Genitourinary Tract and Its Defenses MALE REPRODUCTIVE ANATOMY
structures in the genitourinary tract are really two TESTES: produce sperm cells and hormones
distinct organ systems:
EPIDIDYMIDES: coiled tubes leading out of the testes
URINARY TRACT: removes substances from the
blood, regulating certain body processes VAS DEFERENS: combines with the seminal vesicle and
terminates in the ejaculatory duct
GENITAL SYSTEM: known as the reproductive
system, functions mainly in reproduction : Contents of the ejaculatory duct empty into the urethra during
ejaculation
URINARY TRACT
PROSTATE GLAND: walnut-shaped structure at the base of
KIDNEYS: remove metabolic wastes from the blood, the urethra that contributes to the released semen
acting as a sophisticated filtering system
MALE REPRODUCTIVE SYSTEMS EXTERNAL ORGANS
UTERUS: tubular organs extending from each kidney
to the bladder SCROTUM: contains the testes
BLADDER: collapsible organ that stores urine and PENIS: cylindrical organ that houses the urethra
empties it into the urethra INNATE DEFENSES OF THE MALE REPRODUCTIVE
URETHRA: conduit of urine to the exterior of the SYSTEM
body Flushing action of the urine, which helps move microorganisms
IN MALES: urethra is the terminal organ of the out of the system
reproductive tract FEMALE REPRODUCTIVE SYSTEM
IN FEMALES: urethra is separate from the vagina FEMALE REPRODUCTIVE ANATOMY
DEFENSES OF URINARY TRACT : UTERUS, FALLOPIAN TUBES, OVARIES, VAGINA
: Flushing action of urine flowing out of the system CERVIX: : lower one-third of the uterus that connects to the
: encourages desquamation of epithelial cells lining vagina, serves as the opening to the uterus, and a common sit
the urinary tract, shedding microbes with the cells of infection
BIOTA: most common microbial threat to the urinary FEMALE REPRODUCTIVE SYSTEM: Innate defenses of the
tract female reproductive tract vary over a woman’s lifetime:
: Cells of the lining of the urinary tract have different • Vagina is lined with mucous membranes and has the
chemicals on their surface than those lining the GI protective covering of secreted mucus
tract
MUCUS: major nonspecific defense during childhood and
: adapted to adhere to the chemical structures in the menopause
GI tract cannot attach to the urinary epithelium
SECRETORY IGA: antibodies specific for any previously
DEFENSE IN THE URINE encountered infections
ACIDIC PH FEMALE REORODUCTIVE SYSTEM: Major defense provided
by changes in pH of the vagina brought about by the release o
LYSOZYME: breaks down peptidoglycan estrogen
LACTOFERRIN: iron-binding protein that inhibits : Stimulates glycogen secretion by vaginal mucosa, which
bacterial growth certain bacteria ferment into acid, lowering vaginal pH to
SECRETORY LGA: specific for previously between 4.2 and 5
encountered microorganisms BEFORE PUBERTY: little estrogen is produced, and vagina is
MALE REPRODUCTIVE SYSTEM about pH 7
THE MALE REPRODUCTIVE SYSTEM : Change in pH beginning in adolescence results in vastly
different biota in the vagina
: Produces, maintains, and transports sperm cells
BIOTA DURING CHILD BEARING YEARS: prevents
: Source of male sex hormones establishment of microbes that might harm the developing fetu
,NORMAL BIOTA OF THE GENITOURINARY TRACT: PYELONEPHRITIS: infection of the kidneys
: Lower urethra has a well-established microbiota URETHRITHIS: infection limited to the urethra
: upper urinary tract appears to have fewer types URINARY TRACT INFECTIONS AND SIGNS
and lower abundance
CYSTISIS IS A DISEASE OF SUDDEN ONSET:
Female urethra is short (3.5 cm long) and in close
PAIN AND Frequent urges to urinate, even when the
proximity to the anus: act as a pipeline for bacteria bladder is empty
from the GI tract to the bladder, resulting in urinary tract
infections DYSURIA: burning pain accompanying urination
FLORA OF THE PENIS: Colonized by aerobic : Urine can be cloudy due the presence of bacteria and
