The other woman requested surgery due to a desire to reverse a procedure that was performed without her consent, and a wish to have a genital appearance similar to non infibulated women. They both underwent psychosexual evaluation and therapy and surgery. The histology of the periclitoral fibrosis removed during surgery was analyzed. At 1-year postoperatively, the first woman reported complete disappearance of vulvar pain and improved sexual pleasure, including orgasm. Our second patient also described improved sexuality at 1-year follow-up (increased sexual desire, lubrication, vulvar pleasure, and sensitiveness), which she attributed to a better self body image and confidence. Both women reported feeling satisfied, happy, and more beautiful. We show a positive outcome in pain reduction and improved sexual function, self body image, and gender after psychosexual therapy and clitoral reconstruction. More evidence is needed about clitoral reconstruction to develop guidelines on best practices. Until research is conducted that rigorously evaluates clitoral reconstruction for its impact on pain and sexuality, we advise always
Zhang, Juan-Juan; Zhao, Guang-Lu; Wang, Feng; Hong, Fu-Chang; Luo, Zhen-Zhou; Lan, Li-Na; Zhang, Chun-Lai; Peng, Yi; Liu, Xiao-Li; Feng, Tie-Jian; Chen, Xiang-Sheng
To investigate molecular epidemiology of Chlamydia trachomatis infection among patients recruited from different clinic settings in Shenzhen, China. A total of 2534 patients from the sexually transmitted disease (STD) clinics, obstetrics and gynaecology (OBGYN) clinics and genitourinary medicine (GUM) clinics in 34 hospitals participated in the study. The C trachomatis infection was determined using COBAS Amplicor system. DNA extracted in C trachomatis-positive samples was amplified using a nested PCR based on ompA gene and then genotyped using a microsphere suspension array. The overall prevalence of genital C trachomatis infection was 17.7%. The prevalence in patients at STD or GUM clinics was significantly higher than that in patients at OBGYN clinics. Being male (adjusted OR (AOR) 2.5, 95% CI 1.8 to 3.4), having no consistent use of a condom with casual partners in the past 3 months (AOR 1.7, 95% CI 1.1 to 2.8) and having any STD symptoms (AOR 3.3, 95% CI 2.0 to 5.4) were independently associated with C trachomatis infection. Eight genotypes were identified. The most prevalent genotypes were F (22.3%), E (22.0%) and D/Da (12.7%). Other genotypes were G/Ga (8.0%), J (7.3%), K (2.7%), H (2.7%) and I/Ia (0.4%). Eighty-two samples (18.3%) were infected with multiple genotypes. Genotype D/Da among patients from GUM clinics was more common than those from STD or OBGYN clinics. Infections with genotypes G and F were statistically associated with abnormal vaginal discharge (p=0.001) and being married (p=0.014), respectively. Infection with multiple genotypes was more common among patients with a higher income (p=0.011). A substantial prevalence of genital C trachomatis infection in Shenzhen suggests the importance of detection and treatment of the infection in high-risk groups.
Selek, Mehmet Burak; Bektöre, Bayhan; Sezer, Ogün; Kula Atik, Tuğba; Baylan, Orhan; Özyurt, Mustafa
Urine culture is the gold standard test for revealing the microbial agent causing urinary tract infection (UTI). Culture results are affected by sampling techniques; improper sampling leads to contamination of urine and thus contamination of the culture with urogenital flora. We aimed to evaluate the effect of urogenital cleansing, performed with chlorhexidine-containing genital region cleansing wipes (GRCW) on contamination rates. A total of 2,665 patients with UTI-related complaints and with urine culture requests from various outpatient clinics were enrolled in the study. Of the patients, 1,609 in the experimental group used GRCW before sampling, while 1,046 in the control group did not use any wipes. The contamination rate in the experimental group patients was 7.7%, while it was 15.8% in the control group. Contamination rates were significantly higher in the control group than in the experimental group for both women and men. Contamination rates for children and adults were also significantly lower in the experimental group than in the control group. Our study, conducted in a large population, showed that the use of chlorhexidine-containing cleansing wipes significantly reduced urine culture contamination rates in both genders, in both child and adult age groups. Using GRCW, collection of urine after urogenital area cleansing will decrease the contamination problem.
Edmonds, Emma; Barton, Geraint; Buisson, Sandrine; Francis, Nick; Gotch, Frances; Game, Laurence; Haddad, Munther; Dinneen, Michael; Bunker, Chris
Male genital lichen sclerosus (MGLSc) has a bimodal distribution in boys and men. It is associated with squamous cell carcinoma (SCC). The pathogenesis of MGLSc is unknown. HPV and autoimmune mechanisms have been mooted. Anti extracellular matrix protein (ECM)1 antibodies have been identified in women with GLSc. The gene expression pattern of LSc is unknown. Using DNA microarrays we studied differences in gene expression in healthy and diseased prepuces obtained at circumcision in adult males with MGLSc (n = 4), paediatric LSc (n = 2) and normal healthy paediatric foreskin (n = 4). In adult samples 51 genes with significantly increased expression and 87 genes with significantly reduced expression were identified; paediatric samples revealed 190 genes with significantly increased expression and 148 genes with significantly reduced expression. Concordance of expression profiles between adult and paediatric samples indicates the same disease process. Functional analysis revealed increased expression in the adult and child MGSLc samples in the immune response/cellular defence gene ontology (GO) category and reduced expression in other categories including genes related to squamous cancer. No specific HPV, autoimmune or squamous carcinogenesis-associated gene expression patterns were found. ECM1 and CABLES1 expression were significantly reduced in paediatric and adult samples respectively. PMID:21718371
Bourcier, Marc; Bhatia, Neal; Lynde, Charles; Vender, Ronald
Rising rates of human papillomavirus (HPV) infections in recent decades, including external genital warts (EGWs), underscore the need for effective management of this common sexually transmitted disease. Although treatment is a vital aspect that aims primarily to resolve physical symptoms, health care providers must also address the psychosocial burden that typically accompanies diagnosis, treatment, remission, and recurrence. Education and counseling are integral components of care to address the cascade of negative emotional reactions that follow diagnosis, which often include anger, shame, stigma, frustration, and fear. Health care providers should offer patient information that is clear and simple, both verbally and in written form. Research to date has shown that information is most helpful when it is conveyed in a supportive tone and avoids stigmatization. Treatment decisions should consider the patient's preferences and the clinician's ability to offer certain therapies. A locally relevant algorithm and an individualized treatment approach are recommended by various treatment guidelines to improve the chances of compliance and treatment success. Given that success rates are variable, monitoring treatment is also necessary to gauge the patient's response to treatment, local reactions, and the potential need to switch treatments. Patients diagnosed with EGWs should also be screened for other sexually transmitted diseases because coinfection is common. Vaccination is becoming an increasingly important aspect of prevention strategies for HPV infections and should be considered for eligible patients.
Donati, Manuela; Di Paolo, Maria; Favaroni, Alison; Aldini, Rita; Di Francesco, Antonietta; Ostanello, Fabio; Biondi, Roberta; Cremonini, Eleonora; Ginocchietti, Laura; Cevenini, Roberto
A mouse model for Chlamydia suis genital infection was developed. Ninety-nine mice were randomly divided into three groups and intravaginally inoculated with chlamydia: 45 mice (group 1) received C. suis purified elementary bodies (EBs), 27 (group 2) were inoculated with C. trachomatis genotype E EBs and 27 mice (group 3) with C. trachomatis genotype F EBs. Additionally, 10 mice were used as a negative control. At seven days post-infection (dpi) secretory anti-C. suis IgA were recovered from vaginal swabs of all C. suis inoculated mice. Chlamydia suis was isolated from 93, 84, 71 and 33% vaginal swabs at 3, 5, 7 and 12 dpi. Chlamydia trachomatis genotype E and F were isolated from 100% vaginal swabs up to 7 dpi and from 61 and 72%, respectively, at 12 dpi. Viable C. suis and C. trachomatis organisms were isolated from uterus and tubes up to 16 and 28 dpi, respectively. The results of the present study show the susceptibility of mice to intravaginal inoculation with C. suis. A more rapid course and resolution of C. suis infection, in comparison to C. trachomatis, was highlighted. The mouse model could be useful for comparative investigations involving C. suis and C. trachomatis species. © FEMS 2014. All rights reserved. For permissions, please e-mail: email@example.com.
Aguilar, L V; Lazcano‐Ponce, E; Vaccarella, S; Cruz, A; Hernández, P; Smith, J S; Muñoz, N; Kornegay, J R; Hernández‐Avila, M; Franceschi, S
Objective To elucidate which anatomical sites need to be sampled to detect human papillomavirus (HPV) infection in the lower male genital tract. Method In an HPV survey of Mexican soldiers (median age 24 years; range 16–50 years), a cell sample from 2 cm deep into the distal urethra (group 1; n = 168 men), or 0.5 cm deep into the meatus urethralis (group 2; n = 414 men) was collected, along with a sample from the external genitalia. The different samples were tested for 27 HPV types using a polymerase chain reaction based strip assay. Results HPV DNA was detected more frequently in external genitalia samples (46.4%) than in the urethra (20.8%) or meatus samples (12.1%). Lack of samples from the urethra or meatus would have led to 5.1% and 1.5% false HPV negative results, respectively. The most frequently detected high risk HPV types (HPV 59, 52, 51, and 16) were similar in different sites, whereas low risk types were found rarely in urethra samples. Conclusions The addition of cell samples from the meatus to those from external genitalia contributed negligibly to the evaluation of the prevalence of HPV in men. HPV detection was slightly improved by the addition of urethra samples, but the gain may not justify the discomfort of the procedure in large epidemiological studies. PMID:16461598
Vaitkuviene, A.; Andersen-Engels, S.; Auksorius, E.; Bendsoe, N.; Gavriushin, V.; Gustafsson, U.; Oyama, J.; Palsson, S.; Soto Thompson, M.; Stenram, U.; Svanberg, K.; Viliunas, V.; De Weert, M. J.
Permanent infections recognized as oncogenic factor. STD is common concomitant diseases in early precancerous genital tract lesions. Simple optical detection of early regressive pre cancer in cervix is the aim of this study. Hereditary immunosupression most likely is risk factor for cervical cancer development. Light induced fluorescence point monitoring fitted to live cervical tissue diagnostics in 42 patients. Human papilloma virus DNR in cervix tested by means of Hybrid Capture II method. Ultraviolet (337 nm) laser excited fluorescence spectra in the live cervical tissue analyzed by Principal Component (PrC) regression method and spectra decomposition method. PCr method best discriminated pathology group "CIN I and inflammation"(AUC=75%) related to fluorescence emission in short wave region. Spectra decomposition method suggested a few possible fluorophores in a long wave region. Ultraviolet (398 nm) light excitation of live cervix proved sharp selective spectra intensity enhancement in region above 600nm for High-grade cervical lesion. Conclusion: PC analysis of UV (337 nm) light excitation fluorescence spectra gives opportunity to obtain local immunity and Low-grade cervical lesion related information. Addition of shorter and longer wavelengths is promising for multi wave LIF point monitoring method progress in cervical pre-cancer diagnostics and utility for cancer prevention especially in developing countries.
Mack-Detlefsen, B.; Banaschak, S.; Boemers, T. M.
Background: Female genital mutilation (FGM) occurs mainly in Africa, parts of the Arabian Peninsula and parts of Asia. It is commonly associated with acute complications as well as diverse late/delayed complications. One of the most common of these late complications is progressively enlarging painless cysts of the vulva. Case Report: An 8-year-old girl from Eritrea presented to our paediatric emergency department with a progressively enlarging mass of the vulva. She had undergone a clitoridectomy and partial removal of the labia minora as an infant in Eritrea. We performed surgical excision of the cyst and reconstruction of the labia. Histology showed a traumatic squamous epithelial inclusion cyst of the vulva. Conclusion: Epithelial or dermoid cysts of the vulva following FGM are extremely rare. Symptoms often require surgical intervention. Through increasing migration, more girls and female youths with FGM are likely to present to practices and hospitals in Germany. Thus increased knowledge and awareness of the medical complications of FGM and their treatment will be necessary in years to come. PMID:26500372
Yount, Kathryn M; Abraham, Bisrat K
Female genital cutting (FGC) and HIV/AIDS are both highly prevalent in sub-Saharan Africa, and researchers have speculated that the association may be more than coincidental. Data from 3167 women aged 15-49 who participated in the 2003 Kenya Demographic and Health Survey (KDHS) are used to test the direct and indirect associations of FGC with HIV. Our adjusted models suggest that FGC is not associated directly with HIV, but is associated indirectly through several pathways. Cut women are 1.72 times more likely than uncut women to have older partners, and women with older partners are 2.65 times more likely than women with younger partners to test positive for HIV Cut women have 1.94 times higher odds than uncut women of initiating sexual intercourse before they are 20, and women who experience their sexual debut before age 20 have 1.73 times higher odds than those whose sexual debut comes later of testing positive for HIV. Cut women have 27 percent lower odds of having at least one extra-union partner, and women with an extra-union partner have 2.63 times higher odds of testing positive for HIV. Therefore, in Kenya, FGC may be an early life-course event that indirectly alters women's odds of becoming infected with HIV through protective and harmful practices in adulthood.
Raymakers, Adam J N; Sadatsafavi, Mohsen; Marra, Fawziah; Marra, Carlo A
External genital warts (EGW) are a sexually transmitted infection caused by various strains of human papillomavirus (HPV). Several studies have described the direct and indirect costs of EGW, while others have reported on the burden of EGW in terms of the impact on the quality of life (QOL) of patients. The arrival of a quadrivalent HPV vaccine that protects against both cervical cancer and EGW requires a proper understanding of the impact of vaccines on costs and QOL. Using pre-defined search terms and inclusion/exclusion criteria, we performed a systematic review of the economic and humanistic burden of EGW. The focus of our review was on literature describing the direct and indirect costs of EGW per episode of care (EoC) or per year, as well as the impact of EGW on disease-specific, generic, or preference-based QOL measures. We also reviewed the literature on the national economic burden of EGW from the perspectives of different countries. Other aspects of EGW management that can inform economic modelling studies, such as length of EoC, number of physician visits and indirect costs, were also explored. Our review sheds light on the high economic and humanistic burden of EGW and important differences in the costs between men and women, as well as the differences in health resource utilization and costs across countries. Our study also highlights the dearth of information on the impact of EGW on the QOL and productivity of patients.
Lü, Jun; Huang, Xiao-Dong
Male genital lichen sclerosus (MGLSc) is a chronically relapsing disease characterized by a long course, gradual aggravation, and a tendency towards malignancy. Once called balanitis xerotica obliterans, MGLSc has a distinct predilection for the prepuce and glans, involving the urethra when aggravating, forming scarring tissues, and causing urethral stricture, which may seriously affect the patients'quality of life with such symptoms as urinary stream narrowing, dysuria, and painful penile erection. The etiology and pathogenesis of MGLSc have not yet been adequately explained though it is generally thought to be associated with autoimmune mechanism, genetic factors, infections, local trauma, and chronic urinary irritation. MGLSc can be fairly easily diagnosed according to its clinical manifestations and histopathological results, but can be hardly cured. Early diagnosis and prompt treatment are the most important approaches, which may relieve its symptoms, check its progression, and prevent its long-term sequelae. Ultrapotent topical corticosteroids are the choice for the treatment of MGLSc. For those who fail to respond to expectant medication or have dysuria due to urethral stricture and painful erection, rational surgery may be resorted to, with importance attached to long-term follow-up. This article presents an update of the diagnosis and treatment of MGLSc and MGLSc-induced urethral stricture.
Smith, Helen; Stein, Karin
Women and girls living with female genital mutilation (FGM) are more likely to experience psychological problems than women without FGM. As well as psychological support, this population may need additional care when seeking surgical interventions to correct complications of FGM. Recent WHO guidelines recommend cognitive behavioral therapy for women and girls experiencing anxiety disorders, depression, or post-traumatic stress disorder. The guidelines also suggest that preoperative counselling for deinfibulation, and psychological support alongside surgical interventions, can help women manage the physiological and psychological changes following surgery. This synthesis summarizes evidence on women's values and preferences, and the context and conditions that may be required to provide psychological and counselling interventions. Understanding women's views, their own ways of coping, as well social and cultural factors that influence women's mental well-being, may help identify the types of interventions this population needs at different times and stages of their lives. © 2017 International Federation of Gynecology and Obstetrics. The World Health Organization retains copyright and all other rights in the manuscript of this article as submitted for publication.
