Genitourinary medicine is outpatient based. The largest group of patients are those with sexually transmitted infections (STIs) such as gonorrhoea, syphilis, chlamydia and wart virus infection, and a wide range of allied conditions including, for example, erectile dysfunction. Close collaboration is needed with other specialties and supporting services, so clinics should be sited in acute general hospitals. The numbers of cases attending genitourinary medicine clinics have been rising in recent years and for the first time in 1998 over one million new diagnoses were made at clinics in England. These increases have affected all STIs, with outbreaks reported from various parts of England. Management of STIs is important in the control of human immunodeficiency virus (HIV) infection. Epidemiological evidence indicates that STIs predispose to the transmission of the virus and this is supported by reports of increased viral load in infected genital secretions. Failure to treat STIs in the early stages can lead to chronic complications such as pelvic inflammatory disease.
The other patients managed in genitourinary medicine are those with HIV infection. They form a smaller but more time-consuming group who develop a wide variety of medical, social and other problems. They also provide the inpatient component of genitourinary medicine. Their management involves multidisciplinary care in hospital and multiagency working between hospital and the community. The number of new HIV infections reported in the UK continues to increases and the introduction of highly active anti-retroviral therapy (HAART) with multiple drugs has improved survival. Therefore more patients require care.
Specialty website
- British Association for Sexual Health and HIV