Author/Editor		Kopčavar-Guček, Nena
Title		Obravnava para z urološko-ginekološko simptomatiko v ambulanti družinske medicine
Translated title		Treatment of sexual partners with genitourinary symptoms at the clinic for family medicine
Type		članek
Source		Zdrav Vars
Vol. and No.		Letnik 39, št. 7-8
Publication year		2000
Volume		str. 145-55
Language		slo
Abstract		A man with genitourinary tract symptoms frequently presents his problems primarily to his family physician. After having ruled out all possible noninfective causing agents, sexually tramsmitted infections (STI) are the most probable etiologic factor. Due to the recognition of the new sexually transmitted microorganisms, the variety in presentation of classical STI, the novelties in etiology of sexually tramsitted syndromes, the increasing resistance of microorganisms and the continuosly migrating population, a careful and elaborate treatment is mandatory. Not only the patient, but his - frequently asymptomatic - partner should be treated accirdingly. Sexually transmitted microorganisms can act as the causing agents of infertility syndrome, ectopic pregnancy, anogenital carcinoma and even death. Misdiagnosed and untreated STI can facilitate the ascending of infection into pelvidÐc inflammatory disease (PID) or even systemic infection. STI in a pregnant women can affect the child, causing a variety of clinical symptoms and malformations. The active population in its most productive period of life represents the majority of STI patients. Therefore, the social and economic implications are aggravating. Weakened immune response, caused by HIV, can worsen the symptoms and cause complications in the treatment of STI. Some experts suggest that a synergistic relation exists among STIs. STI demands a specific approach to the treatment. Both the patient and his sexual partenr(s) should be included. Beside diagnosing and therapy, such couple should be accordingly advised, all further contacts notified and the infection registered. Family physician represents the gateway into public health system, particularly for men. On the contrary, women are frequently seen primarily by their gynecologists. (Abstracts truncated at 2000 characters).
Summary		Moški s simptomi bolezni sečil se pogosto najprej zateče k izbranemu splošnemu družinskemu zdravniku. Po izključitvi neinfektivnih vzrokov za težave je najbolj verjetno, da gre za spolno prenosljivo okužbo (SPO). Glede na pojav novih spolno prenosljivih mikroorganizmov, spremembe v pojavljanju klasičnih SPO, novosti v etiologiji spolno prenosljivih sindromov, pojav in naraščajoče odpornosti mikroorganizmov in premike v populaciji je nujna skrbna diagnostična in terapevtska obravnava bolnika in - pogosto asimptomatske(-ga) - partnerke(-ja). Spolno prenosljivi organizmi so lahko povzročitelji sindroma neplodnosti, zunajmaternične nosečnosti, anogenitalnega karcinoma in celo smrti. Pozno odkritje ali nezdravljene SPO vodijo v ascendentno razširitev vnetja v mali medenici in v sistemski razvoj okužbe. Pri okuženi noseči ženski lahko SPO vpliva na plod in povzroči vrsto kliničnih sindromov in malformacij. HIV oslabi imunski odgovor, s tem pa poslabša simptome in povzroči zaplete drugih SPO. Nekateri strokovnjaki poudarjajo sinergistično delovanje SPO. Večina prizadetih s SPO je v času okužbe in njenih posledic v najproduktivnejšem življenjskem obdobju, zato so socialne in ekonomske posledice ogromne. Zaradi svoje spedcifičnosti terjajo SPO poseben način obravnave. Nujno potrebna je obravnava para, bolnika in njegovega partnerja. Poleg razpoznavanja in zdravljenja je pomembno tudi svetovanje, obveščanje spolnih partnerjev in evidentiranje (prijava). Ambulanta splošnega/družinskega zdravnika predstavlja vstopna vrata v sistem zdravstvenega varstva za vse bolnike s SPO, še posebno za moške. Ženske se pogosto zatekajo neposredno k izbranemu ginekologu, ki pristojnemu osebnemu zdravniku posreduje informacije in navodila za nadaljnje spremljanje bolnice in njenega partnerja. (Izvleček prekinjen pri 2000 znakih).
Descriptors		FAMILY PRACTICE URINARY TRACT INFECTIONS SEXUALLY TRANSMITTED DISEASES SEXUAL PARTNERS MEDICAL HISTORY TAKING PHYSICAL EXAMINATION CHLAMYDIA TRACHOMATIS GONORRHEA SYPHILIS HERPES GENITALIS CONDYLOMATA ACUMINATA VAGINITIS CANDIDIASIS, VULVOVAGINAL VAGINOSIS, BACTERIAL TRICHOMONAS VAGINITIS IMPOTENCE INFERTILITY