Mohammed, Ghada F; Hassan, Magdy M; Eyada, Moustafa M
Female genital mutilation/cutting (FGM/C) is a prevalent, deeply rooted traditional practice in Egypt. Specification of the motives behind the continuation of FGM/C in Egyptian community and evaluation of the sexual function in women with FGM/C. This cross-sectional study, involved 2,106 sexually active female participants with FGM/C. Full history-taking and general examination to evaluate the type of FGM/C were conducted. Sexual function was assessed by using the Female Sexual Function Index (FSFI) questionnaire. Enumerate and specify the motivational factors and its percent among the participants. The correlation between FGM/C and FSFI domain scores was done with Pearson's correlation. Tradition, cleanliness, and virginity were the most common motives empowering the continuation of FGM/C (100%), followed by men's wish, esthetic factors, marriage, and religion factors (45.2-100%). Type I FGM/C was the most common, followed by type II. There was only negative correlation between the type II FGM/C and sexual satisfaction. No statistically significant difference between type I and non-FGM/C was found. FGM/C remains high. A variety of socio-cultural myths, religious misbelievers, and hygienic and esthetic concerns were behind the FGM/C. Overall, a large proportion of the participants supported the continuation of FGM/C in spite of adverse effect and sexual dysfunction associated with FGM/C. © 2014 International Society for Sexual Medicine.
O'Dey, D M
Female genital mutilation/cutting (FGM/C) is a worldwide problem affecting millions of women and is especially common in Africa and Arabia. Women suffer from serious physical and psychological problems. Anatomic reconstruction, therefore, is an important and life-changing option for many affected women. This work gives a short overview of specialized techniques invented by the author for functional and aesthetic vulvar reconstruction following FGM/C. This work does not intend to provide anatomic or surgical details. The anterior obturator artery perforator flap (aOAP flap), the omega domed flap (OD flap), and a microsurgical procedure called neurotizing and molding of the clitoral stump (NMCS procedure) are described. The aOAP-flap for vulvar reconstruction, the OD-flap for clitoral prepuce reconstruction, and the NMCS-procedure for reconstruction of the clitoral tip provided natural, reliable, and long-lasting results, all of which normalize the anatomy of the mutilated outer female genitalia. The reconstructive options presented contribute to re-establish normal anatomy and, thus, support women's health and relieve the burden forced upon them by FGM/C.
Chen, Peggy G; Ofori-Atta, Angela; Ilozumba, Ukwuoma O; Karfo, Kapouné; Bradley, Elizabeth H
Abstract Objective To conduct a cross-national comparative study of the prevalence and correlates of female genital cutting (FGC) practices and beliefs in western Africa. Methods Data from women who responded to the Multiple Indicator Cluster Surveys between 2005 and 2007 were used to estimate the frequencies of ever having been circumcised, having had a daughter circumcised, and believing that FGC practices should continue. Weighted logistic regression using data for each country was performed to determine the independent correlates of each outcome. Findings The prevalence of FGC was high overall but varied substantially across countries in western Africa. In Sierra Leone, Gambia, Burkina Faso and Mauritania, the prevalence of FGC was 94%, 79%, 74% and 72%, respectively, whereas in Ghana, Niger and Togo prevalence was less than 6%. Older age and being Muslim were generally associated with increased odds of FGC, and higher education was associated with lower odds of FGC. The association between FGC and wealth varied considerably. Burkina Faso was the only country in our study that experienced a dramatic reduction in FGC prevalence from women (74%) to their daughters (25%); only 14.2% of the women surveyed in that country said that they believe the practice should continue. Conclusion The prevalence of FGC in western Africa remains high overall but varies substantially across countries. Given the broad range of experiences, successful strategies from countries where FGC is declining may provide useful examples for high-prevalence countries seeking to reduce their own FGC practices. PMID:22423163
van Heyningen, V; Bickmore, W A; Seawright, A; Fletcher, J M; Maule, J; Fekete, G; Gessler, M; Bruns, G A; Huerre-Jeanpierre, C; Junien, C
Detailed molecular definition of the WAGR region at chromosome 11p13 has been achieved by chromosome breakpoint analysis and long-range restriction mapping. Here we describe the molecular detection of a cytogenetically invisible 1-megabase deletion in an individual with aniridia, cryptorchidism, and hypospadias but no Wilms tumor (WT). The region of overlap between this deletion and one associated with WT and similar genital anomalies but no aniridia covers a region of 350-400 kilobases, which is coincident with the extent of homozygous deletion detected in tumor tissue from a sporadic WT. A candidate WT gene located within this region has recently been isolated, suggesting nonpenetrance for tumor expression in the first individual. The inclusion within the overlap region of a gene for WT predisposition and a gene for the best-documented WT-associated genitourinary malformations leads us to suggest that both of these anomalies result from a loss-of-function mutation at the same locus. This in turn implies that the WT gene exerts pleiotropic effect on both kidney and genitourinary development, a possibility supported by the observed expression pattern of the WT candidate gene in developing kidney and gonads. Images PMID:1973540
MacFarlane, Geoff R; Vasey, Paul L
Same-sex genital interactions (SSGIs) occur across the order primates, yet explaining their maintenance in evolutionary terms appears problematic; as such interactions seem to counteract reproductive goals. We hypothesised that in more promiscuous species, where sexual motivation, mating effort, and non-conceptive heterosexual behaviour are greater, SSGIs may also occur at greater frequencies without necessarily impeding reproduction. We found that the expression of both male and female SSGIs were greater in multimale systems than in unimale ones. Both male and female SSGIs were positively correlated with the degree of promiscuity (relative testes mass). As mating system confers biases in the sex ratio that may influence the expression of SSGIs, we controlled for availability of members of the same-sex. When employing this control, results were largely congruent. For males, SSGIs were expressed more frequently in multimale systems. For both sexes, SSGIs were expressed more frequently with greater relative testes mass. We suggest SSGIs in primates may be a neutral by-product of selection for increases in promiscuous sexual activity, and that in certain instances these interactions may be co-opted to facilitate adaptive social functions.
Nelius, Thomas; Armstrong, Myrna L; Rinard, Katherine; Young, Cathy; Hogan, LaMicha; Angel, Elayne
To provide quantitative and qualitative data that will assist evidence-based decision making for men and women with genital piercings (GP) when they present to urologists in ambulatory clinics or office settings. Currently many persons with GP seek nonmedical advice. A comprehensive 35-year (1975-2010) longitudinal electronic literature search (MEDLINE, EMBASE, CINAHL, OVID) was conducted for all relevant articles discussing GP. Authors of general body art literature tended to project many GP complications with potential statements of concern, drawing in overall piercings problems; then the information was further replicated. Few studies regarding GP clinical implications were located and more GP assumptions were noted. Only 17 cases, over 17 years, describe specific complications in the peer-reviewed literature, mainly from international sources (75%), and mostly with "Prince Albert" piercings (65%). Three cross-sectional studies provided further self-reported data. Persons with GP still remain a hidden variable so no baseline figures assess the overall GP picture, but this review did gather more evidence about GP wearers and should stimulate further research, rather than collectively projecting general body piercing information onto those with GP. With an increase in GP, urologists need to know the specific differences, medical implications, significant short- and long-term health risks, and patients concerns to treat and counsel patients in a culturally sensitive manner. Targeted educational strategies should be developed. Considering the amount of body modification, including GP, better legislation for public safety is overdue. Copyright Â© 2011 Elsevier Inc. All rights reserved.
Okeke, Tc; Anyaehie, Usb; Ezenyeaku, Cck
Nigeria, due to its large population, has the highest absolute number of female genital mutilation (FGM) worldwide, accounting for about one-quarter of the estimated 115-130 million circumcised women in the world. The objective of this review is to ascertain the current status of FGM in Nigeria. Pertinent literature on FGM retrieved from internet services [Google search on FGM in Nigeria, www.online Nigeria, PubMed of the national library of medicine www.medconsumer. Info/tropics/fgm.htm, Biomedcentral and African Journal Online (AJOL) (FGM)] and textbooks, journals, and selected references for proper understanding of the topic was included in this review. The national prevalence rate of FGM is 41% among adult women. Evidence abound that the prevalence of FGM is declining. The ongoing drive to eradicate FGM is tackled by World Health Organization, United Nations International Children Emergency Fund, Federation of International Obstetrics and Gynecology (FIGO), African Union, The economic commission for Africa, and many women organizations. However, there is no federal law banning FGM in Nigeria. There is need to eradicate FGM in Nigeria. Education of the general public at all levels with emphasis on the dangers and undesirability of FGM is paramount.
Shell-Duncan, Bettina; Hernlund, Ylva; Wander, Katherine; Moreau, Amadou
Although the international community has recently promoted legislation as an important reform strategy for ending female genital cutting (FGC), there exist divergent views on its potential effects. Supporters argue that legal prohibition of FGC has a general deterrent effect, while others argue legislation can be perceived as coercive, and derail local efforts to end the practice. This study examines the range of responses observed in rural Senegal, where a 1999 anti-FGC law was imposed on communities in which the practice was being actively contested and targeted for elimination. Drawing on data from a mixed-methods study, we analyze responses in relation to two leading theories on social regulation, the law and economics and law and society paradigms, which make divergent predictions on the interplay between social norms and legal norms. Among supporters of FGC, legal norms ran counter to social norms, and did little to deter the practice, and in some instances incited reactance or drove the practice underground. Conversely, where FGC was being contested, legislation served to strengthen the stance of those contemplating or favoring abandonment. We conclude that legislation can complement other reform strategies by creating an “enabling environment” that supports those who have or wish to abandon FGC. PMID:24771947
A new US law criminalizes female genital mutilation (FGM) and requires notification of this fact to immigrants from Africa and the Middle East. In addition, US representative to international financial institutions are directed to oppose issuance of foreign aid to countries that lack established educational programs to eradicate FGM. FGM involves a range of procedures characterized by the amount of tissue removed and may be carried out in infants, adolescents, or new mothers. Complications include death, debilitating illness, and increased risk during child birth. FGM is firmly entrenched in countries in sub-Saharan Africa and parts of the Arab peninsula and extends to a few groups in Asia and immigrant populations in developed countries. Most women in an Egyptian study had undergone FGM and justified the practice as a way of reducing sexual desire and, thus, preserving premarital virginity. Many women also consider FGM a religious requirement, but this claim is unsubstantiated. Successful eradication campaigns in Kenya have preserved the social and coming-of-age ritual aspects of the practice while rejecting the physical mutilation, and efforts in Nigeria have focuses on health education. A New York-based group working to eradicate FGM has criticized the new US law because it requires education of affected communities without allocating the necessary funding. The group charges that the new law needs revision to remove criminal liability from family members who may object to a proposed FGM procedure but fail to report or stop it.
Muteshi, Jacinta K; Miller, Suellen; Belizán, José M
Female Genital Mutilation/Cutting (FGM/C) comprises different practices involving cutting, pricking, removing and sometimes sewing up external female genitalia for non-medical reasons. The practice of FGM/C is highly concentrated in a band of African countries from the Atlantic coast to the Horn of Africa, in areas of the Middle East such as Iraq and Yemen, and in some countries in Asia like Indonesia. Girls exposed to FGM/C are at risk of immediate physical consequences such as severe pain, bleeding, and shock, difficulty in passing urine and faeces, and sepsis. Long-term consequences can include chronic pain and infections. FGM/C is a deeply entrenched social norm, perpetrated by families for a variety of reasons, but the results are harmful. FGM/C is a human rights issue that affects girls and women worldwide. The practice is decreasing, due to intensive advocacy activities of international, national, and grassroots agencies. An adolescent girl today is about a third less likely to be cut than 30 years ago. However, the rates of abandonment are not high enough, and change is not happening as rapidly as necessary. Multiple interventions have been implemented, but the evidence base on what works is lacking. We in reproductive health must work harder to find strategies to help communities and families abandon these harmful practices.
Svare, J; Andersen, L F; Langhoff-Roos, J; Madsen, H; Jensen, E T; Bruun, B; Lind, I
To examine whether there is a relationship between the uro-genital microbial colonization and threatening preterm delivery. The microflora in the urine and endocervix was studied in 43 women with preterm labor, 45 women with preterm premature rupture of the membranes (PPROM) and 80 normal pregnant women at 26-34 weeks of gestation. Amniotic fluid was examined in 20 of the patients with preterm labor. Data were analyzed by Fisher's exact test (two-tailed). The microflora in the urine was not significantly different in patients with preterm labor, PPROM and normal pregnant women. Compared with normal pregnant women, patients with preterm labor had significantly lower prevalences of corynebacteria (p < 0.05) and coagulase-negative staphylococci (p < 0.01) in the cervix, while patients with PPROM had significantly lower prevalences of lactobacilli (p < 0.05) and coagulase-negative staphylococci (p < 0.05) in the cervix. Positive amniotic fluid cultures were detected in three of the 20 patients with preterm labor who underwent transabdominal amniocentesis. Evidence of ascending colonization was found in two of these cases. The microbial colonization of the urine was not associated with threatening preterm delivery. Reduced prevalences of lactobacilli, corynebacteria and coagulase-negative staphylococci in the cervix were associated with threatening preterm delivery.
van Heyningen, V.; Bickmore, W.A.; Seawright, A.; Fletcher, J.M.; Maule, J.; Hastie, N.D. ); Fekete, G. ); Gessler, M.; Bruns, G.A.P. ); Huerre-Jeanpierre, C.; Junien, C. ); Williams, B.R.G. )
Detailed molecular definition of the WAGR region at chromosome 11p13 has been achieved by chromosome breakpoint analysis and long-range restriction mapping. Here the authors describe the molecular detection of a cytogenetically invisible 1-megabase deletion in an individual with aniridia, cryptorchidism, and hypospadias but no Wilms tumor (WT). The region of overlap between this deletion and one associated with WT and similar genital anomalies but no aniridia covers a region of 350-400 kilobases, which is coincident with the extent of homozygous deletion detected in tumor tissue from a sporadic WT. A candidate WT gene located within this region has recently been isolated, suggesting nonpenetrance for tumor expression in the first individual. The inclusion within the overlap region of a gene for WT predisposition and a gene for the best-documented WT-associated genitourinary malformations leads to suggest that both of these anomalies result from a loss-of-function mutation at the same locus. This in turn implies that the WT gene exerts pleiotropic effect on both kidney and genitourinary development, a possibility supported by the observed expression pattern of the WT candidate gene in developing kidney and gonads.
Mhatre, Mohak; McAndrew, Thomas; Carpenter, Colleen; Burk, Robert D.; Einstein, Mark H.; Herold, Betsy C.
