Genital Hygiene | Maintenance

Genital Hygiene

According to a report published in peer reviewed medical journal Gynecology & Obstetrics (1) investigators reported that the overall prevalence of abnormal vaginal discharge in females is 12 to 30%.  Report also suggested that most cases of genital infections (Genital Herpes Learn More) or sexually transmitted diseases (What are STD’s Learn More) are preventable with optimal genital hygiene.

Genital hygiene is a broad term that include several behavioral and habitual factors required for the maintenance of overall physical and sexual health (Healthy Sexual Relationship). Besides reducing the risk of infectious diseases like HIV (HIV Global Learn More), Hepatitis B (Oral STD’s Learn More) and C; optimal genital hygiene also reduces the risk of sexually transmitted infections such as gonorrhea (Gonorrhea Treatment Learn More), Chlamydia (Chlamydia Symptoms Learn More), HPV (HPV in Men Learn More) and other similar ailments.  Unlike the popular belief, the concept of maintaining genital hygiene applies to both males and females.

Palaniswamy (2) and associates conducted a study on male patients with a history of urethral strictures. Investigators reported that most study participants reported passage of infected/ pus like urine, frank balanoposthitis and subpreputial calculi along with secondary or multiple urethral strictures. On deeper analysis, it was observed that poor genital hygiene was the main culprit in over 88% of the cases.

 

Maintaining Optimal Genital Hygiene

A multi-modal approach is needed to maintain functional genital hygiene; a few guidelines are listed below

Besides periodic changing of undergarments, there are several other factors that may help in reducing the risk of infections by optimizing personal and genital hygiene. Such as cotton undergarments offer less friction/ irritation to genital region as compared to silk garments; pantyhose and tight fighting garments increases the risk of genital irritation. Likewise, use of briefs in males increase the risk of sweat accumulation and resulting irritation.

Research conducted by Nigel O’Farrell and associates (3) suggested that uncircumcised males (Circumcision Benefits Lear More) are at much higher risk of developing sexually transmitted diseases and infections than circumcised males. Likewise, uncircumcised males require more proactive approach to maintain genital hygiene.

 

Obsessed With Genital Hygiene – Helpful or Hazardous?

Limiting the use of perfumed/ scented products for sanitation:

It is also very important not to get overly obsessed with genital cleanliness. For example, a lot of women use perfumed/ scented sanitary products that are extremely dangerous (especially if you have a sensitive skin or propensity to develop allergic reactions).

If you are suffering from bad vaginal odor (Yeast Infection Learn More) or foul smelling vaginal discharge, using douche or scented products can exacerbate the problem. It is recommended to see a healthcare professional for advice.

Cleaning vagina with soap – A Big No-No:

Cleaning/ washing the vagina (inner aspect) with a soap is also fairly hazardous especially because the internal environment and pH of vagina is maintained under strict limits with the help of normal commensals of genital tract. Any alteration in the pH of vagina can increase the risk of infections several folds.

 

General Tips for Genital Maintenance

If you have any questions or concerns regarding your personal or sexual hygiene or if you are experiencing recurrent attacks of urinary or genital infections; speak to a genital hygienist for further advice.

 

References:

Sevil, S., Kevser, O., Aleattin, U., Dilek, A., & Tijen, N. (2013). An Evaluation of the Relationship between Genital Hygiene Practices, Genital Infection. Gynecol Obstet, 3(187), 2161-0932.
Palaniswamy, R., & Bhandari, M. (1983). Point of focus: poor genital hygiene and terminal urethral strictures. Tropical and geographical medicine, 35(2), 139-143.
O’Farrell, N., Quigley, M., & Fox, P. (2005). Association between the intact foreskin and inferior standards of male genital hygiene behaviour: a cross-sectional study. International journal of STD & AIDS, 16(8), 556-559.
Weiss, H. A. (2007). Male circumcision as a preventive measure against HIV and other sexually transmitted diseases. Current opinion in infectious diseases, 20(1), 66-72.
Mazzola, B. L., von Vigier, R. O., Marchand, S., Tönz, M., & Bianchetti, M. G. (2002). Behavioral and functional abnormalities linked with recurrent urinary tract infections in girls. Journal of nephrology, 16(1), 133-138.[/fusion_builder_column][/fusion_builder_row][/fusion_builder_container]

Pediatric Urology Conditions

Pediatric Urology Conditions

Pediatric urology conditions in pediatric aged children are often hard to diagnose due to complexity of symptoms and lack of subjective complaints. It has been reported that prevalence of congenital urological conditions is as high as 0.2-0.9% (1). Most urological issues are related to genital malformation or other related issues that may require surgical correction for complete resolution of symptoms. It is very important to identify and manage these issues at an early age.

