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Core Urology · STICore Urology / Infections

Sexually Transmitted Infections

Sexually transmitted infections present to urology as urethritis, genital ulcers, and genital growths, and the practical skill is to map the presentation to the organism.

Orientation

The big picture

Sexually transmitted infections present to urology as urethritis, genital ulcers, and genital growths, and the practical skill is to map the presentation to the organism — because the syndromes are few and the bugs are predictable. Two patterns cover most of it: urethral discharge (gonococcal vs non-gonococcal) and genital ulcers (painful vs painless). Get those two patterns and you can reason to the organism and the test.

Golden rule

The framework: organise STIs by syndrome — urethritis (gonorrhoea, chlamydia, NGU), genital ulcers (syphilis, herpes, chancroid, LGV, donovanosis), and growths (HPV/genital warts) — and remember the rising incidence and the young age group most affected.

Pathophysiology

Mechanism pathway

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Work-up

Diagnostic algorithm

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Exam

Board traps

Urethritis = gonococcal vs non-gonococcal (chlamydia); treat for both because they coexist.

Painless genital ulcer → syphilis; painful → herpes or chancroid.

LGV is caused by C. trachomatis serovars L1–L3 — distinct from the urethritis-causing serovars.

Chancroid = Haemophilus ducreyi (painful ulcer); donovanosis = Klebsiella granulomatis.

HPV causes warts and carries oncogenic potential (penile/cervical cancer).

Highest rates are in the 15–24 age group; herpes/HPV/trichomonas are under-reported.

Test yourself

Quiz

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