Background Clinical studies demonstrate increased prevalence of human papillomavirus (HPV)-associated disease in HIV-infected individuals and an increased risk of HIV acquisition in HPV-infected individuals. The mechanisms underlying this synergy are not defined. We hypothesize that women with cervical intraepithelial neoplasia (CIN) will exhibit changes in soluble mucosal immunity that may promote HPV persistence and facilitate HIV infection. Methods The concentrations of immune mediators and endogenous anti-Escherichia coli activity in genital tract secretions collected by cervicovaginal lavage were compared in HIV-negative women with high-risk HPV-positive (HRHPV+) CIN-3 (n = 37), HRHPV+ CIN-1 (n = 12), or PAP-negative control subjects (n = 57). Results Compared with control subjects, women with CIN-3 or CIN-1 displayed significantly higher levels of proinflammatory cytokines including interleukin (IL)-1α, IL-1β, and IL-8 (P < 0.002) and significantly lower levels of anti-inflammatory mediators and antimicrobial peptides, including IL-1 receptor antagonist, secretory leukocyte protease inhibitor (P < 0.01), and human β defensins 2 and 3 (P < 0.02). There was no significant difference in endogenous anti-E. coli activity after controlling for age and sample storage time. Conclusion HRHPV+ CIN is characterized by changes in soluble mucosal immunity that could contribute to HPV persistence. The observed mucosal inflammation suggests a mechanism that may also contribute to the epidemiologic link between persistent HPV and HIV. PMID:22801340
García-López, Silvia Juliana; Pérez-Martínez, Andrés; Chávez-Martínez, Sareni; Sereno-Coló, José Antonio
Tuberculosis continues to be a worldwide public health issue, known as "the great pretender" resembling many diseases. Overall 1% of women infected with Mycobacterium species develop genital tuberculosis (GT) which is widespread more commonly during their fertility age, 20-40 years old. GT is the second most common cause of extra pulmonary tuberculosis. One of the clinical manifestations in these patients is Infertility; with a poor prognosis of a successful pregnancy even with a correct diagnosis, medical and/or surgical treatment. Most pregnancies result in ectopic pregnancies or abortions. In low income countries GT may account for 5-20% of infertility cases. It was widely believed that pregnancy represented a period of risk to women infected with tuberculosis; and actually abortion is suggested. We report a case of a 21 year old female patient who came to the General Hospital Dr. Miguel Silva in the city of Morelia, Michoacán with the diagnosis of late puerperium postpartum complicated with retained placental tissue to perform a uterine curettage. The patient had fever and anemia for which we had to perform a laparotomy exploration of the doubt of uterin perforation; the surgical findings were pathognomonic of GT for which we continue to realize Hysterectomy. The macro and microscopically pathologic findings consists in GT, confirming the diagnosis with Ziehl-Neelsen acid stain. GT findings must always be differentiated from ovarian cancer.
Ali, Hammad; Donovan, Basil; Wand, Handan; Read, Tim R H; Regan, David G; Grulich, Andrew E; Fairley, Christopher K; Guy, Rebecca J
To measure the effect on genital warts of the national human papillomavirus vaccination programme in Australia, which started in mid-2007. Trend analysis of national surveillance data. Data collated from eight sexual health services from 2004 to 2011; the two largest clinics also collected self reported human papillomavirus vaccination status from 2009. Between 2004 and 2011, 85,770 Australian born patients were seen for the first time; 7686 (9.0%) were found to have genital warts. Rate ratios comparing trends in proportion of new patients diagnosed as having genital warts in the pre-vaccination period (2004 to mid-2007) and vaccination period (mid-2007 to the end of 2011). Large declines occurred in the proportions of under 21 year old (92.6%) and 21-30 year old (72.6%) women diagnosed as having genital warts in the vaccination period-from 11.5% in 2007 to 0.85% in 2011 (P<0.001) and from 11.3% in 2007 to 3.1% in 2011 (P<0.001), respectively. No significant decline in wart diagnoses was seen in women over 30 years of age. Significant declines occurred in proportions of under 21 year old (81.8%) and 21-30 year old (51.1%) heterosexual men diagnosed as having genital warts in the vaccination period-from 12.1% in 2007 to 2.2% in 2011 (P<0.001) and from 18.2% in 2007 to 8.9% in 2011 (P<0.001), respectively. No significant decline in genital wart diagnoses was seen in heterosexual men over 30 years of age. In 2011 no genital wart diagnoses were made among 235 women under 21 years of age who reported prior human papillomavirus vaccination. The significant declines in the proportion of young women found to have genital warts and the absence of genital warts in vaccinated women in 2011 suggests that the human papillomavirus vaccine has a high efficacy outside of the trial setting. Large declines in diagnoses of genital warts in heterosexual men are probably due to herd immunity.
An emerging body of research targets women's relationship to their genitals, particularly as pubic hair removal and the promotion of female genital surgeries increase in popularity and visibility. This study asked women to discuss their subjective feelings about three related but distinct genital attitudes: pubic hair grooming, sex during menstruation, and genital/vaginal self-image. Specifically, this study applied thematic analysis to qualitative interviews with a community sample of 20 women (mean age=34, SD=13.35) from diverse ages, races, and sexual identity backgrounds to illuminate seven themes in women's narratives about their vaginas: (1) "dirty" or "gross"; (2) needing maintenance; (3) unknown or frustrating; (4) unnatural; (5) comparative; (6) ambivalent; (7) affirmative. Overwhelmingly, women used strong emotional language when discussing their genitals, often evoking descriptions of anxiety, excess, and need for control. Fusions between sexuality and body image, and connections between "genital panics" and internalized racism, sexism, and homophobia, also appeared.
Ozouaki, Francis; Ndjoyi-Mbiguino, Angélique; Legoff, Jérôme; Onas, Isabelle Ndombi; Kendjo, Eric; Si-Mohamed, Ali; Mbopi-Kéou, François-Xavier; Malkin, Jean-Elie; Bélec, Laurent
The prevalence of genital shedding of herpes simplex virus (HSV)-2 and related risk factors was evaluated in a prospective population of 355 women attending the Maternity Joséphine Bongo, in Libreville, Gabon. We found a high prevalence (66%) of HSV-2 seropositivity, with a high proportion, 14%, of women harbouring HSV-2 DNA shedding in their genital secretions. HSV-2 genital shedding was positively associated with previous episodes of genital blisters, current genital ulcer, current genital blister, HIV seropositivity and HSV-2 seropositivity. The high prevalence of HSV-2 in childbearing-aged population indicates that young women living in Gabon are at high risk for HIV acquisition in HIV-seronegative women sexually exposed to HIV, for HIV transmission in HIV-infected women co-infected by HSV-2 and finally for HSV-2 vertical transmission during pregnancy.
Lurie, Samuel; Mizrachi, Yossi; Chodick, Gabi; Katz, Rachel; Schejter, Eduardo
Genital warts are the most common sexually transmitted disease and have a detrimental impact on quality of life. Genital warts could be prevented by prophylactic HPV vaccination. The objective was to study real-life benefit of opportunistic HPV vaccination on age and gender specific incidence of genital warts. We performed a register-based population cohort study from publicly funded health-care provider in Israel. The incidence of genital warts was assessed during three time frame intervals: 2006-2008 (pre-vaccination effect period) 2009-2012 (early post-vaccination effect period) and 2013-2015 (late post-vaccination effect period), with an average annual number of members of 1,765,481, 1,906,774 and 2,042,678 in the years 2006-2008, 2009-2012 and 2013-2015, respectively. Among females, annual incidence of genital warts per 100,000 women decreased from 210.43 to 161.71 (OR 0.76, 95%CI 0.71-0.82, p<0.001) and to 146.8 (OR 0.69, 95%CI 0.66-0.72, p<0.001) between pre-vaccination period and early and late post-vaccination periods, respectively. Among males, annual incidence of genital warts per 100,000 men decreased from 262.85 to 232.40 (OR 0.88, 95%CI 0.83-0.93, p<0.001) and to 234.01 (OR 0.88, 95%CI 0.86-0.91, p<0.001) between pre-vaccination period and early and late post-vaccination periods, respectively. There is a potential benefit in reducing incidence of genital warts even in opportunistic HPV vaccination structure. This information may be relevant for health-care providers in countries where national immunization programs do not include HPV vaccines. Copyright © 2017 Elsevier Inc. All rights reserved.
Thompson, Karen J; Jones, Alaine D; Miller, Sandra A
In female grasshoppers, oviposition is a highly specialized behavior involving a rhythm-generating neural circuit, the oviposition central pattern generator, unusual abdominal appendages, and dedicated muscles. This study of Schistocerca americana (Drury) grasshoppers was undertaken to determine whether the simpler pregenital abdominal segments, which do not contain ovipositor appendages, share common features with the genital segment, suggesting a roadmap for the genesis of oviposition behavior. Our study revealed that although 5 of the standard pregenital body wall muscles were missing in the female genital segment, homologous lateral nerves were, indeed, present and served 4 ovipositor muscles. Retrograde labeling of the corresponding pregenital nerve branches in male and female grasshoppers revealed motor neurons, dorsal unpaired median neurons, and common inhibitor neurons which appear to be structural homologues of those filled from ovipositor muscles. Some pregenital motor neurons displayed pronounced contralateral neurites; in contrast, some ovipositor motor neurons were exclusively ipsilateral. Strong evidence of structural homology was also obtained for pregenital and ovipositor skeletal muscles supplied by the identified neurons and of the pregenital and ovipositor skeletons. For example, transient embryonic segmental appendages were maintained in the female genital segments, giving rise to ovipositor valves, but were lost in pregenital abdominal segments. Significant proportional differences in sternal apodemes and plates were observed, which partially obscure the similarities between the pregenital and genital skeletons. Other changes in reorganization included genital muscles that displayed adult hypertrophy, 1 genital muscle that appeared to represent 2 fused pregenital muscles, and the insertion points of 2 ovipositor muscles that appeared to have been relocated. Together, the comparisons support the idea that the oviposition behavior of genital
Pulverman, Carey S; Hixon, J Gregory; Meston, Cindy M
Based on analytic techniques that collapse data into a single average value, it has been reported that women lack category specificity and show genital sexual arousal to a large range of sexual stimuli including those that both match and do not match their self-reported sexual interests. These findings may be a methodological artifact of the way in which data are analyzed. This study examined whether using an analytic technique that models data over time would yield different results. Across two studies, heterosexual (N = 19) and lesbian (N = 14) women viewed erotic films featuring heterosexual, lesbian, and gay male couples, respectively, as their physiological sexual arousal was assessed with vaginal photoplethysmography. Data analysis with traditional methods comparing average genital arousal between films failed to detect specificity of genital arousal for either group. When data were analyzed with smoothing regression splines and a within-subjects approach, both heterosexual and lesbian women demonstrated different patterns of genital sexual arousal to the different types of erotic films, suggesting that sophisticated statistical techniques may be necessary to more fully understand women's genital sexual arousal response. Heterosexual women showed category-specific genital sexual arousal. Lesbian women showed higher arousal to the heterosexual film than the other films. However, within subjects, lesbian women showed significantly different arousal responses suggesting that lesbian women's genital arousal discriminates between different categories of stimuli at the individual level. Implications for the future use of vaginal photoplethysmography as a diagnostic tool of sexual preferences in clinical and forensic settings are discussed.
Heinen-Kay, J L; Langerhans, R B
Male genital morphology is remarkably diverse across internally fertilizing animals, a phenomenon largely attributed to sexual selection. Ecological differences across environments can alter the context of sexual selection, yet little research has addressed how this may influence the rapid, divergent evolution of male genitalia. Using the model system of Bahamas mosquitofish (Gambusia hubbsi) undergoing ecological speciation across blue holes, we used geometric morphometric methods to test (i) whether male genital shape (the small, approximately 1 mm long, distal tip of the sperm-transfer organ, the gonopodium) has diverged between populations with and without predatory fish and (ii) whether any observed divergence has a genetic basis. We additionally examined the effects of genetic relatedness and employed model selection to investigate other environmental factors (i.e. interspecific competition, adult sex ratio and resource availability) that could potentially influence genital shape via changes in sexual selection. Predation regime comprised the most important factor associated with male genital divergence in this system, although sex ratio and some aspects of resource availability had suggestive effects. We found consistent, heritable differences in male genital morphology between predation regimes: Bahamas mosquitofish coexisting with predatory fish possessed more elongate genital tips with reduced soft tissue compared with counterparts inhabiting blue holes without predatory fish. We suggest this may reflect selection for greater efficiency of sperm transfer and fertilization during rapid and often forced copulations in high-predation populations or differences in sexual conflict between predation regimes. Our study highlights the potential importance of ecological variation, particularly predation risk, in indirectly generating genital diversity.
Tang, Sheng; Chen, Si-ping
Severe sex ratio imbalance at birth is now becoming an important issue in several Asian countries. Its leading immediate cause is prenatal sex-selective abortion following illegal sex identification by ultrasound scanning. In this paper, a fast automatic recognition and location algorithm for fetal genital organs is proposed as an effective method to help prevent ultrasound technicians from unethically and illegally identifying the sex of the fetus. This automatic recognition algorithm can be divided into two stages. In the 'rough' stage, a few pixels in the image, which are likely to represent the genital organs, are automatically chosen as points of interest (POIs) according to certain salient characteristics of fetal genital organs. In the 'fine' stage, a specifically supervised learning framework, which fuses an effective feature data preprocessing mechanism into the multiple classifier architecture, is applied to every POI. The basic classifiers in the framework are selected from three widely used classifiers: radial basis function network, backpropagation network, and support vector machine. The classification results of all the POIs are then synthesized to determine whether the fetal genital organ is present in the image, and to locate the genital organ within the positive image. Experiments were designed and carried out based on an image dataset comprising 658 positive images (images with fetal genital organs) and 500 negative images (images without fetal genital organs). The experimental results showed true positive (TP) and true negative (TN) results from 80.5% (265 from 329) and 83.0% (415 from 500) of samples, respectively. The average computation time was 453 ms per image.
Njunda, Anna L.; Nsagha, Dickson S.; Assob, Jules C.N.; Palle, John N.; Kamga, Henri L.; Nde, Peter F.; Ntube, Mengang N.C.; Weledji, Patrick E.
Genital mycoplasmas are implicated in pelvic inflammatory diseases, puerperal infection, septic abortions, low birth weight, nongonococcal urethritis and prostatitis as well as spontaneous abortion and infertility in women. There is paucity of data on colonisation of genital mycoplasma in women and their drug sensitivity patterns. The aim of our study was to determine the prevalence of genital mycoplasmas (Ureaplasma urealiticum and Mycoplasma hominis) infection and their drug sensitivity patterns in women. A mycofast kit was used for biochemical determination of mycoplasma infection in 100 randomly selected female patients aged 19–57 years, attending the University of Yaoundé Teaching Hospital (UYTH) from March to June 2010. Informed consent was sought and gained before samples were collected. Genital mycoplasmas were found in 65 patients (65%) [95% CI=55.7–74.3%] and distributed as 41 (41%) [95% CI=31.4–50.6%] for U. urealiticum and 4 (4%) [95% CI=0.20– 7.8%] for M. hominis while there was co-infection in 20 women (20%) [95% CI=12.16–27.84%]. In our study, 57 (57%) [95% CI=47.3–67%] had other organisms, which included C. albicans (19 [19%]), G. vaginalis (35 [35%]) and T. vaginalis (3 [3%]). Among the 65 women with genital mycoplasma, the highest co-infection was with G. vaginalis (33.8%). Pristinamycine was the most effective antibiotic (92%) and sulfamethoxazole the most resistant (8%) antibiotic to genital mycoplasmas. We conclude that genital mycoplasma is a problem in Cameroon and infected women should be treated together with their partners. PMID:28299057
Background Genital ulcers (GU) are associated with an increased risk of HIV transmission. Understanding risk factors for genital ulcers and sexual behaviour patterns after onset of symptoms and health seeking behaviour among GU-patients can provide useful information to aid design effective prevention strategies for genital ulcers. We investigated risk factors of self-reported GUs and care-seeking in the general population, and assessed GU patients regarding past care-seeking, recent sexual behaviour and partner awareness of the disease. Methods We analysed national data on genital ulcers from the 2007 Zambia Demographic and Health Survey, and data from a cross-sectional survey of genital ulcer patients from primary health care facilities in Lusaka, Zambia. Results The prevalence of GU in 2007 in the general population of Lusaka was 3.6%. Important predictors for genital ulcers were age 25–29 years, being widowed/separated/divorced and having a high number of life-time sexual partners. No differences in care-seeking were observed by residence, wealth and gender, and 60% of the respondents sought care from public health facilities. Among patients with GUs in Lusaka, 14% sought care >2 weeks after symptom onset. Forty-two percent were not aware of their HIV status, 57% reported sex after onset of symptoms and only 15% reported consistent condom use. Conclusions Low awareness of HIV status despite high probability of being infected and low condom use after onset of genital ulcer symptoms leads to a high potential for transmission to sexual partners. This, combined with the fact that many patients with GUs delayed seeking care, shows a need for awareness campaigns about GUs and the importance of abstinence or use of condoms when experiencing such symptoms. PMID:22672697
Sénécal, Martin; Brisson, Marc; Maunsell, Elizabeth; Ferenczy, Alex; Franco, Eduardo L; Ratnam, Sam; Coutlée, François; Palefsky, Joel M; Mansi, James A
The quadrivalent human papillomavirus (HPV) vaccine is effective against HPV types responsible for 90% of anogenital warts. This study estimated the quality of life lost to genital warts using the EQ-5D, a generic instrument widely used for applications in economic analyses. The findings are described in terms that are more specific to individuals with genital warts using psychosocial questions adapted from the HPV impact profile, a measure developed for HPV-related conditions. Between September 2006 and February 2008, 42 physicians across Canada recruited 330 consenting patients 18 years and older with genital warts, either at the first or follow-up visit for an initial or recurrent episode. The quality of life lost associated with genital warts was estimated by the difference between participants' EQ-5D scores and age and gender-specific population norms. The study questionnaire was self-completed by 270 participants who were aged 31.5 years (SD 10.4) on average. The majority of participants were women (53.3%), heterosexual (93.5%) and in a stable relationship (66.0%). Genital warts were associated with detriments in the EQ-5D domains of anxiety/depression, pain/discomfort and usual activities. The absolute difference in the EQ-5D utility score and the EQ-VAS health status between genital warts patients and population norms was 9.9 (95% CI 7.3 to 12.5) and 6.0 (95% CI 4.1 to 7.9) percentage points, respectively. These results did not vary significantly according to patient age, gender, time since first episode or number of episodes. The results suggest that genital warts negatively affect the wellbeing of men and women as reflected by poorer quality of life scores compared with population norms.
