Congenital hydronephrosis

Disease Description (Causes and Symptoms)

Sexually transmitted diseases (sexually transmitted infections) are a general term for infectious diseases transmitted through sexual contact (vaginal intercourse, oral sex, anal sex, skin-to-skin contact, etc.). Causative pathogens include viruses (e.g., human papillomavirus [HPV], herpes simplex virus [HSV], HIV), bacteria (e.g., gonococci, chlamydia, syphilis bacteria), protozoa (e.g., Trichomonas), fungi (e.g., Candida), and ectoparasites (e.g., pubic lice, scabies). Although the pathophysiology and clinical findings vary depending on the pathogen, common symptoms include the following.

• Local symptoms: pruritus (itching), pain, burning sensation, redness, blisters or ulcers, swelling, and enlarged lymph nodes
• Discharge: urethral discharge, abnormal vaginal discharge (changes in odor or color)
• Systemic symptoms: fever and muscle aches (with certain infections) Complications include infertility, chronic pelvic pain, increased risk of ectopic pregnancy, fetal infection during pregnancy, increased risk of cancer with some viral infections (e.g., HPV and cervical cancer), and increased risk of other sexually transmitted diseases or HIV infection.

Treatment Methods and Precautions

• Standard treatment specific to the pathogen is administered after diagnosis. General treatment principles include:
  • Bacterial infections (gonorrhea, chlamydia, syphilis, etc.): antibiotics (use of the first-line medication selected by a doctor). Medication selection according to clinical guidelines and compliance with the treatment duration are necessary.
  • Viral infections (HSV, HIV, HPV): HSV symptoms are relieved and recurrences suppressed with antiviral medications (e.g., acyclovir/valacyclovir). HIV is managed chronically with antiretroviral therapy (ART). There is no medication that eliminates HPV itself; lesion treatment (condyloma removal, excision and laser treatment, etc.) and prevention (vaccination) are important.
  • Protozoa (Trichomonas): antiprotozoal medications (e.g., metronidazole or tinidazole).
  • Fungi (Candida): topical or oral antifungal medications.
  • Ectoparasites (pubic lice, scabies): topical preparations such as permethrin or oral medications.
• Diagnostic methods: medical history and physical examination, urine/discharge NAAT (nucleic acid amplification test), culture, serologic testing (syphilis and HIV antibodies), microscopic examination, and HPV testing/cervical cytology (Pap smear), among others.
• Precautions (including self-care)
  • Abstinence from sexual intercourse or use of condoms is recommended during treatment and until treatment is complete (sexual intercourse before completion of treatment carries a risk of reinfection and transmission).
  • Notify partners and ensure simultaneous treatment (to break the chain of transmission).
  • If pregnant, consultation with an obstetrics and gynecology or infectious diseases specialist is required because the use of some medications is restricted.
  • Check for drug allergies and interactions with medications currently being taken (especially anticoagulants, antiviral medications, etc.).
  • Prevention is possible through HPV vaccination (confirm the recommended age and indications).
• Risk of complications: If early diagnosis and treatment are not provided, there may be infertility, chronic pain, systemic infection (such as bacterial bloodstream infection), neonatal infection, and increased risk of cancer.

Outpatient Visit Checklist (Including Preparations and Sample Questions)

Items/records to prepare:

• A list of all medications currently being taken (including prescription drugs, over-the-counter medications, and supplements)
• History of drug allergies
• Records of when symptoms began and how they have changed (color, odor, and amount of discharge; pain and itching, etc.)
• Sexual contact history (number of recent partners, whether there is a new partner, and whether a partner has symptoms) — accurately informing the doctor is important for treatment
• Previous sexually transmitted disease test results or treatment records, and cervical cytology (Pap) results (for women)
• Whether pregnancy is possible and the method of contraception
• Results of recent tests (blood tests, urinalysis, culture, etc.), if available Preparation for testing and medical care:
• If possible, avoid vaginal douching (use of vaginal cleansing products) within 24–48 hours before the examination (to prevent reduced test accuracy)
• When testing for urethral discharge, avoiding urination immediately before the test may be helpful (follow instructions) Sample questions (self-check before the outpatient visit):
• When did the symptoms begin?
• Have you had a new sexual partner recently?
• Is pregnancy possible?

General Sample Questions to Ask the Doctor

• What is the cause of this infection, and what tests should I have?
• What treatment is recommended, and what is the expected treatment duration?
• What are the side effects of this medication, and what should I be careful about while taking it?
• When can I resume sexual intercourse?
• When should I have repeat testing (follow-up testing), and which items will be tested?
• When and how should my partner be tested and treated?
• If I am pregnant, what are the risks to the fetus and what safe treatment options are available?

Sample Questions Tailored to the Disease

• (When discharge or urethral symptoms are present) “What do the results of my discharge test mean? What additional tests should I have?”
• (HPV or abnormal cervical findings) “If I have an HPV infection, which tests (HPV testing and Pap testing) and vaccines are recommended to prevent cervical cancer? What will the treatment and follow-up schedule be?”

(Key point) Early diagnosis and appropriate treatment, notifying partners, and prevention (condom use, HPV vaccination, and regular checkups) are key to managing sexually transmitted diseases. If you have symptoms or suspect exposure, seek testing at a medical institution without delay.