Pseudomonas and Staphylococcus species white blood cells
UNCICUMCISED PENIS: area under the foreskin is HEMATURIA: presence of blood in the urine causes it
colonized by anaerobic gram-negatives to have an orange color
NORMAL BIOTA OF MALE GENITAL TRACT : Low-grade fever and nausea
: urethra is the terminal organ of the genital tract, it is PYELONOPHRITIS: • Back pain and high fever
comprised of the same residents mentioned previously
• A serious infection that can result in permanent
: After sexual activity begins, microbes associated with damage to the kidneys if improperly or inadequately
STIs can sometimes become long-term residents treated
CIRCUMCISIONS: has a large effect on the “normal” ACUTE UNCOMPLICATED UTI: only the bladder is
biota of the penis involved in infection
UNCIRCUMCISED PENIS: s hosts a larger, more URINARY TRACT INFECTIONS CAUSATIVE
diverse population of microbes, and more anaerobic AGENTS
species
CATHETER ASSOCIATED UTI: caused by normal
NORMAL BIOTA OF FEMALE GENITAL TRACTS biota of the gastrointestinal tract: Escherichia coli is
responsible for 80% of these
: “trespassers” or possibly permanent residents of the
upper female reproductive tract STAPHYLOCOCCUS SAPROPHYTICUS: members of
the Enterobacteriaceae family (Klebsiella pneumoniae,
BEFORE PUBERTY AND AFTER MANOPAUSE: Proteus mirablis) are common culprits
estrogen leads to glycogen release in the vagina,
resulting in an acidic Ph COMMUNITY ACQUIRED UTIS: Not transmitted from
one person to another but from the GI tract to the
LACTOBACILLUS: species thrive in the acidic urinary system
environment and contribute to it by converting sugars to
acid : common in women than men because of the nearness
of the urethral opening to the anus
PREDOMINANCE OF LACTOBACILLUS: combined
with the acidic environment, discourages the growth of MANY WOMEN EXPERIENCES RECURRENT
many microorganism URINARY TRACT INFECTIONS
CANDIDA ALBICANS: also present at low levels. SOME E COLI: can invade the deeper tissue of the
Overgrowth may result in a symptomatic yeast infection urinary tract and avoid being killed by antibiotics
URINARY TRACT INFECTION: flushing action of urine : emerge later to cause symptoms again
helps to keep infections to a minimum in the urinary
URINARY TRACT INFECTION TREATMENT
tract
NITROFURANTOIN: most often used for UTIs of
: Urine itself is a good growth medium for many
various etiologies
microorganisms
CYSTITIS: infection of the urinary bladder that occurs
when urine flow is reduced or bacteria are accidentally
introduced into the bladder
, NON ANTIBIOTIC PHENAZOPYRRIDINE Early treatment with doxycycline, penicillin G, or
ceftriazone rapidly reduces symptoms and shortens the
: Relieves the uncomfortable symptoms of burning and course of the disease
urgency
• Delayed therapy is less effective
: Should only be administered for two days
• Other spirochete diseases, such as syphilis, exhibit
: Azo dye that turns the urine to a dark orange to red color same pattern of being susceptible to antibiotics early in
: large percentage of E. coli strains are resistant to infection but less so later on
penicillin derivatives Not all reproductive tract diseases are sexually
LEPTOSPIROSIS: Zoonosis associated with wild and transmitted, though many are
domesticated animals. VAGINITIS/VAGINOSIS: may or may not be sexually
• Kidneys • Liver • Brain • Eyes transmitted
LEPTOSPIRIMIC PHASE: PROSTATITIS: probably not sexually transmitted
• Pathogen appears in the blood and cerebrospinal fluid CDC: blames these increases on budget cuts to state an
local STD clinics
• Sudden high fever
RECENT YEARS: 20 STD clinics closed altogether
• Chills
DISCHARGED DISEASES: Infectious agent causes an
• Headache increase in fluid discharge in the male and female
reproductive tract
• Muscle aches
CAUSATIVE REAGENTS: transferred to new hosts whe