Predictors of chlamydia and gonorrhoea can be used to increase the cost-effectiveness and acceptability of screening programmes, and allow targeting of control strategies. All women attending an STD clinic in 1988-1990 were offered screening for chlamydia and gonorrhoea, and the test results correlated with a wide range of potential predictors using multiple logistic regression. Of 4822 attenders, 3533 (73.3%) were tested for chlamydia over a total of 5430 episodes, yielding 348 (6.4%) positives, and 3510 (72.8%) were tested for gonorrhoea over a total of 5450 episodes, yielding 100 (1.0%) positives. Independent predictors of chlamydial infection were being an STD contact, having endocervical gonorrhoea, being under 25, not having genital herpes, being Aboriginal, using oral contraception, not having a steady partner and having vaginal discharge or dysuria. For gonorrhoea such predictors were being Aboriginal, an STD contact, under 25, tattooed, having vaginal discharge or dysuria, and having had sex outside the state in the past three months. Selective screening criteria for gonorrhoea provided 91% of positives, eliminated the need for 42% of tests and resulted in an increased yield ratio of 1.5 whereas the corresponding outcomes for screening criteria for chlamydia were 91%, 29% and 1.3, respectively. The diversity of STD epidemiology requires development of empirical screening guidelines for diverse settings. Standardisation of methodology to facilitate comparisons and extrapolation should include investigation of a wide range of variables, available before patient examination, by multivariate analysis, and choice of selective criteria to cover at least 90% of the infected population as well as resulting in a substantially increased yield (preferably an increased yield ratio of at least 1.5).
BACKGROUND--Predictors of chlamydia and gonorrhoea can be used to increase the cost-effectiveness and acceptability of screening programmes, and allow targeting of control strategies. METHODS--All women attending an STD clinic in 1988-1990 were offered screening for chlamydia and gonorrhoea, and the test results correlated with a wide range of potential predictors using multiple logistic regression. RESULTS--Of 4822 attenders, 3533 (73.3%) were tested for chlamydia over a total of 5430 episodes, yielding 348 (6.4%) positives, and 3510 (72.8%) were tested for gonorrhoea over a total of 5450 episodes, yielding 100 (1.0%) positives. Independent predictors of chlamydial infection were being an STD contact, having endocervical gonorrhoea, being under 25, not having genital herpes, being Aboriginal, using oral contraception, not having a steady partner and having vaginal discharge or dysuria. For gonorrhoea such predictors were being Aboriginal, an STD contact, under 25, tattooed, having vaginal discharge or dysuria, and having had sex outside the state in the past three months. Selective screening criteria for gonorrhoea provided 91% of positives, eliminated the need for 42% of tests and resulted in an increased yield ratio of 1.5 whereas the corresponding outcomes for screening criteria for chlamydia were 91%, 29% and 1.3, respectively. CONCLUSIONS--The diversity of STD epidemiology requires development of empirical screening guidelines for diverse settings. Standardisation of methodology to facilitate comparisons and extrapolation should include investigation of a wide range of variables, available before patient examination, by multivariate analysis, and choice of selective criteria to cover at least 90% of the infected population as well as resulting in a substantially increased yield (preferably an increased yield ratio of at least 1.5). PMID:1398655
Teixeira, A L; Lisboa, M
Due to globalized migratory processes, female genital mutilation/cutting (FGM/C) has spread to other countries, including countries in Europe, where, with a few exceptions, it remains a concealed problem. To the authors' knowledge, this is the first national extensive study to estimate the prevalence of FGM/C in Portugal. Prevalence estimation. Using extrapolation of country-of-origin prevalence data and the 2011 Census data, this study estimated: the prevalence of FGM/C in Portugal among women of reproductive age (15-49 years) and among all women aged ≥15 years; and the number of girls aged <15 years living in Portugal who have undergone or will probably undergo FGM/C. It is estimated that 6576 women aged ≥15 years living in Portugal have undergone FGM/C, with cases distributed unevenly throughout the national territory. In addition, it is estimated that 1830 girls aged <15 years living in Portugal have undergone or are likely to undergo FGM/C. This study estimated that more than 6000 women living in Portugal have undergone FGM/C, and many girls remain at risk. These two groups need different types of interventions. Awareness of the number and geographical dispersion of cases of FGM/C will enable more informed and targeted definition of public health policies for protection of females who have undergone or are at risk of undergoing FGM/C. Copyright © 2016 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.
Lewis-Bell, Karen; Luciani, Silvana; Unger, Elizabeth R; Hariri, Susan; McFarlane, Shelly; Steinau, Martin; Prieto-Lara, Elisa; Vicari, Andrea S; Irons, Beryl; Lewis, Merle J; Andrus, Jon Kim
To characterize the prevalence and distribution of genital human papillomavirus (HPV) types among women in Jamaica, and to explore risk factors associated with HPV infection. This was a cross-sectional study that took place in April-July 2010 with 852 sexually-active women, 16-49 years of age, who had attended a selected public or private primary health clinic in one of Jamaica's four health authority regions. Sociodemographic data was collected from each participant by trained study staff. Each participant had a gynecological examination that included a clinical Pap test and a cervical sample for HPV detection and typing-performed using the Research Use Only Linear Array (LA) genotyping assay (Roche Diagnostics Corp., Indianapolis, Indiana, United States). Overall and type-specific prevalence of HPV infection was calculated for 37 HPV types included in the LA genotyping assay. HPV DNA was detected in 460 of the 852 women (54.0%). Oncogenic HPV was detected in 297 women (34.9%) and HPV types 16/18 were found in 86 women (10.1%). The most frequently occurring HPV types were: 16 (6.2%); 35 (6.0%); 62 and 83 (5.5%); 61 and 58 (5.4%); 84 (4.7%); 18 (4.3%); and, 66 and 81 (4.2%). HPV prevalence was highest among women who were single, young (16-19 years), and had had more than three sexual partners in their lifetime. These results, coupled with high rates of cervical cancer, support introducing HPV vaccines while maintaining and strengthening cervical cancer screening services. Policy decision-making that reflects these results is instrumental to establishing a comprehensive cervical cancer program in Jamaica.
Rettenberger, Martin; Hill, Andreas; Dekker, Arne; Berner, Wolfgang; Briken, Peer
INTRODUCTION.: The present study investigates the relevance of genital abnormalities (GA) like cryptorchidism, hypospadias, and phimosis usually diagnosed in early childhood for the development of psychosexual problems and deficits in a sample of N = 163 convicted sexual homicide perpetrators. AIMS.: The first aim was to investigate the prevalence of early childhood GA in a sample of sexual homicide perpetrators. The second was to explore differences in the psychosexual development of participants with GA in early childhood compared with those without GA. It was expected that offenders with GA show specific problems in their psychosexual development compared with offenders without GA. METHODS.: The data for the present study were obtained by reanalyzing an existing database derived from a large-scale research project about sexual homicide. Using a predominantly exploratory design we, therefore, divided the total sample into two subgroups (with vs. without indicators of GA). MAIN OUTCOME MEASURES.: Main outcome measures were the number of sexual homicide perpetrators showing GA in early childhood and the differences of subjects with and without GA with regard to their psychosexual development (i.e., according to sexual deviant interests or sexual dysfunctions). RESULTS.: The prevalence of GA is substantially higher in this sample than epidemiological studies indicated in the normal population. This result provided first support for the importance of GA in the population of sexual homicide perpetrators. Further analyses indicate significant differences between both subgroups: Offenders with GA in early childhood showed indicators for more sexual dysfunctions (e.g., erectile dysfunction) in adulthood and a distinct tendency of more masochistic sexual interests. CONCLUSION.: Even if the exploratory design of the present investigation allows no causal conclusions between GA and sexual homicide offenses, the result provided support for the relevance of early
Barone, Mark A.; Frajzyngier, Vera; Ruminjo, Joseph; Asiimwe, Frank; Barry, Thierno Hamidou; Bello, Abubakar; Danladi, Dantani; Ganda, Sanda Oumarou; Idris, Sa’ad; Inoussa, Maman; Lynch, Maura; Mussell, Felicity; Podder, Dulal Chandra
Objective To determine predictors of fistula repair outcomes 3 months postsurgery. Methods We conducted a multicountry prospective cohort study between 2007 and 2010. Outcomes, measured 3 months postsurgery, included fistula closure, and residual incontinence in women with a closed fistula. Potential predictors included patient and fistula characteristics, and context of repair. Multivariable generalized estimating equation models were used to generate adjusted risk ratios (ARR) and 95% confidence intervals (CI). Results Women who returned for follow-up 3 month postsurgery were included in predictors of closure analyses (n=1,274). Small bladder size (ARR 1.57; 95% CI 1.39–1.79), prior repair (ARR 1.40; 95% CI 1.11–1.76), severe scarring (ARR 1.56; 95% CI 1.20–2.04), partial urethral involvement (ARR 1.36; 95% CI 1.11–1.66), and complete urethral destruction/circumferential defect (ARR 1.72; 95% CI 1.33–2.23) predicted failed fistula closure. Women with a closed fistula at 3 month follow-up were included in predictors of residual incontinence analyses (n=1041). Prior repair (ARR 1.37; 95% CI 1.13–1.65), severe scarring (ARR 1.35; 95% CI 1.10–1.67), partial urethral involvement (ARR 1.78; 95% CI 1.27–2.48), and complete urethral destruction or circumferential defect (ARR 2.06; 95% CI 1.51–2.81) were significantly associated with residual incontinence. Conclusions The prognosis for genital fistula closure is related to preoperative bladder size, previous repair, vaginal scarring, and urethral involvement. PMID:22914460
Ahmadi, Amjad; Khodabandehloo, Mazaher; Ramazanzadeh, Rashid; Farhadifar, Fariba; Roshani, Daem; Ghaderi, Ebrahim; Farhangi, Niloofar
Background: Chlamydia trachomatis is the etiology of most of sexually transmitted diseases. Colonization of C. trachomatis in the genital tract during early gestation has been associated with preterm birth, and preterm premature rupture of the membranes. The role of C. trachomatis on spontaneous abortion has not yet been proved completely. The aim of this study was to evaluate the frequency of C. trachomatis infection among pregnant women and its association with spontaneous abortion. Methods: This case-control study was conducted from August 2012 until January 2013. Totally, 218 women were included; 109 women with spontaneous abortion with gestation age between 10–20 weeks (cases), and 109 women with normal pregnancy with gestation age between 20–30 weeks (controls) in Sanandaj, Iran. DNA was extracted from endocervical swabs and a PCR test was conducted for detection of C. trachomatis infection in women using specific primers. Independent T-test and Chi-square were used for comparison of quantitative and qualitative variables, respectively, and p<0.05 was considered significant. Results: The total prevalence of C. trachomatis infection was 38(17.43%) in endocervical swabs of women. However, the number of cases with C. trachomatis infections was 25 out of 109(22.9%) in the case group and 13 out of 109(11.9%) in control group, respectively. Association between chlamydia infection and spontaneous abortion was statistically significant (OR=2.198, CI 95%: 1.058–4.56). Conclusion: Our study showed that C. trachomatis infection was associated with spontaneous abortion. Thus, screening and treatment of pregnant women may prevent this adverse pregnancy outcome. PMID:27141466
Zurynski, Yvonne; Sureshkumar, Premala; Cherian, Sarah; Deverell, Marie; Elliott, Elizabeth J
Objective The WHO reports that female genital mutilation/cutting (FGM/C) is an ancient cultural practice prevalent in many countries. FGM/C has been reported among women resident in Australia. Our paper provides the first description of FGM/C in Australian children. Design Cross-sectional survey conducted in April–June 2014. Setting Paediatricians and other child health specialists recruited through the Australian Paediatric Surveillance Unit were asked to report children aged <18 years with FGM/C seen in the last 5 years, and to provide data for demographics, FGM/C type, complications and referral for each case. Participants Of 1311 eligible paediatricians/child health specialists, 1003 (76.5%) responded. Results Twenty-three (2.3%) respondents had seen 59 children with FGM/C and provided detailed data for 31. Most (89.7%) were identified during refugee screening and were born in Africa. Three (10.3%) were born in Australia: two had FGM/C in Australia and one in Indonesia. All parents were born overseas, mainly Africa (98.1%). Ten children had WHO FGM/C type I, five type II, five type III and six type IV. Complications in eight children included recurrent genitourinary infections, menstrual, sexual, fertility and psychological problems. Nineteen children (82.6%) were referred to obstetrics/gynaecology: 16 (69.9%) to social work and 13 (56.5%) to child protection. Conclusions This study confirms that FGM/C is seen in paediatric clinical practice within Australia. Paediatricians need cultural awareness, education and resources to help them identify children with FGM/C and/or at risk of FGM/C, to enable appropriate referral and counselling of children, families and communities to assist in the prevention of this practice. PMID:28082321
Brentjens, Mathijs H; Yeung-Yue, Kimberly A; Lee, Patricia C; Tyring, Stephen K
Herpes genitalis is one of the most common viral sexually transmitted diseases in the world, with an estimated seroprevalence in the US of greater than 20%. Two viruses of the same family cause herpes genitalis: herpes simplex virus 1 and 2. After the resolution of primary infection, the virus persists in the nerve roots of the sacral plexus, often causing recurrent (though generally less severe) outbreaks. These outbreaks, as well as the infectious potential to the patient's sexual partners, results in significant psychological stress on the patient, and has a tremendous negative impact on QOL. Current treatment modalities may result in a reduction in the number of outbreaks and viral shedding, but no cure exists. Although studies have clearly demonstrated the negative impact of recurrent genital herpes on QOL, an assessment scale specific to herpes was not developed until recently. Earlier studies indicated that patients did not perceive a significant benefit from episodic treatment with antivirals, but studies using the Recurrent Genital Herpes Quality of Life Questionnaire (RGHQoL) have now demonstrated that suppressive antiviral therapy improves quality of life in patients with frequent recurrences of genital herpes. However, not all patients with recurrent genital herpes need suppressive therapy, and proposed factors to consider include frequency of recurrence, physical and psychological distress caused by recurrences, and the potential for transmission to the patient's sexual partner. Newer therapeutic modalities, including the topical immune response modifier resiquimod and herpes vaccines, may eventually be shown to further decrease the psychological morbidity of recurrent genital herpes.