 

Common Pediatric Urology Conditions:

Hypospadias:

Hypospadias is a congenital condition that reportedly affects one in 250 male babies with the primary complaints of malpositioned urethral opening. Most babies have urethral opening at the base of penis (instead of terminal end of penile head), or anywhere along the penile or scrotal region.

In most cases of pediatric urology conditions, health care providers and pediatric surgeons perform corrective surgery at the age of 6 months (or ideally in the first year of postnatal life).

Parents should know that circumcision should not be attempted in such babies mainly because the foreskin is used for reconstructive surgery to create the new urethral opening.

Antenatal Hydronephrosis:

Mal-development of fetal kidneys can lead to antenatal hydronephrosis (a condition marked by enlargement of fetal kidneys due to excessive urine production or abnormal urinary drainage). Most cases are identified before birth (during antenatal assessments and ultrasono logical examinations).

Hydronephrosis is the most common pediatric urology conditions anomaly (50% of all the reported urological issues in this age group) as suggested by the report published in British Medical Journal (1).

Some cases, of pediatric urology conditions, may respond to non-invasive treatment after birth while others may require surgical intervention for resolution of symptoms. A delay in management can increase the risk of permanent destruction of kidneys.

Non -Surgical Treatment of Incontinence ImageNocturnal Enuresis (Bedwetting):

Most children achieve bladder control by the age of 5 to 6 years; but some encounter difficulty in achieving continence at night. According to a study conducted by BJU International (3) the prevalence of nocturnal enuresis at the age of 7.5 years is 5.5%.

Undescended Testes (Cryptorchidism):

The overall prevalence of undescended testis in full-term babies is 3.4% to 5.8%; however, in most cases testes descend by 1 year of age. The overall prevalence of undescended testes at the age of 1 year is only 0.8%. Most common site of undescended testes is inguinal canal (in about 80% cases).

Urgent management by procedures like orchidopexy is needed to minimize the risk of testicular malignancy and permanent sterility.

Ureteropelvic Junction (UPJ) Obstruction:

Ureteral is naturally constricted at the ureteropelvic junction (where ureter enters the kidney); but in about 1 in 500 live births (1), the UPJ is completely or partially obstructed. The resultant effect is a higher propensity of the baby to develop hydronephrosis (before or after birth).

Hydrocoele: 

Fluid collection between the two layers of tunica vaginalis (visceral and parietal) is referred to as hydrocele. Prevalence of congenital hydrocele is 4.7% that may resolve spontaneously in 84-90% cases (5).

Circumcision ComplicationsOther Common Pediatric Urology Conditions Are:

 

What Are the Consequences of Pediatric Urology Conditions?

Although untreated or poorly managed urological problems in pediatric urology conditions aged children lead to complications (as discussed above); often time deleterious complications can also result from diagnostic and treatment procedures. A report published in The Journal of Urology (4) suggested that the rate of complications during laparoscopic procedures is as high as 2.7%.

It is therefore suggested by healthcare providers and pediatricians to keep up with periodic pediatric examinations in order to optimize the health of children for pediatric urology conditions.

References:

1. Prem, A. R. (2006). Common paediatric problems. BMJ, 333(7566),486-489.

2. Koff SA, Mutabagani KH. Anomalies of the kidney. In: Adult and Pediatric Urology, 4th ed, Gillenwater JY, Grayhack JT, Howards SS, Mitchell ME (Eds), Lippincott Williams and Wilkins, Philadelphia 2002. p.2129.

3. Butler, R. J., Golding, J., & Northstone, K. (2005). Nocturnal enuresis at 7.5 years old: prevalence and analysis of clinical signs. BJU international, 96(3), 404-410.

4. Esposito, C., Lima, M., Mattioli, G., Mastroianni, L., Centonze, A., Monguzzi, G. L., … & Jasonni, V. (2003). Complications of pediatric urological laparoscopy: mistakes and risks. The Journal of urology, 169(4),
1490-1492.

5. Osifo, O. D., & Osaigbovo, E. O. (2008). Congenital hydrocele: prevalence and outcome among male children who underwent neonatal circumcision in Benin City, Nigeria. Journal of pediatric urology, 4(3), 178-182.