• Conjunctivitis
the fluids in which they live contact the mucosal surfaces
• Vomiting of the receiving partner
IMMUNE PHASE: Blood infection is cleared by natural : Trichomoniasis Gonorrhea Chlamydia
defenses
GONORRHEA:
MILD FEVER: headache due to leptospiral meningitis
SYMPTOMS IN MALES
WEIL’S SYNDROME: kidney invasion, hepatic disease,
• Urethritis
jaundice, anemia, neurological disturbances
• Painful urination
: Long-term disability and death can result from damage
to kidneys and liver, but they occur primarily with the most • Yellowish discharge
virulent strains and in elderly persons
• Relatively large number of cases are asymptomatic
LEPTOSPIROSIS CAUSATIVE AGENT: Typical
spirochete bacteria with tight, regular, individual coils with • In most cases, infection is limited to the distal urogenita
a bend or hook at one or both ends tract • Can occasionally spread from the urethra to the
prostate gland and the epididymis
LEPTOSPIRA INTEROGGANS: Species that causes
leptospirosis in humans and animals • Scar tissue formed in the spermatic ducts during the
healing of an invasive infection can render a man infertile
: Nearly 200 serotypes, resulting in extreme variations in
disease manifestation GONORREHEA SIGNS AND SYMPTOMS IN FEMALE
LEPTOSPIROSIS TRNASMISSION, EPIDEMIOLOGY, • Likely that both the urinary and genital tracts will be
TREATMENT infected during sexual intercourse
: occurs entirely through contact of skin abrasions or • Mucopurulent (containing mucus and pus) or bloody
mucous membranes with animal urine or some vaginal discharge occurs in a minority of the cases
environmental source containing urine • Painful urination if the urethra is affected
dozens of athletes competing in the swimming phase of a • Major complications occur when the infection ascends
triathlon in Illinois contracted leptospirosis from the water the vagina and cervix to higher reproductive structures
such as the uterus and fallopian tubes
structures in the genitourinary tract are really two TESTES: produce sperm cells and hormones
distinct organ systems:
EPIDIDYMIDES: coiled tubes leading out of the testes
URINARY TRACT: removes substances from the
blood, regulating certain body processes VAS DEFERENS: combines with the seminal vesicle and
terminates in the ejaculatory duct
GENITAL SYSTEM: known as the reproductive
system, functions mainly in reproduction : Contents of the ejaculatory duct empty into the urethra during
ejaculation
URINARY TRACT
PROSTATE GLAND: walnut-shaped structure at the base of
KIDNEYS: remove metabolic wastes from the blood, the urethra that contributes to the released semen
acting as a sophisticated filtering system
MALE REPRODUCTIVE SYSTEMS EXTERNAL ORGANS
UTERUS: tubular organs extending from each kidney
to the bladder SCROTUM: contains the testes
BLADDER: collapsible organ that stores urine and PENIS: cylindrical organ that houses the urethra
empties it into the urethra INNATE DEFENSES OF THE MALE REPRODUCTIVE
URETHRA: conduit of urine to the exterior of the SYSTEM
body Flushing action of the urine, which helps move microorganisms
IN MALES: urethra is the terminal organ of the out of the system
reproductive tract FEMALE REPRODUCTIVE SYSTEM
IN FEMALES: urethra is separate from the vagina FEMALE REPRODUCTIVE ANATOMY
DEFENSES OF URINARY TRACT : UTERUS, FALLOPIAN TUBES, OVARIES, VAGINA
: Flushing action of urine flowing out of the system CERVIX: : lower one-third of the uterus that connects to the
: encourages desquamation of epithelial cells lining vagina, serves as the opening to the uterus, and a common sit
the urinary tract, shedding microbes with the cells of infection
BIOTA: most common microbial threat to the urinary FEMALE REPRODUCTIVE SYSTEM: Innate defenses of the
tract female reproductive tract vary over a woman’s lifetime:
: Cells of the lining of the urinary tract have different • Vagina is lined with mucous membranes and has the
chemicals on their surface than those lining the GI protective covering of secreted mucus
tract
MUCUS: major nonspecific defense during childhood and
: adapted to adhere to the chemical structures in the menopause
GI tract cannot attach to the urinary epithelium
SECRETORY IGA: antibodies specific for any previously
DEFENSE IN THE URINE encountered infections
ACIDIC PH FEMALE REORODUCTIVE SYSTEM: Major defense provided
by changes in pH of the vagina brought about by the release o
LYSOZYME: breaks down peptidoglycan estrogen
LACTOFERRIN: iron-binding protein that inhibits : Stimulates glycogen secretion by vaginal mucosa, which
bacterial growth certain bacteria ferment into acid, lowering vaginal pH to
SECRETORY LGA: specific for previously between 4.2 and 5
encountered microorganisms BEFORE PUBERTY: little estrogen is produced, and vagina is
MALE REPRODUCTIVE SYSTEM about pH 7
THE MALE REPRODUCTIVE SYSTEM : Change in pH beginning in adolescence results in vastly
different biota in the vagina
: Produces, maintains, and transports sperm cells
BIOTA DURING CHILD BEARING YEARS: prevents
: Source of male sex hormones establishment of microbes that might harm the developing fetu
,NORMAL BIOTA OF THE GENITOURINARY TRACT: PYELONEPHRITIS: infection of the kidneys
: Lower urethra has a well-established microbiota URETHRITHIS: infection limited to the urethra
: upper urinary tract appears to have fewer types URINARY TRACT INFECTIONS AND SIGNS
and lower abundance
CYSTISIS IS A DISEASE OF SUDDEN ONSET:
Female urethra is short (3.5 cm long) and in close
PAIN AND Frequent urges to urinate, even when the
proximity to the anus: act as a pipeline for bacteria bladder is empty
from the GI tract to the bladder, resulting in urinary tract
infections DYSURIA: burning pain accompanying urination
FLORA OF THE PENIS: Colonized by aerobic : Urine can be cloudy due the presence of bacteria and
Pseudomonas and Staphylococcus species white blood cells
UNCICUMCISED PENIS: area under the foreskin is HEMATURIA: presence of blood in the urine causes it
colonized by anaerobic gram-negatives to have an orange color
NORMAL BIOTA OF MALE GENITAL TRACT : Low-grade fever and nausea
: urethra is the terminal organ of the genital tract, it is PYELONOPHRITIS: • Back pain and high fever
comprised of the same residents mentioned previously
• A serious infection that can result in permanent
: After sexual activity begins, microbes associated with damage to the kidneys if improperly or inadequately
STIs can sometimes become long-term residents treated
CIRCUMCISIONS: has a large effect on the “normal” ACUTE UNCOMPLICATED UTI: only the bladder is
biota of the penis involved in infection
UNCIRCUMCISED PENIS: s hosts a larger, more URINARY TRACT INFECTIONS CAUSATIVE
diverse population of microbes, and more anaerobic AGENTS
species
CATHETER ASSOCIATED UTI: caused by normal
NORMAL BIOTA OF FEMALE GENITAL TRACTS biota of the gastrointestinal tract: Escherichia coli is
responsible for 80% of these
: “trespassers” or possibly permanent residents of the
upper female reproductive tract STAPHYLOCOCCUS SAPROPHYTICUS: members of
the Enterobacteriaceae family (Klebsiella pneumoniae,
BEFORE PUBERTY AND AFTER MANOPAUSE: Proteus mirablis) are common culprits
estrogen leads to glycogen release in the vagina,
resulting in an acidic Ph COMMUNITY ACQUIRED UTIS: Not transmitted from
one person to another but from the GI tract to the
LACTOBACILLUS: species thrive in the acidic urinary system
environment and contribute to it by converting sugars to
acid : common in women than men because of the nearness
of the urethral opening to the anus
PREDOMINANCE OF LACTOBACILLUS: combined
with the acidic environment, discourages the growth of MANY WOMEN EXPERIENCES RECURRENT
many microorganism URINARY TRACT INFECTIONS