Kimberlin, David W; Baley, Jill
Herpes simplex virus (HSV) infection of the neonate is uncommon, but genital herpes infections in adults are very common. Thus, although treating an infant with neonatal herpes is a relatively rare occurrence, managing infants potentially exposed to HSV at the time of delivery occurs more frequently. The risk of transmitting HSV to an infant during delivery is determined in part by the mother's previous immunity to HSV. Women with primary genital HSV infections who are shedding HSV at delivery are 10 to 30 times more likely to transmit the virus to their newborn infants than are women with recurrent HSV infection who are shedding virus at delivery. With the availability of commercial serological tests that reliably can distinguish type-specific HSV antibodies, it is now possible to determine the type of maternal infection and, thus, further refine management of infants delivered to women who have active genital HSV lesions. The management algorithm presented herein uses both serological and virological studies to determine the risk of HSV transmission to the neonate who is delivered to a mother with active herpetic genital lesions and tailors management accordingly. The algorithm does not address the approach to asymptomatic neonates delivered to women with a history of genital herpes but no active lesions at delivery.
Valencia, Frances; Veselenak, Ronald L; Bourne, Nigel
Both the guinea pig and mouse are important animal models for the study of genital herpes. The murine model has been used extensively to evaluate vaccines and antiviral agents by measuring the incidence of infection and the magnitude of viral replication; however, this model is limited with regard to distinguishing between candidate vaccines or treatments. In contrast, the guinea pig closely mimics human infection and provides an excellent model of both primary and recurrent genital herpes disease. This animal model is especially important in the study of viral transmission through the evaluation of latent viral reactivation and virus shedding into the genital tract. Here, we describe methodologies to determine viral infection, severity of primary disease, and quantification of primary viral replication in the genital tract for both the guinea pig and murine models of genital herpes. Additionally, we detail the evaluation of the onset of primary disease and progression to the day of death in the mouse model. Further, we summarize methods to assess the frequency of recurrences, frequency and magnitude of virus shedding, and latent viral load in the sensory nerve ganglia of the guinea pig.
Jiang, Janina; Liu, Guangchao; Kickhoefer, Valerie A.; Rome, Leonard H.; Li, Lin-Xi; McSorley, Stephen J.; Kelly, Kathleen A.
Chlamydia trachomatis genital infection is the most common sexually transmitted bacterial disease, causing a significant burden to females due to reproductive dysfunction. Intensive screening and antibiotic treatment are unable to completely prevent female reproductive dysfunction, thus, efforts have become focused on developing a vaccine. A major impediment is identifying a safe and effective adjuvant which induces cluster of differentiation 4 (CD4) cells with attributes capable of halting genital infection and inflammation. Previously, we described a natural nanocapsule called the vault which was engineered to contain major outer membrane protein (MOMP) and was an effective vaccine which significantly reduced early infection and favored development of a cellular immune response in a mouse model. In the current study, we used another chlamydial antigen, a polymorphic membrane protein G-1 (PmpG) peptide, to track antigen-specific cells and evaluate, in depth, the vault vaccine for its protective capacity in the absence of an added adjuvant. We found PmpG-vault immunized mice significantly reduced the genital bacterial burden and histopathologic parameters of inflammation following a C. muridarum challenge. Immunization boosted antigen-specific CD4 cells with a multiple cytokine secretion pattern and reduced the number of inflammatory cells in the genital tract making the vault vaccine platform safe and effective for chlamydial genital infection. We conclude that vaccination with a Chlamydia-vault vaccine boosts antigen-specific immunities that are effective at eradicating infection and preventing reproductive tract inflammation. PMID:28106821
Sauer, Pieter J J; Neubauer, David
Female genital mutilation or female circumcision is frequently performed worldwide. It is estimated by the World Health Organisation that worldwide, 100-140 million girls and women currently have to live with the consequences of female genital mutilation. The article argues that the tradition is one of the causes, while another four possible reasons for undergoing such cruel mutilation of young girls exist. Today, there exists a classification of at least four different ways of such mutilation which has no health benefits, and it harms girls and women in many ways. Long-term consequences like recurrent urinary tract infections, dysmenorrhea, sexual problems, infertility and complications both for the mother and infant at delivery are mentioned. Female genital mutilation is a violation of the fundamental human rights, as well as a savage breach of the integrity and personality. The European Academy of Paediatrics advises its members to initiate appropriate counselling for parents and female adolescents regarding the risk of female genital mutilation and strongly condemns female genital mutilation and councils its members not to perform such procedures.
Wang, S-H; Chi, C-C; Wong, Y W; Salim, A; Manek, S; Wojnarowska, F
The association of lichen sclerosus (LS) with genital squamous cell carcinoma is well recognized. However, the relationship between LS and verrucous carcinoma remains unclear. To evaluate the associations of genital and perianal verrucous carcinomas with LS. We conducted a retrospective study on patients with a genital or perianal verrucous carcinoma and reviewed their histopathology specimens and clinical notes. We also conducted a literature review. We identified a total of 13 patients (including 6 women and 7 men) with a genital or perianal verrucous carcinoma. All 5 women with vulval verrucous carcinoma had coexisting LS (5/5), and 1 man with penile verrucous carcinoma had coexisting LS (1/3). In contrast, no coexisting LS was found in all 5 cases of perianal verrucous carcinoma (0/5). Half of the cases of verrucous carcinoma with coexisting LS had recurrences (3/6), while no recurrences were found in those without coexisting LS (0/7). Our study and review of the literature demonstrate that vulval verrucous carcinoma is strongly associated with LS. In contrast, perianal verrucous carcinoma is not associated with LS. When genital verrucous carcinoma is diagnosed, it is important to consider LS as a potential concomitant diagnosis and offer appropriate treatments and close follow-up to detect recurrence of verrucous carcinoma.
Ahmadnia, Elahe; Kharaghani, Roghieh; Maleki, Azam; Avazeh, Azar; Mazloomzadeh, Saeideh; Sedaghatpisheh, Tahereh; Jalilvand, Ahmad; Molae, Behnaz
Objectives This study aimed to determine the prevalence of genital and sexually transmitted infections and its related factors in married women in Iran. Methods We conducted a cross-sectional study of 4 274 married women living in urban and rural areas of the Zanjan province from 2012 to 2013. We used stratified cluster sampling to select the participants. Data collection included demographic characteristics, reproductive status, and cervical cytology results. Results The prevalence of lower genital infections and sexually transmitted infections were 20.1% and 7.4%, respectively. The most common vaginal infection was bacterial vaginosis with a prevalence of 8.5%, and the most common sexually transmitted infection was Trichomonas vaginalis (1.4%). The use of the intrauterine device (IUD) as a contraceptive, living in an urban area, and experiencing vaginal discharge were significantly related to genital tract and sexually transmitted infections. Conclusions There was a high prevalence of genital infection among women living in Zanjab. Screening and treatment of genital infection are necessary to prevent adverse consequences in women who use an IUD or live in urban areas. PMID:27974960
Soori, Tahereh; Hallaji, Zahra; Noroozi-Nejad, Esmat
Genital wart is the most common sexually transmitted disease worldwide. Sexual risk factors and sexual behavior pattern may be different in various countries. In this study, we tried to evaluate demographic information and some sexual behaviors and risk factors in Iranian patients with genital warts. In this cross-sectional study, 250 patients with anogenital warts were evaluated. They had been referred to the Sexually Transmitted Diseases Clinic of Razi Hospital. Demographic information and sexual risk factors and pattern of sexual behaviors were recorded in the questionnaires. One hundred twenty-five men and 125 women with genital warts were evaluated. The most common age group was 20- 30 years old; 24.8% were single; 29.6% had academic education; 35 (14%) of the patients had started sexual activity before 15 years of age; 92% reported unsafe sex; seven (2.8%) of them were HIV infected; two cases (0.8%) were homosexual; and seven cases (2.8%) were bisexual. Genital herpes simplex type 2 was the most common coincident sexually transmitted disease (6.4%). Genital wart in men may be as common as women, married and singles, and mostly involves younger people. Sexual high-risk behaviors and unsafe sex make them at risk for HIV infection. Sexual health education should be considered in high-risk groups.
Satoh, Masataka; Yamamoto, Toshiyuki
Pyoderma gangrenosum is an ulcerative skin disorder showing characteristic non-infectious ulcers and affects the lower extremities in approximately 70% of cases. Pyoderma gangrenosum is commonly associated with systemic diseases such as inflammatory bowel disease, rheumatoid arthritis and hematological malignancies. Herein, we report two cases of Japanese patients diagnosed with genital pyoderma gangrenosum. Case 1 was a 74-year-old woman without associated systemic complications, whose skin lesion resembled a squamous cell carcinoma and was limited to the vulva. Case 2 is an 89-year-old man, who suffered from myelodysplastic syndrome and acute myeloid leukemia, and presented with penile and leg ulcers mimicking pressure sores. Both cases responded well to systemic steroids. We review 13 genital pyoderma gangrenosum cases (76.9% male; aged 30-89 years) from 1996 to 2012 in Japan, including 11 previously reported cases and the present study's two cases. Four of the 13 genital pyoderma gangrenosum cases had associated systemic diseases and their skin lesions spread to the extragenital areas. Eight of the remaining nine genitalia-localized pyoderma gangrenosum cases had no associated systemic diseases. In conclusion, genital pyoderma gangrenosum is rare and may be misdiagnosed. It should therefore be considered in cases of refractory genital ulcers. In addition, genitalia-localized pyoderma gangrenosum tends to be without systemic complications.
Oraekwe, Obinna Izuchukwu; Udensi, Maduabuchi Amagh; Nwachukwu, Kelechi Chiemela; Okali, Uka Kalu
Genital prolapse is an important cause of morbidity among postmenopausal and multiparous women especially in our environment where a high premium is placed on large family size. This study was done to determine the prevalence, risk factors, clinical presentation, and management options of genital prolapse. Data of those diagnosed with genital prolapse were retrieved from records in the clinic, wards, theater, and from patients' folders in the medical records department. Data were analyzed using Statistical Package for Social Sciences version 20 with P < 0.05. Genital prolapse accounted for 0.8% of gynecological clinic attendances and 5.2% of major gynecological operations. The mean age of patients was 56.7 ± 15.5 years. Farmers constituted 60.7% of the patients while 72.1% and 70.5% were postmenopausal and grandmultiparous women, respectively. The sensation of something coming down the vagina was the most common symptom noted in 98.4% of the patients. Most (23.0%) of the patients had unsupervised delivery at home. Uterovaginal prolapse was the most common (70.5%) type of genital prolapse, and third-degree uterovaginal prolapse was its most frequent presentation. Majority of the patients (44.4%) were managed expectantly while the most common surgery performed was vaginal hysterectomy with pelvic floor repair (33.3%). Widespread availability of antenatal services especially in the rural communities and limitation on family size can significantly reduce the burden of this disease.
Harding, Tristan; Hayes, Jenny; Simonis, Magdalena; Temple-Smith, Meredith
Labiaplasty, the surgical reduction of the labia minora, has significantly increased in demand in Australia. Although general practice is one gatekeeper for patients requesting labiaplasty, as a referral is necessary to claim Medicare entitlements, there is little information available to assist general practitioners (GPs) in managing these requests for female genital cosmetic surgery. Semi-structured interviews were conducted with health professionals, including GPs, gynaecologists and plastic surgeons. Participants were recruited through the Victorian Primary Care Practice-based Research Network (VicReN), clinical teaching hospitals and snowball sampling. All interviews were digitally recorded, transcribed, and analysed using content and thematic analysis. Twenty-seven interviews were conducted. All participants were aware of genital labiaplasty; many had patients who were concerned about genital appearance, for which information had often been sought opportunistically. All participants agreed on the need for resources to inform women of normal genital appearance. This novel study demonstrates a need for clinical resources for GPs managing requests for genital labiaplasty.
Smith, Elaine M; Ritchie, Justine M; Galask, Rudolph; Pugh, Erica E; Jia, Jian; Ricks-McGillan, Joan
OBJECTIVE: To evaluate the risk of vulvar vestibulitis syndrome (VVS) associated with genital infections in a case-control study. METHODS: Diagnosed cases with VVS (n = 69) and age-frequency-matched healthy controls (n = 65) were enrolled from gynecology clinics in a university medical hospital during 1999. They were compared for potential risk factors and symptoms of disease. RESULTS: VVS cases had a significantly higher risk of physician-reported bacterial vaginosis (BV) (odds ratio, OR = 9.4), Candida albicans (OR = 5.7), pelvic inflammatory disease (PID) (OR = 11.2), trichomoniasis (OR = 20.6), and vulvar dysplasia (OR = l5.7) but no risk associated with human papillomavirus (HPV), ASCUS, cervical dysplasia, genital warts, chlamydia, genital herpes or gonorrhea. Genital symptoms reported significantly more often with VVS included vulvar burning (91 vs. 12%), dyspareunia (81 vs. 15%), vulvar itching (68 vs. 23%) and dysuria (54 vs. 19%) (p < 0.0001). CONCLUSION: A history of genital infections is associated with an increased risk of VVS. Long-term follow-up case-control studies are needed to elucidate etiologic mechanisms, methods for prevention and effective treatment. PMID:12648313
Lundqvist, Annika; Fernandez-Rodrigues, Julia; Ahlman, Karin; Lagergård, Teresa
Haemophilus ducreyi causes genital ulceration (chancroid), a sexually transmitted infection and still an important factor which contributes to the spread of HIV in developing countries. The bacterium produces a cytolethal distending toxin (HdCDT) causing cell cycle arrest and apoptosis/necrosis of human cells and contributes to the aggravation of ulcers. The aim of the study was to induce toxin-neutralizing antibodies in the genital tract of mice. Repeated subcutaneous (sc) immunisations with 5-10microg active HdCDT induced low levels of serum anti-HdCDT IgG without neutralizing capacity. High levels of specific IgG1 antibodies in serum and genital tract were generated after sc immunisations with 10microg formaldehyde detoxified HdCDT toxoid alone and the addition of aluminium salts or RIBI (based on the lipid A moiety) as adjuvant further increased the level of serum antibodies. A high correlation was found between elevated levels of anti-HdCDT IgG in sera, the level of neutralizing activity and the antibody level in genital tract (r=0.8). Thus, induction of high antibody levels specific to HdCDT in the genital tissue can be achieved by parenteral immunisation with the toxoid. The HdCDT toxoid can be considered as a candidate component in vaccine against chancroid.
Walley, C J
This article lays the groundwork for a feminist and anthropological political response to female genital "operations" that transcends the current debate over the phenomenon, which is couched in terms of cultural relativism or of politically-informed outrage. After an introduction, the study considers the politics involved in assigning a name to the procedure and explains the author's reason for choosing female genital "operation" over the more commonly used "circumcision," "mutilation," or "torture." In the next section, clitoridectomy is contextualized through a recounting of the circumstances under which the procedure was performed in the western Kenyan village of Kikhome in 1988. This discussion focuses on the ceremonies surrounding the circumcisions of young men and women, the author's attempts to discover how the young women involved really felt about the tradition, and a review of the anthropological literature on the significance and impact of these practices. The analysis then examines the international controversy surrounding female genital mutilation and provides an overview of the colonial discourse on female genital mutilation in Africa to expose 1) the origins of justifications for colonial dominance in the dominance of non-Western women by non-Western men and 2) the fact that use of cultural arguments that fuse women and tradition can support culturally-defined power relationships. The article concludes with a consideration of who is qualified to speak out against female genital mutilation given the fact that all women and all debates are the products of longstanding, tenacious power relationships.