Tips To Avoid Your Urologist

Tips To Avoid Your Urologist

According to the statistics reported by National Ambulatory Medical Care Survey (1)

 –      Over 8 million male adults visit urologist clinics per year for prostate related problems (Prostatitis, Prostatic Hyperplasia or Malignancy) in United States (1).

        Over 2.5 million adults see their urologists for bladder related issues like UTI or urinary tract infection, marked by burning urination, increase in the overall frequency and urgency of urination and other similar symptoms.

        About 718,430 male adults consult their physician for urinary incontinence (the prevalence is almost thrice as much in the females for same indication).

Blausen_0082_BladderCancerOther common causes of visits to urologist clinic include bladder stones, erectile dysfunction, urethral diseases, urinary reflux and cystitis. Urological issues are disabling and can compromise the quality of your life. Moreover, long standing urological infections and complaints can evolve into much bigger health problems like chronic kidney disease, renal failure and cancer.

But, you can definitely avoid your urologist by adopting healthy habits and lifestyle modifications. This consequently will reduce your healthcare cost for ambulatory and non-ambulatory urological care, which according to latest statistics (2) is over $1.6 billion for UTI management alone.

Some Simple Tips To Avoid Urologist:

  1. Increase Your Water Intake:

Male Testicle Size ImageUrinary system is highly effective at filtering your blood to excrete toxins, chemicals and nitrogenous waste products via urine. Increasing water intake to at least 2 liters per day is advised by most healthcare providers.

Mere increase in water intake can prevent urinary or renal stones (formed as a result of deposition of minerals or salts due to passage of very concentrated urine). Increase in water intake helps in flushing out the crystals before deposition. Likewise, bacterial and fungal infections can be prevented due to frequent flushing of toxins/ chemicals that may favor bacterial growth.

You should ideally increase your basal water intake in these conditions.

          Hot and humid weather

          After strenuous physical activity

          In acute or chronic illness/ infection

  1. Control Your Salt Intake:

Intake of excessive salt (via diet) is an important contributing factor for calcium stone formation (Yes- it is not the calcium that cause calcium stones, but sodium from table salt). High sodium intake favors the excessive excretion of calcium that may get precipitated in the form of crystals/ stones.

  1. Manage Your Chronic Illnesses:

Long standing and poorly managed metabolic or medical health issues like diabetes, hypertension, systemic lupus erythematous and others can affect the integrity of blood vessels and may increase the propensity to develop infections, chronic renal disease and renal failure.

  1. Control Your Intake of Caffeinated and Alcoholic Beverages:

Coffee and Prostate Cancer ImageAlcoholic or caffeinated beverages have a mild diuretic action that may increase the passage of urine (and also increase the risk of intra-cellular dehydration). Intake of caffeine is directly associated with interstitial cystitis and urinary tract infections (3)

Other Helpful Tips Are:

  1. Maintain optimal hygiene (physical and reproductive). Always wipe front to back in order to prevent contamination of urinary region with fecal matter .
  2. Sexually active males and females require extra caution in maintaining reproductive hygiene (washing or cleaning after each sexual encounter and use of condoms/ diaphragms to prevent transmission of infectious agents .
  3. Increase your intake of fresh fruits and vegetables that are rich in Vitamin C (Broccoli, Berries esp. Cranberries and Citrus fruits) .
  4. Keep up with annual physical examination to detect any abnormality / ailment at earlier stage .
  5. Showers are better at reducing the risk of bacterial contamination as compared to baths .
  6. Reduce your intake of sugars (as both bacteria and fungi rely on sugar substrates for energy generation and multiplication) .

It is good to practice preventive medicine (with the aim to avoid your urologist) but make sure to see a healthcare professional at earliest convenience if you are experiencing one or more of these symptoms for over two days .

 –        Burning urination (with or without urgency, increased frequency, flank pain, high grade fever with rigors or chills)

 –        Clouding of urine

 –        Passage of blood/blood clots/ pus in urine

 

 References:

  1. http://udaonline.net/pdf-compendium/Sections/Urologic_Diseases_in_America.4.13.12.pdf
  2. Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins. 2010. p. 1359 .
  3. Friedlander, J. I., Shorter, B., & Moldwin, R. M. (2012). Diet and its role in interstitial cystitis/bladder . pain syndrome (IC/BPS) and comorbid conditions. BJU international, 109(11), 1584-1591.

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