CANDIDA ALBICANS: also present at low levels. SOME E COLI: can invade the deeper tissue of the
Overgrowth may result in a symptomatic yeast infection urinary tract and avoid being killed by antibiotics
URINARY TRACT INFECTION: flushing action of urine : emerge later to cause symptoms again
helps to keep infections to a minimum in the urinary
URINARY TRACT INFECTION TREATMENT
tract
NITROFURANTOIN: most often used for UTIs of
: Urine itself is a good growth medium for many
various etiologies
microorganisms
CYSTITIS: infection of the urinary bladder that occurs
when urine flow is reduced or bacteria are accidentally
introduced into the bladder
, NON ANTIBIOTIC PHENAZOPYRRIDINE Early treatment with doxycycline, penicillin G, or
ceftriazone rapidly reduces symptoms and shortens the
: Relieves the uncomfortable symptoms of burning and course of the disease
urgency
• Delayed therapy is less effective
: Should only be administered for two days
• Other spirochete diseases, such as syphilis, exhibit
: Azo dye that turns the urine to a dark orange to red color same pattern of being susceptible to antibiotics early in
: large percentage of E. coli strains are resistant to infection but less so later on
penicillin derivatives Not all reproductive tract diseases are sexually
LEPTOSPIROSIS: Zoonosis associated with wild and transmitted, though many are
domesticated animals. VAGINITIS/VAGINOSIS: may or may not be sexually
• Kidneys • Liver • Brain • Eyes transmitted
LEPTOSPIRIMIC PHASE: PROSTATITIS: probably not sexually transmitted
• Pathogen appears in the blood and cerebrospinal fluid CDC: blames these increases on budget cuts to state an
local STD clinics
• Sudden high fever
RECENT YEARS: 20 STD clinics closed altogether
• Chills
DISCHARGED DISEASES: Infectious agent causes an
• Headache increase in fluid discharge in the male and female
reproductive tract
• Muscle aches
CAUSATIVE REAGENTS: transferred to new hosts whe
• Conjunctivitis
the fluids in which they live contact the mucosal surfaces
• Vomiting of the receiving partner
IMMUNE PHASE: Blood infection is cleared by natural : Trichomoniasis Gonorrhea Chlamydia
defenses
GONORRHEA:
MILD FEVER: headache due to leptospiral meningitis
SYMPTOMS IN MALES
WEIL’S SYNDROME: kidney invasion, hepatic disease,
• Urethritis
jaundice, anemia, neurological disturbances
• Painful urination
: Long-term disability and death can result from damage
to kidneys and liver, but they occur primarily with the most • Yellowish discharge
virulent strains and in elderly persons
• Relatively large number of cases are asymptomatic
LEPTOSPIROSIS CAUSATIVE AGENT: Typical
spirochete bacteria with tight, regular, individual coils with • In most cases, infection is limited to the distal urogenita
a bend or hook at one or both ends tract • Can occasionally spread from the urethra to the
prostate gland and the epididymis
LEPTOSPIRA INTEROGGANS: Species that causes
leptospirosis in humans and animals • Scar tissue formed in the spermatic ducts during the
healing of an invasive infection can render a man infertile
: Nearly 200 serotypes, resulting in extreme variations in
disease manifestation GONORREHEA SIGNS AND SYMPTOMS IN FEMALE
LEPTOSPIROSIS TRNASMISSION, EPIDEMIOLOGY, • Likely that both the urinary and genital tracts will be
TREATMENT infected during sexual intercourse
: occurs entirely through contact of skin abrasions or • Mucopurulent (containing mucus and pus) or bloody
mucous membranes with animal urine or some vaginal discharge occurs in a minority of the cases
environmental source containing urine • Painful urination if the urethra is affected
dozens of athletes competing in the swimming phase of a • Major complications occur when the infection ascends
triathlon in Illinois contracted leptospirosis from the water the vagina and cervix to higher reproductive structures
such as the uterus and fallopian tubes