Shokri, Hojjatollah; Khosravi, Alireza; Sharifzadeh, Aghil; Tootian, Zahra
Yeasts are commensal organisms found in the skin, genital and gastrointestinal tracts, and other mucosal sites in mammalians. The purposes of this study were to identify yeast flora and to determine the number of colony forming units (CFUs) in genital tract of healthy female dromedary camels, establishing their connection in both mated and unmated conditions. The samples were taken from different parts of genital tract including vestibule, vagina, cervix, uterine body, and uterine horns of 50 camels using sterilized cotton swabs. They were cultured onto Sabouraud glucose agar containing chloramphenicol and incubated at 30 degrees C for 7-10 days. A total of 454 yeast colonies were obtained from genital tract. Yeast isolates belonged to 8 genera: Candida (73.1%), Trichosporon (10.1%), Geotrichum (7.5%), Kluyveromyces (3.5%), Rhodotorula (2.4%), Aureobasidium (1.4%), Cryptococcus (1.1%) and Prototheca (0.8%). Among different Candida species, C. zeylanoides was the most common isolated species, representing significant difference with other Candida species (P<0.05). The mean number of yeasts found in the vestibule (46%) was significantly higher than the results obtained from other parts (P<0.05). In addition, the mean value of CFUs from unmated females (71.1%) was significantly higher than mated females (P<0.05). The results showed that C. zeylanoides was a common component of healthy camel females' genital mycoflora and the number of yeasts varied between mated and unmated females.
Edelstein, Zoe R.; Carter, Joseph J.; Garg, Ruchi; Winer, Rachel L.; Feng, Qinghua; Galloway, Denise A.
Background. Although the prevalence of human papillomavirus (HPV) genital infection is similarly high in males and females, seroprevalence is lower in males. This study assessed rates and determinants of seroconversion after detection of genital HPV infection in young men. Methods. We investigated HPV type-specific seroconversion in a cohort of heterosexual male university students who had an α9 HPV type (HPV-16, -31, -33, -35, -52, -58, or -67) detected in the genital tract (n = 156). HPV DNA and antibodies were detected and typed using liquid bead-based multiplex assays. We calculated seroconversion using Kaplan–Meier survival analysis. Cox proportional hazards models with generalized estimating equations were used to examine associations with seroconversion. Results. Within 24 months of detecting genital HPV infection, type-specific seroconversion ranged from 4% for HPV–52 to 36% for HPV-31. HPV-16 seroconversion at 24 months was 13% (95% confidence interval [CI], 7%–25%). Among incident HPV infections, ever cigarette smoking and infection site(s) (shaft/scrotum and glans/urine vs shaft/scrotum or glans/urine only) were positively associated with type-specific seroconversion. Conclusions. For each of the α9 HPV types, type-specific seroconversion within 24 months was observed in 36% or less of infected men. Seroconversion might be related to cigarette smoking and genital site(s) infected. PMID:21673030
Pazmany, Els; Bergeron, Sophie; Van Oudenhove, Lukas; Verhaeghe, Johan; Enzlin, Paul
With a prevalence of 15-21%, dyspareunia is one of the most commonly reported sexual dysfunctions in pre-menopausal women under the age of 40. Studies to date have focused primarily on clinical samples, showing that women with dyspareunia report overall sexual impairment, anxiety, and feelings of sexual inadequacy. However, little is known about their body image and genital self-image and few studies have sampled women exclusively from the general population. The aim of the present, controlled study was to investigate body image and genital self-image in a community sample of pre-menopausal women with self-reported dyspareunia. In total, 330 women completed an online survey, of which 192 (58%) had dyspareunia and 138 (42%) were pain-free control women. In comparison to pain-free control women, women with dyspareunia reported significantly more distress about their body image and a more negative genital self-image. Moreover, findings from a logistic regression, in which trait anxiety was controlled for, showed that a more negative genital self-image was strongly and independently associated with an increased likelihood of reporting dyspareunia. These results suggest that, in women with dyspareunia, body image and genital self-image are significantly poorer and would benefit from more attention from both clinicians and researchers.
Xu, Xijin; Zhang, Yuling; Yekeen, Taofeek Akangbe; Li, Yan; Zhuang, Bingrong; Huo, Xia
In recent years, occupational and environmental exposure to toxic pollutants has increasingly contributed to declining sperm quality and increasing morbidity of human male genital diseases. This study explored the effects of electronic waste (e-waste) environmental pollutions on male genital health in Guiyu, one of the largest e-waste recycling centers in the world. We collected outpatient case information from 2001 to 2009 in Guiyu and a control hospital and performed statistical analysis on male genital diseases morbidity (MGDM). The MGDM in Guiyu and the control hospital per thousand from 2004 to 2009 were 1.410/0.403 (2004), 0.539/0.385 (2005), 0.248/0.284 (2006), 0.485/0.195 (2007), 1.107/0.272 (2008), and 0.741/0.586 (2009) while the average total MGDM from 2004 to 2009 were 0.753 and 0.355 per thousand, respectively. Percentage of occurrence of epididymitis, impotence and prospermia, redundant prepuce, gonorrhea, urethritis, sexual function dysfunction, azoospermia, asthenospermia, and unknown etiology male sterility were higher in Guiyu (P < 0.05), whereas the frequency of prostatitis, condyloma accuminatum, and genital herpes were higher in the control (P < 0.05). Morbidity of male genital diseases was higher in Guiyu than in the control area. Male reproductive health may be threatened by e-waste environmental pollution in Guiyu, especially for diseases that could be influenced by environmental factors, and it may influence local population diathesis.
Nicholson, Abbigail E; Siegel, Dustin S
Male salamanders use nephrons from the genital kidney to transport sperm from the testicular lobules to the Wolffian duct. The microstructure of the epithelia of the genital kidney proximal tubule and distal tubule was studied over 1 year in a population of Notophthalmus viridescens from Crawford and Pike counties in central Missouri. Through ultrastructural analysis, we were able to support the hypothesis that the genital kidney nephrons are modified to aid in the transportation of sperm. A lack of folding of the basal plasma membrane, in both the genital kidney proximal and distal tubules when compared to the pelvic kidney proximal and distal tubules, reduces the surface area and thus likely decreases the efficiency of reabsorption in these nephron regions of the genital kidney. Ciliated epithelial cells are also present along the entire length of the genital kidney proximal tubule, but are lacking in the epithelium of the pelvic kidney proximal tubule. The exact function of these cilia remains unknown, but they may aid in mixing of seminal fluids or the transportation of immature sperm through the genital kidney nephrons. Ultrastructural analysis of proximal and distal tubules of the genital kidney revealed no seasonal variation in cellular activity and no mass production of seminal fluids throughout the reproductive cycle. Thus, we failed to support the hypothesis that the cellular activity of the epithelia lining the genital kidney nephrons is correlated to specific events in the reproductive cycle. The cytoplasmic contents and overall structure of the genital and pelvic kidney epithelial cells were similar to recent observations in Ambystoma maculatum, with the absence of abundant dense bodies apically in the epithelial cells lining the genital kidney distal tubule.
Background Human papillomaviruses are the most common sexually transmitted infections, and genital warts, caused by HPV-6 and 11, entail considerable morbidity and cost. The natural history of genital warts in relation to HIV-1 infection has not been described in African women. We examined risk factors for genital warts in a cohort of high-risk women in Burkina Faso, in order to further describe their epidemiology. Methods A prospective study of 765 high-risk women who were followed at 4-monthly intervals for 27 months in Burkina Faso. Logistic and Cox regression were used to identify factors associated with prevalent, incident and persistent genital warts, including HIV-1 serostatus, CD4+ count, and concurrent sexually transmitted infections. In a subset of 306 women, cervical HPV DNA was tested at enrolment. Results Genital wart prevalence at baseline was 1.6% (8/492) among HIV-uninfected and 7.0% (19/273) among HIV-1 seropositive women. Forty women (5.2%) experienced at least one incident GW episode. Incidence was 1.1 per 100 person-years among HIV-uninfected women, 7.4 per 100 person-years among HIV-1 seropositive women with a nadir CD4+ count >200 cells/μL and 14.6 per 100 person-years among HIV-1 seropositive women with a nadir CD4+ count ≤200 cells/μL. Incident genital warts were also associated with concurrent bacterial vaginosis, and genital ulceration. Antiretroviral therapy was not protective against incident or persistent genital warts. Detection of HPV-6 DNA and abnormal cervical cytology were strongly associated with incident genital warts. Conclusions Genital warts occur much more frequently among HIV-1 infected women in Africa, particularly among those with low CD4+ counts. Antiretroviral therapy did not reduce the incidence or persistence of genital warts in this population. PMID:21251265
Ondoa, Pascale; Gautam, Raju; Rusine, John; Lutter, Rene; Jurriaans, Suzanne; Kootstra, Neeltje; Karita, Etienne; van de Wijgert, Janneke
Background Genital viral load (GVL) is the main determinant of sexual transmission of human immune-deficiency virus (HIV). The effect of antiretroviral therapy (ART) on local cervico-vaginal immunological factors associated with GVL is poorly described. We aimed to identify the risk factors of detectable GVL, and the impact of ART on HIV genital shedding and its correlates in a cohort of HIV-infected women, attending HIV care in Kigali, Rwanda. Materials and Methods All participants were evaluated for GVL, plasma viral load (PVL), CD4 count, various sexually-transmitted infections (STIs) at baseline and at month 12. Genital concentration of 19 cytokines and mRNA expression of APOBEC3G and BST2, two host HIV restriction factors, were evaluated at baseline in all participants. Cytokine levels were re-assessed at month 12 only in participants eligible for ART at baseline. Risk factors of GVL ≥40copies/mL at baseline and month 12 were assessed using logistic regression. Effect of 12-month ART on various local and systemic immunological parameters was examined using a paired t-test and McNemar as appropriate. Results 96 of the 247 women enrolled in the study were eligible for ART. After 12 months of ART, PVL and GVL decreased to undetectable level in respectively 74 and 88% of treated participants. ART did not affect cytokine levels. HIV genital shedding occurred only when PVL was detectable. At baseline, GVL was independently associated with IL-1β after controlling for PVL, age and N. gonorrhea infection (95% CI 1.32-2.15) and at month 12 with MIP-1β (95% CI 0.96-21.32) after controlling for baseline GVL, PVL and month 12 IL-8. Conclusion Suppressive ART does not necessarily reduce genital level of immune activation. Minimizing all conditions favoring genital inflammation, including active detection and treatment of STIs, might reduce the risk of HIV transmission as supplement to the provision of potent ART. PMID:26010956
Mandal, Ranajit; Kundu, Pratip; Biswas, Jaydip
Human papillomavirus (HPV) is a well-established causative agent of malignancy of the female genital tract and a common Sexually Transmitted Infection. The probable co-factors that prevent spontaneous clearance of HPV and progression to neoplasia are genital tract infections from organisms like Chlamydia, Trichomonas vaginalis etc, smoking, nutritional deficiencies and multiparity. Inflammatory conditions can lead to pre-neoplastic manifestations in the cervical epithelium; however their specific role in cervical carcinogenesis is not yet established. Therefore it is imperative to study the likely association between HPV and co-infection with various common pathogens in the genital tract of women having cervical precancer or cancer. A “Pubmed” search was made for articles in Literature on this topic using the words: Cervical neoplasia, HPV, co-infections, Cervical Intraepithelial Neoplasia (CIN), Trichomonas vaginalis, Candida, Chlamydia and the relevant information obtained was used to draft the review. PMID:27042571
Hayford, Sarah R; Trinitapoli, Jenny
The relationship between religious obligations and female genital cutting is explored using data from Burkina Faso, a religiously and ethnically diverse country where approximately three-quarters of adult women are circumcised. Data from the 2003 Burkina Faso Demographic and Health Survey are used to estimate multilevel models of religious variation in the intergenerational transmission of female genital cutting. Differences between Christians, Muslims, and adherents of traditional religions are reported, along with an assessment of the extent to which individual and community characteristics account for religious differences. Religious variation in the intergenerational transmission of female genital cutting is largely explained by specific religious beliefs and by contextual rather than individual characteristics. Although Muslim women are more likely to have their daughters circumcised, the findings suggest the importance of a collective rather than individual Muslim identity for the continuation of the practice.
Quintal, Amanda P N; Borges, Bruna C; Brígido, Paula C; Silva, Rebecca T; Notário, Ana F; Santos, Marlus A; de Souza, Maria A; Nascimento, Fernanda G O; Mundim, Antônio V; Costa, Guilherme M J; Vasconcelos, André B; da Silva, Claudio V
Leishmaniasis causes alterations and lesions in the genital system, which leads to azoospermia and testicular atrophy in animals during the chronic phase of the infection. The aim of this study was to reveal the kinetics of Leishmania chagasi infection in the genital system of male golden hamsters (Mesocricetus auratus). Animals were intraperitoneally inoculated with amastigotes from L. chagasi. At different time points animals were euthanized and genital organs processed for histo-pathological, qPCR, cytokines and testosterone detection assays. Our results showed a high parasite load in testis, followed by an increase of pro-inflammatory cytokines IL1-β, TNF-α and IFN-γ, and testosterone. Subsequently, IL-4 expression was upregulated and basal parasite persistence in testis was observed using the experimental approach. Extracellular amastigotes migrated to the epididymis posing as a potential major factor of parasite persistence and venereal transmission of L. chagasi infection in hamsters.
Pirtea, L; Grigoras, D; Ilina, R; Mueller-Funogea, A
The surgical treatment of complete genital prolapse must aim the restoration of the vaginal support structures. All 3 levels of the vaginal support system must be recreated. Ablation of the uterus is not useful for pelvic floor support. Sparing of the uterus offers the advantage of a reduced surgical trauma, and better pelvic floor restoration. We present the case of a 60-year old woman with complete genital prolapse where the uterus was spared, and sacrospinous fixation, anterior mesh repair,perineal body repair and suburethral sling insertion were performed. The results were very good, by means of pelvic floor statics and physiology of micturition. genital prolapse must be cured by reconstruction of the vaginal support system, not by hysterectomy. Celsius.
Hayford, Sarah R.; Trinitapoli, Jenny
The relationship between religious obligations and female genital cutting is explored using data from Burkina Faso, a religiously and ethnically diverse country where approximately three-quarters of adult women are circumcised. Data from the 2003 Burkina Faso Demographic and Health Survey are used to estimate multilevel models of religious variation in the intergenerational transmission of female genital cutting. Differences between Christians, Muslims, and adherents of traditional religions are reported along with an assessment of the extent to which individual and community characteristics account for religious differences. Religious variation in the intergenerational transmission of female genital cutting is largely explained by specific religious beliefs and by contextual rather than individual characteristics. Although Muslim women are more likely to have their daughter circumcised, the findings suggest the importance of a collective rather than individual Muslim identity for the continuation of the practice. PMID:21969936
Dare, F O; Oboro, V O; Fadiora, S O; Orji, E O; Sule-Odu, A O; Olabode, T O
This study was conducted at three teaching hospitals in South-Western Nigeria. Paturients were examined to find out if they had had female genital mutilation. Those who did were given a self-administered questionnaire. Results show that all the patients had either Type I (69%) or Type II (31%) mutilation (using WHO classification). The average age at which the procedure was performed was 6.9+/-2.9 years, with 4% of women having the procedure performed in pregnancy. The majority of the procedures were performed by medically untrained personnel (89%). Up to 67% of the women reported complications following the procedure. Severe pain and bleeding were the most common (69%) of the complications reported. The most common reason given for the procedure is cultural/traditional (63%). About a fifth of the women want their female child to undergo female genital mutilation. This study highlights the need for further interventions aimed at discouraging the practice of female genital mutilation.
Yang, Chun-Jun; Liu, Sheng-Xiu; Liu, Jiang-Bo; Wang, Zhong-Ying; Luo, Di-Feng; Zhang, Guo-Long; Zhang, Xue-Jun; Yang, Sen
The treatment and relapse rate of genital warts are significant problems. The aim of this observational study was to assess the efficacy of holmium laser treatment of genital warts. A total of 1500 outpatients with genital human papillomavirus-induced lesions presenting from August 2002 to June 2005 were treated with holmium laser. The effects and side-effects of treatment were observed and analysed. Of this large cohort, lesions were excised at the first visit in 1488 cases. Twelve cases were treated a second or third time in the event that the lesions were too large to be removed at the first visit. The incidence of side-effects and complications after treatment with holmium laser was found to be low. Almost all warts can be excised at first treatment by holmium laser therapy with little bleeding during the treatment.
