What is Genitourinary Medicine ?

The principal role of GUM physicians is the prevention, detection, management and control of sexually transmitted infections (STIs). They also manage a number of non-infectious medical genital problems such as dermatoses (affecting the skin).

HIV care involves

• The management of complex antiretroviral treatments (drugs used to slow down the spread of the infection)

• A knowledge of drug interactions

• Understanding antiretroviral drug resistance patterns, treatment side effects and co-infections (where a patient is infected by more than one pathogen)

In recent years the specialty has expanded into other areas of sexual health, including the provision of contraception and the management of sexual dysfunction.

Patients are able to self-refer or be referred by

primary care services such as general practitioners and family planning and youth clinics other hospital specialties such as paediatrics, obstetrics and gynaecology, urology, emergency units, ophthalmology, general medicine schools, social services and the police.

GUM physicians treat conditions such as

• STIs including Chlamydia, Gonorrhoea, Genital Herpes, Genital Warts and Syphilis

• HIV

• Vaginal infections

• Pelvic infection and inflammation

• Genital infestations such as scabies and pubic lice

Common procedures/interventions

These include:

A sexual screen which may include an examination to take genital microbiological samples treatment with the use of specific antimicrobials (agents that kill micro-organisms or inhibit their growth) outpatient minor surgical procedures such as cryocautery (a procedure that uses very high temperatures to treat the female genital tract) light microscopy and dark ground microscopy (where the field around the specimen is dark) skin biopsies and the insertion and removal of contraceptive devices including contraceptive implants and intra-uterine devices (IUDs)

Sub-specialties

Many GUM physicians develop sub-specialty interests such as:

• Genital dermatoses (skin conditions)

• Sexual dysfunction

• Contraception

• Public health

Objectives

To determine how patients aged 50 and above had been referred to a department of genitourinary medicine (GUM), why they had attended, their sexual histories, and what diagnoses were made. To identify any special sexual health needs in this group of patients.

Methods

A case note review was undertaken of all patients aged 50 and over attending the Portsmouth GUM department over a 3 month period.

Results

There was a marked difference in reason for attendance between men and women in this older age group. Men were more likely to attend for a sexual health screen, often with minimal or no symptoms, following an extramarital or casual liaison. Women more commonly had symptoms causing difficulties with sexual intercourse with their regular partner.

Older people present to GUM departments with a wide range of sexually associated problems. The diagnostic and management expertise available in GUM departments makes them ideal providers of sexual health care for this as well as younger age groups.

Genitourinary Medicine Options are available at Senior Citizen Healthcare