Borges, Edson Moreira; Branco, Érika; de Lima, Ana Rita; Leal, Leonardo Martins; Martins, Leandro Luiz; Reis, Ana Carolina Gonçalves; Cruz, Claudinei; Machado, Márcia Rita Fernandes; Miglino, Maria Angelica
The spotted paca is the second largest rodent in Brazil, where it is of great economic interest in impoverished regions in view of its prominence as a low-cost source of protein. Little is known about the morphology of the accessory genital glands of this species. Thus, we studied the position and morphology of the genitals in ten adult male spotted pacas. The animals were divided into two groups, five animals were used for fixing of samples in 10% aqueous formaldehyde for macroscopic studies and the other five animals were designated for microscopic analysis. These were arranged in pairs and had the vesicular, prostate, coagulating and bulbourethral glands identified, being structured as mucous glands, which lead into the pelvic urethra. It was concluded that the accessory genital glands found in the paca are the same as those found in most rodents, showing similar histological aspects.
Huppert, Jill S
Acute genital ulcers are painful and distressing to women and perplexing to the providers who care for them. The differential diagnosis includes sexually and nonsexually transmitted infections, autoimmune conditions, drug reactions, and local manifestations of systemic illness. However, in many cases, no causative agent is identified, and lesions are classified as idiopathic aphthosis. In the setting of fever and acute onset of genital ulcers in girls and women, the term Lipschutz ulcers has been used to describe ulcers associated with an immunologic reaction to a distant source of infection or inflammation. The aims of this article are to review the differential diagnosis and pathogenesis of acute genital ulcers, to offer an evaluation and classification scheme, and to discuss treatment options for the dermatologist who cares for women and girls with vulvar ulcers. © 2010 Wiley Periodicals, Inc.
Brinca, Ana; Canelas, Maria Miguel; Carvalho, Maria João; Vieira, Ricardo; Figueiredo, Américo
Lipschütz Ulcer, or ulcus vulvae acutum, is a rare and probably underdiagnosed entity that usually presents as an acute painful vulvar ulcer in young women. The etiology is unknown, although recent reports have associated it with the Epstein-Barr virus. The diagnosis is made by exclusion after ruling out sexually transmitted diseases, autoimmune causes, trauma, and other etiologies of genital ulcerations. We report a case of a young woman who developed flu-like symptoms and painful vulvar ulcers. Complementary examinations ruled out sexually transmitted diseases and the other usual causes of genital ulcers; lesions healed with no sequelae or recurrences. This case represents a rare important differential diagnosis of genital ulceration.
Mullinax, Margo; Herbenick, Debby; Schick, Vanessa; Sanders, Stephanie A; Reece, Michael
Research increasingly shows genital attitudes have an impact on sexual well-being and health seeking behaviours. This study explored what women and men like and dislike about women's genitals. Data are from open-ended items, part of a cross-sectional Internet-based survey anonymously completed by 496 women and 198 men. Overall, both women and men had positive attitudes towards women's genitals, although there was overlap between likes and dislikes. Some of the most common likes for women related to aesthetics and for men related to tactile and sexual aspects. Men listed more likes than dislikes. The emphasis on both positive and negative messages provides a more complete image of the complex ways people interact with their own and other's bodies and can help tailor clinical and educational messages.
Barranco, Isabel; Perez-Patiño, Cristina; Tvarijonaviciute, Asta; Parrilla, Inmaculada; Vicente-Carrillo, Alejandro; Alvarez-Rodriguez, Manuel; Ceron, Jose J; Martinez, Emilio A; Rodriguez-Martinez, Heriberto; Roca, Jordi
The paraoxonase type 1 (PON1) is an enzyme with antioxidant properties recently identified in the seminal plasma (SP) of several species, including the porcine. The aims of the present study were to (1) describe the immunohistochemical localisation of PON1 in the genital organs of fertile boars and (2) evaluate the relationship among PON1 activity and high-density lipoprotein cholesterol (HDL-C) concentration in fluids of the boar genital organs. Immunohistochemical analysis demonstrated that PON1 was present in testis (specifically in Leydig cells, blood vessels, spermatogonia and elongated spermatids), epididymis (specifically in the cytoplasm of the principal epithelial cells, luminal secretion and in the surrounding smooth muscle) and the lining epithelia of the accessory sexual glands (cytoplasmic location in the prostate and membranous in the seminal vesicle and bulbourethral glands). The Western blotting analysis confirmed the presence of PON1 in all boar genital organs, showing in all of them a band of 51 kDa and an extra band of 45 kDa only in seminal vesicles. PON1 showed higher activity levels in epididymal fluid than those in SP of the entire ejaculate or of specific ejaculate portions. A highly positive relationship between PON1 activity and HDL-C concentration was found in all genital fluids. In sum, all boar genital organs contributing to sperm-accompanying fluid/s were able to express PON1, whose activity in these genital fluids is highly dependent on the variable HDL-C concentration present. © 2017 Society for Reproduction and Fertility.
Kjetland, E F; Poggensee, G; Helling-Giese, G; Richter, J; Sjaastad, A; Chitsulo, L; Kumwenda, N; Gundersen, S G; Krantz, I; Feldmeier, H
A total of 51 women with urinary schistosomiasis haematobium were examined in order to identify diagnostic indicators for female genital schistosomiasis (FGS). Patients were selected at random from the outpatient department of the Mangochi District Hospital, Malawi. The medical histories were recorded according to a pre-designed questionnaire and the women were subjected to a thorough gynaecological examination including colposcopy and photographic documentation of lesions. Microscopy of genital biopsies revealed that 33 of the 51 women had S. haematobium ova in cervix, vagina and/or vulva in addition to the presence of ova in urine. The most sensitive diagnostic procedure was beside microscopic examination of a wet cervix biopsy crushed between two glass slides, which revealed 25 of the 33 genital infections. There was a significant correlation between the size of genital lesions and the number of ova counted per mm2 of crushed tissue. Women with FGS had significantly more tumours in the vulva than women with schistosomiasis limited to the urinary tract. Most of the observed genital pathology could easily be identified by the naked eye, but colposcopic examination yielded valuable additional information like the demonstration of neovascularisation around cervical sandy patches. Few of the symptoms previously regarded as indicators for FGS could be linked to the presence of schistosome ova in genital tissue. Husbands of infertile women with FGS had children with other women significantly more often than husbands of women who only had urinary schistosomiasis. This, together with the finding that the majority of the divorced women had FGS, indicates that the manifestation of this disease may have implications for the marital and sexual life of the affected women.
Derancourt, C; Mougin, C; Chopard Lallier, M; Coumes-Marquet, S; Drobacheff, C; Laurent, R
The association between mucosal oncogenic human papillomaviruses (HPV) and bowenoid papulosis or genital Bowen's disease is well documented. In contrast this association with extra-genital Bowen's disease is poorly studied. The aim of this study was to detect oncogenic (16/18, 31/33/51) and non oncogenic (8/11) mucosal HPV using a in situ hybridization method in 28 skin biopsy specimens of extra-genital Bowen's disease. Twenty-eight cases of extra-genital Bowen's disease seen in the period 1990-96 in the Dermatology department were included: 19 women and 9 men (mean age: 72 years). Bowen's disease locations were: hands and feet (8 cases), limbs (11 cases), face (8 cases), trunk (1 case). Blinded histopathologic examination confirmed the diagnosis of Bowen's disease and signs of HPV infection (koilocytosis). In situ hybridization was performed using three biotinylated probes detecting HPV types 6/11, 16/18, 31/33/51. Oncogenic HPV genoma was detected in 8 skin samples (28.6 p. 100). In all these cases, 16/18 probe was positive and in two cases, both 16/18 and 31/33/51 probes were positive; 4/8 Bowen's diseases of the extremities were positive for HPV. Koilocytes were found in 6/8 of skin samples with positive HPV detection. Mucosal oncogenic HPV are detected by in situ hybridization in 28.6 p. 100 of extra-genital Bowen's disease. In situ hybridization is an easier technique than Southern-Blot hybridization which is the gold standard. Five studies reported similar results and three studies reported different results that we discuss. A precise understanding of oncogenic HPV implication in the development of extra-genital Bowen's disease could lead to the development of new therapeutic strategies (topical cidofovir or imiquimod).
Woodhall, S; Ramsey, T; Cai, C; Crouch, S; Jit, M; Birks, Y; Edmunds, W J; Newton, R; Lacey, C J N
One of the two new human papillomavirus (HPV) vaccines protects against HPV types 6 and 11, which cause over 95% of genital warts, in addition to protecting against HPV types 16 and 18. In anticipation of HPV vaccine implementation, the impact of genital warts on health-related quality of life (HRQoL) was measured to assess the potential benefits of the quadrivalent over the bivalent vaccine. Genitourinary medicine clinic patients aged 18 years and older with a current diagnosis of genital warts were eligible; 81 consented and were interviewed by a member of the research team. A generic HRQoL questionnaire, the EQ-5D (comprising EQ-5D index and EQ visual analogue scale (VAS) scores) and a disease-specific HRQoL instrument, the CECA10, were administered. Previously established UK population norms were used as a control group for EQ-5D comparisons. Cases (with genital warts) had lower EQ VAS and EQ-5D index scores than controls. After adjusting for age a mean difference between cases and controls 30 years of age and under (n = 70) of 13.9 points (95% CI 9.9 to 17.6, p<0.001) for the EQ VAS and 0.039 points (95% CI 0.005 to 0.068, p = 0.02) on the EQ-5D index (also adjusted for sex) was observed. The difference between cases and controls for the EQ VAS was especially notable in young women. Genital warts are associated with a significant detriment to HRQoL. The potential added benefit of preventing most cases of genital warts by HPV vaccination should be considered in decisions about which HPV vaccine to implement in the United Kingdom.
Anderson, Christopher M; Langerhans, R Brian
The study of male genital diversity has long overshadowed evolutionary inquiry of female genitalia, despite its nontrivial diversity. Here, we identify four nonmutually exclusive mechanisms that could lead to genital divergence in females, and potentially generate patterns of correlated male-female genital evolution: (1) ecological variation alters the context of sexual selection ("ecology hypothesis"), (2) sexually antagonistic selection ("sexual-conflict hypothesis"), (3) female preferences for male genitalia mediated by female genital traits ("female-choice hypothesis"), and (4) selection against inter-population mating ("lock-and-key hypothesis"). We performed an empirical investigation of all four hypotheses using the model system of Bahamas mosquitofish inhabiting blue holes that vary in predation risk. We found unequivocal support for the ecology hypothesis, with females exhibiting a smaller genital opening in blue holes containing piscivorous fish. This is consistent with stronger postmating female choice/conflict when predators are present, but greater premating female choice in their absence. Our results additionally supported the lock-and-key hypothesis, uncovering a pattern of reproductive character displacement for genital shape. We found no support for the sexual conflict or female choice hypotheses. Our results demonstrate a strong role for ecology in generating female genital diversity, and suggest that lock-and-key may provide a viable cause of female genital diversification.
Background Female genital mutilation/cutting (FGM/C) is still prevalent in several communities in Kenya and other areas in Africa, as well as being practiced by some migrants from African countries living in other parts of the world. This study aimed at detecting clustering of FGM/C in Kenya, and identifying those areas within the country where women still intend to continue the practice. A broader goal of the study was to identify geographical areas where the practice continues unabated and where broad intervention strategies need to be introduced. Methods The prevalence of FGM/C was investigated using the 2008 Kenya Demographic and Health Survey (KDHS) data. The 2008 KDHS used a multistage stratified random sampling plan to select women of reproductive age (15–49 years) and asked questions concerning their FGM/C status and their support for the continuation of FGM/C. A spatial scan statistical analysis was carried out using SaTScan™ to test for statistically significant clustering of the practice of FGM/C in the country. The risk of FGM/C was also modelled and mapped using a hierarchical spatial model under the Integrated Nested Laplace approximation approach using the INLA library in R. Results The prevalence of FGM/C stood at 28.2% and an estimated 10.3% of the women interviewed indicated that they supported the continuation of FGM. On the basis of the Deviance Information Criterion (DIC), hierarchical spatial models with spatially structured random effects were found to best fit the data for both response variables considered. Age, region, rural–urban classification, education, marital status, religion, socioeconomic status and media exposure were found to be significantly associated with FGM/C. The current FGM/C status of a woman was also a significant predictor of support for the continuation of FGM/C. Spatial scan statistics confirm FGM clusters in the North-Eastern and South-Western regions of Kenya (p < 0.001). Conclusion This suggests that the
Biglu, Mohammad-Hossein; Farnam, Alireza; Abotalebi, Parvaneh; Biglu, Sahar; Ghavami, Mostafa
Female Genital Mutilation/Cutting (FGM/C) or female circumcision is the procedure of eliminating some or all parts of the external female genitalia. FGM/C is carried out by traditional circumcisers. They usually use cutting tools like a blade or straight-razor. Although FGM/C is well described in the African continent and some Arabic countries, data from Iran are scarce. The major objective of this current study was to investigate the effects of FGM/C on the female sexual function of married women compared to the non-circumcised women in the Kurdistan province of Iran. A case-control study was conducted in a sample of 280 married women (140 circumcised-women and 140 non-circumcised-women) who referred to the healthcare centers for vaccination, midwifery, or family planning services. Participants were requested to complete the Persian-translated version of the Female Sexual Function Index. The total score of the FSFI and its individual domains. Of the circumcised women, 51.4% reported circumcision procedures before the age of 3 years. Religion motivation (53.6%) was mentioned as the most important factor for the family leading to FGM/C. Almost all operations were performed by traditional circumcisers. Non-circumcised women had significantly higher Persian-FSFI total score (25.3 ± 4.34) compared to the circumcised women (17.9 ± 5.39). Sexual function in women with FGM/C is adversely altered. In Kurdistan province women, FGM/C is associated with reduction of scores of Persian-FSFI on all domain scores. Education in general and informing the people that FGM/C is not a religious Hadith certainly would have a great impact on the suffering of the women from FGM/C as well as the level of "desire, arousal, lubrication, orgasm, satisfaction, and pain in the sexual function of women". Copyright © 2016 Elsevier B.V. All rights reserved.
Achia, Thomas N O
Female genital mutilation/cutting (FGM/C) is still prevalent in several communities in Kenya and other areas in Africa, as well as being practiced by some migrants from African countries living in other parts of the world. This study aimed at detecting clustering of FGM/C in Kenya, and identifying those areas within the country where women still intend to continue the practice. A broader goal of the study was to identify geographical areas where the practice continues unabated and where broad intervention strategies need to be introduced. The prevalence of FGM/C was investigated using the 2008 Kenya Demographic and Health Survey (KDHS) data. The 2008 KDHS used a multistage stratified random sampling plan to select women of reproductive age (15-49 years) and asked questions concerning their FGM/C status and their support for the continuation of FGM/C. A spatial scan statistical analysis was carried out using SaTScan™ to test for statistically significant clustering of the practice of FGM/C in the country. The risk of FGM/C was also modelled and mapped using a hierarchical spatial model under the Integrated Nested Laplace approximation approach using the INLA library in R. The prevalence of FGM/C stood at 28.2% and an estimated 10.3% of the women interviewed indicated that they supported the continuation of FGM. On the basis of the Deviance Information Criterion (DIC), hierarchical spatial models with spatially structured random effects were found to best fit the data for both response variables considered. Age, region, rural-urban classification, education, marital status, religion, socioeconomic status and media exposure were found to be significantly associated with FGM/C. The current FGM/C status of a woman was also a significant predictor of support for the continuation of FGM/C. Spatial scan statistics confirm FGM clusters in the North-Eastern and South-Western regions of Kenya (p<0.001). This suggests that the fight against FGM/C in Kenya is not yet over
Mochtar, Chaidir A.; Hamid, Agus Rizal A. H.; Sukasah, Chaula L.
Condyloma acuminata in the external genitalia (genital warts) is a sexually transmitted disease that is often caused by human papillomavirus (HPV). We report a case of giant genital condyloma acuminata in a 35-year-old male patient with HIV comorbidity treated by wide surgical excision. Excision defect was covered with split thickness skin graft (STSG) and double keystone flaps. There was no complication after surgery. Ten months following surgery, there was no new condyloma lesion and the patient had normal voiding and erectile functions. PMID:27974988
Kochorova, M N; Kosnikov, A G
Comparative analysis of two groups of patients with female genital tuberculosis treated at the Saint Petersburg Research Institute of Phthiosiopulmonology in 1980 to 2005 has shown that patients of younger age have recently fallen ill with this disease. The genital tuberculous process is commonly preceded or attended by other forms of tuberculosis of various organs and systems, such as the lung, lymph nodes, and kidney. The pain syndrome and impaired menstrual cycle are observed in half the patients; infertility is present in 60%; profound anatomic changes are less frequently seen in the fallopian tubes. Improvement of bacteriological methods promoted the timely diagnosis of the disease.
Wilkinson, D; Ndovela, N; Kharsany, A; Connolly, C; Sturm, A W
Genital tract infections are important causes of ill health in developing countries, but diagnosis is difficult. Bacterial vaginosis (BV) was correctly diagnosed by using a vaginal specimen obtained by tampon sampling in 22 of 24 women (91.6%) for whom BV was diagnosed by Gram staining. The yield for other vaginal infections was higher (28% for Trichomonas vaginalis and 32.7% for Candida albicans) than it was for cervical infections (0% for Neisseria gonorrhoeae and 30% for Chlamydia trachomatis). Tampon sampling was acceptable to patients and may facilitate diagnosis of genital infections in developing countries. PMID:9276426
Veasey, John Verrinder; Framil, Valéria Maria de Souza; Nadal, Sidney Roberto; Marta, Alessandra Cristine; Lellis, Rute Facchini
Genital warts can be diagnosed through physical examination and confirmed by histopathology. Noninvasive methods are useful for ruling out other diagnoses with no harm to the patient. In this study the clinical findings were compared to dermoscopy, reflectance confocal microscopy (RCM), and to histopathology findings, in order to determine possible patterns that can aid diagnosis of the lesion. It was possible to identify structural changes on reflectance confocal microscopy that are already known by dermoscopy, in addition to cellular changes previously seen only by histopathological examination. This study shows the use of reflectance confocal microscopy in cases of genital warts, providing important information that can be used in further studies.
Veasey, John Verrinder; Framil, Valéria Maria de Souza; Nadal, Sidney Roberto; Marta, Alessandra Cristine; Lellis, Rute Facchini
Genital warts can be diagnosed through physical examination and confirmed by histopathology. Noninvasive methods are useful for ruling out other diagnoses with no harm to the patient. In this study the clinical findings were compared to dermoscopy, reflectance confocal microscopy (RCM), and to histopathology findings, in order to determine possible patterns that can aid diagnosis of the lesion. It was possible to identify structural changes on reflectance confocal microscopy that are already known by dermoscopy, in addition to cellular changes previously seen only by histopathological examination. This study shows the use of reflectance confocal microscopy in cases of genital warts, providing important information that can be used in further studies. PMID:24626658
Tawfeek, S; Sholapurkar, S; Sharp, N
The aim of the study was to determine the incidence of occlusion of the upper genital tract following microwave endometrial ablation (MEA) in women treated for therapy-resistant menorrhagia. A total of 35 women were recruited between January 1997 and January 2005, Royal United Hospital Bath, to have interval hysterosalpingogram (HSG) post-MEA. After a successful MEA, either with general or local anaesthesia, 35 HSGs were performed 3 or more months later. Complete occlusion of the upper genital tract was found in 30 women (85.7%) and incomplete occlusion with tubal patency persisted in 5 (14.3%).
Kalmar, Isabelle; Vanrompay, Daisy
Chlamydia trachomatis is a Gram-negative obligate intracellular bacterial pathogen. It is the leading cause of bacterial sexually transmitted disease in the world, with more than 100 million new cases of genital tract infections with C. trachomatis occurring each year. Animal models are indispensable for the study of C. trachomatis infections and the development and evaluation of candidate vaccines. In this paper, the most commonly used animal models to study female genital tract infections with C. trachomatis will be reviewed, namely, the mouse, guinea pig, and nonhuman primate models. Additionally, we will focus on the more recently developed pig model. PMID:23836817
Aksel, Sarp; Sinai, Irit; Yee, Kimberly Aumack
This report examines the implications of female genital cutting and other intra-vaginal practices for offering the TwoDay Method® of family planning.This fertility awareness-based method relies on the identification of cervicovaginal secretions to identify the fertile window. Female genital cutting and traditional vaginal practices, such as the use of desiccants, may affect the presence or absence of secretions and therefore the woman’s perception of her fertility. These issues and their implications for service delivery of the method are discussed.
Biggs, M; Stermac, L E; Divinsky, M
BACKGROUND: The literature on sexual assault has not directly addressed the question of genital injuries in women without prior sexual intercourse experience. Given the paucity of research and the current importance of physical evidence in the criminal justice system, this study was designed to document the type and site of genital injuries from sexual assault in women without and with prior sexual intercourse experience. METHODS: The charts were reviewed of 132 women who had been sexually assaulted and had sought medical treatment at the Sexual Assault Care Centre (SACC), Women's College Hospital, Toronto, within 10 days after the assault. Half (66) of the women reported that, at the time of the assault, they had no prior sexual intercourse experience. The Sexual Assault Evidence Kit in each patient's file was reviewed to ascertain the type and location of genital injuries. Types of injuries were classified into 3 categories (nonperforating soft-tissue injuries, lacerations or current bleeding) and locations into 6 categories (labia majora and minora, posterior fourchette and introitus, hymen, vagina, cervix, and anus). RESULTS: Significantly more women without than with prior sexual intercourse experience had visible genital injuries (65.2% v. 25.8%, p < 0.01). However, of the women without prior experience, only 9.1% had hymenal perforation. Analyses of the data for only women with genital injuries indicated no difference between those without and those with prior sexual intercourse experience in the overall mean number of injured sites (1.65 and 1.47 respectively) or in the mean number of sites with nonperforating soft-tissue injuries (0.349 and 0.706), lacerations (0.953 and 0.471) and bleeding (0.279 and 0.294). INTERPRETATION: The results suggest that genital injuries are more common in women without prior sexual intercourse experience but that substantial proportions of all women, regardless of their prior sexual experience at the time of assault, will not
Politch, Joseph A.; Marathe, Jai; Anderson, Deborah J.
Human immunodeficiency virus (HIV)–infected leukocytes have been detected in genital secretions from HIV-infected men and women and may play an important role in the sexual transmission of HIV. However, they have been largely overlooked in studies on mechanisms of HIV transmission and in the design and testing of HIV vaccine and microbicide candidates. This article describes the characteristics and quantities of leukocytes in male and female genital secretions under various conditions and also reviews evidence for the involvement of HIV-infected cells in both horizontal and vertical cell-associated HIV transmission. Additional research is needed in this area to better target HIV prevention strategies. PMID:25414414
Gamberini, Maria Thereza; Bolognesi, Maria Laura; Nasello, Antonia Gladys
The interaction between dopaminergic and cholinergic pathways in the induction of behavioral responses has been previously established. In the brain, M2 receptors are found predominantly in presynaptic cholinergic neurons as autoreceptors, and in dopaminergic neurons as heteroceptors, suggesting a control role of acetylcholine and dopamine release, respectively. Our aim was to investigate the role of M2 receptors on the yawning and genital grooming of rats induced by apomorphine, a dopaminergic receptor agonist, focusing on the interaction between cholinergic and dopaminergic pathways. Initially, the effect of atropine, a non-selective muscarinic antagonist, on yawning and genital grooming induced by apomorphine (100 μg/kg s.c.) was analyzed. Atropine doses of 0.5, 1 and 2 mg/kg i.p. were administered to Wistar rats 30 min before induction of the behavioral responses by apomorphine. Number of yawns and time spent genital grooming were quantified over a 60 min period. Apomorphine-induced yawning was increased by low dose (0.5 mg/kg i.p.) but not by high doses (1 and 2 mg/kg, i.p.) of atropine. Genital grooming was antagonized by 2 mg/kg i.p. of atropine and showed no changes at the other doses tested. Tripitramine, a selective M2 cholinergic antagonist, was used as a tool for distinguishing between M2 and all other muscarinic receptor subtypes in yawning and genital grooming. Tripitramine doses of 0.01, 0.02 and 0.04 μmol/kg i.p. were administered to Wistar rats 30 min before apomorphine (100 μg/kg s.c.). Number of yawns and time spent genital grooming were also quantified over a 60 min period. Tripitramine 0.01 μmol/kg increased all parameters. Higher doses, which possibly block all subtypes of muscarinic receptor, did not modify the response of apomorphine, suggesting a non-selective effect of tripitramine at these doses. Given that low doses of tripitramine increased the behavioral responses induced by apomorphine and that the main distribution of the M2
Schober, Justine M; Meyer-Bahlburg, Heino F L; Dolezal, Curtis
To assess the perceptions of healthy men of their genital anatomy and sexual sensitivity, along with the re-test reliability of these ratings, in a new self-reported questionnaire, the Self-Assessment of Genital Anatomy and Sexual Function, Male (SAGASF-M). Eighty-one healthy, sexually active, men aged 22-57 years (median 33), with no history of genital surgery, completed the SAGASF-M. This questionnaire comprises written text and images enabling men to rate details of their genital appearance, overall genital erotic and pain sensitivity, orgasm intensity, and effort required for achieving orgasm through stimulation of specified areas around the glans and shaft of the penis, scrotum and anus, along with the contribution of other sexually sensitive areas of the body. Anatomical locations were compared for the functional ratings by mixed-model analysis of variance (anova). A second sample of 38 healthy men (median age 26 years, range 22-64) from the same source completed the SAGASF-M twice with an interval of 2 weeks. There was little variability in anatomy ratings. Ratings of overall penile sensitivity to sexual stimulation gave higher values of 'sexual pleasure' for penile stimulation by the partner than by self (P = 0.002) and marginally higher ratings of 'orgasm intensity' by partner stimulation (P = 0.077), but there were no corresponding differences on ratings of 'effort needed to reach orgasm' or of 'discomfort/pain'. Overall discrimination between genital areas was highly significant (mixed-model anova, P = 0.001) for ratings of 'sexual pleasure', 'orgasm intensity' and 'orgasm effort', but was not significant for 'discomfort/pain'. Ranked by degree of 'sexual pleasure', the area 'underside of the glans' was highest, followed by 'underside of the penile shaft', 'upper side of the glans', 'left and right sides of the glans', 'one or both sides of the penis', 'upper side of the penile shaft', 'foreskin' (11 subjects), 'skin between the scrotum and anus', 'back
About 27,000 women from countries in which female genital mutilation (FGM) is a common practice are presently living in Sweden. This means that FGM is a phenomenon that directly affects the Swedish health care system. Knowledge and understanding of the background, meaning and consequences of FGM are a prerequisite for effective prevention, proper clinical handling and supportive reception of the women. To avoid a stigmatizing reception it is also important to understand the situation of genitally mutilated women, and to become aware of the identity crisis many of them experience when they come to Sweden and lose their identity as "normal" women. It is essential to remember that female genital mutilation is one of many forms of discrimination affecting girls and women around the world. This discrimination knows no national or cultural borders and varies in expression and extent. In order to offer optimal care and reception of women who have been socialized into a gender role that is often seen as completely different from the gender role that Swedish society is said to embrace, it is of the utmost importance to first take a critical look beneath the veil of alleged gender equality of Swedish women.
Dubow, S. R.; Giardino, A. P.; Christian, C. W.; Johnson, C.F.
Objective: To evaluate how well a group of recently trained pediatric chief residents could label anatomic structures on two different photographs of female prepubertal genitalia. Additionally, the study sought to explore aspects of pediatric training in sexual abuse and clinical practice issues surrounding the routine genital examination. Method:…
Tanaka, Satomi S; Nishinakamura, Ryuichi
Sex determination is essential for the sexual reproduction to generate the next generation by the formation of functional male or female gametes. In mammals, primary sex determination is commenced by the presence or absence of the Y chromosome, which controls the fate of the gonadal primordium. The somatic precursor of gonads, the genital ridge is formed at the mid-gestation stage and gives rise to one of two organs, a testis or an ovary. The fate of the genital ridge, which is governed by the differentiation of somatic cells into Sertoli cells in the testes or granulosa cells in the ovaries, further determines the sex of an individual and their germ cells. Mutation studies in human patients with disorders of sex development and mouse models have revealed factors that are involved in mammalian sex determination. In most of mammals, a single genetic trigger, the Y-linked gene Sry (sex determination region on Y chromosome), regulates testicular differentiation. Despite identification of Sry in 1990, precise mechanisms underlying the sex determination of bipotential genital ridges are still largely unknown. Here, we review the recent progress that has provided new insights into the mechanisms underlying genital ridge formation as well as the regulation of Sry expression and its functions in male sex determination of mice.
Boda, Daniel; Neagu, Monica; Constantin, Carolina; Voinescu, Razvan Nicolae; Caruntu, Constantin; Zurac, Sabina; Spandidos, Demetrios A.; Drakoulis, Nikolaos; Tsoukalas, Dimitrios; Tsatsakis, Aristides M.
The incidence of human papillomavirus (HPV) in the human cancer domain is still a subject of intensive study. In this study, we examined cervical swab samples from 713 females with genital warts, and tested the samples for high- and low-risk genital HPV. HPV genotyping was assessed using a Genotyping test that detects HPV by the amplification of target DNA using polymerase chain reaction and nucleic acid hybridization. In total, we detected 37 anogenital HPV DNA genotypes [6, 11, 16, 18, 26, 31, 33, 35, 39, 40, 42, 45, 51, 52, 53, 54, 55, 56, 58, 59, 61, 62, 64, 66, 67, 68, 69, 70, 71, 72, 73 (MM9), 81, 82 (MM4), 83 (MM7), 84 (MM8), IS39 and CP6108] and investigated the incidence of these genotypes in the patients with genital warts. We found differences in the distribution of high-/low-risk strains and the incidence of high-risk strains was found to occur mainly in females under 35 years of age. The data from our study suggest that a detailed oral, rectal and genital identification of high-risk strains should be performed to visualize the entire pattern of possible triggers of carcinogenesis. PMID:27602111
Richards, Julie; Krantz, Elizabeth; Selke, Stacy; Wald, Anna
Symptoms among patients with first episode herpes simplex virus (HSV) likely influence health seeking and sexual behavior. An improved understanding of this relationship provides insight into the experience of having genital herpes and has implications for counseling. To describe the healthcare seeking and sexual behavior in patients with symptomatic laboratory confirmed first episode HSV infection. Two hundred thirty-six patients (94 men and 142 women) with newly acquired genital herpes were asked to complete a demographic and sexual history questionnaire. To confirm initial HSV diagnosis, swabs of lesions were collected for viral culture and HSV DNA polymerase chain reaction and blood was drawn for confirmation of HSV serostatus using the Western blot. Women reported pain and men reported lesions as the most frequent and bothersome symptom or sign causing each to seek healthcare. Forty-three percent of all participants missed some work or school because of their symptoms; women missed more school or work, sought care sooner, and saw more providers than men. Before diagnosis, most respondents (67%) suspected genital herpes was the etiology of the symptoms. Twenty-seven percent reported having sex after noticing their symptoms, though those who missed more school or work were less likely to engage in sexual intercourse. Men and women have different experiences with first episode HSV, but morbidity is substantial, especially among women. Both men and women may continue to engage in sexual activity after onset of genital herpes, emphasizing the need for providers to counsel their patients to avoid exposing partners to the infection.
Adams, Joyce A.; Wells, Robert
Preselected colposcopic photographs of the anogenital area of 16 patients were shown to 170 medical examiners, who rated their level of suggestion or indication of penetrating injury. Agreement between the participants and experts was higher on the abnormal cases than on the normal cases, and higher on genital findings than on anal findings.…
Gilbert, Lisa K.; Levandowski, Brooke A.; Roberts, Craig M.
Objectives and Participants: In the United States, genital herpes (GH) prevalence is 10.6% among 20- to 29-year-olds and about 90% of seropositive persons do not know their status. This study investigated individual characteristics associated with GH screening and diagnosis in sexually active young adults aged 18 to 24. Methods: Two data sets were…