Wilderness and Rescue Medicine 7th Edition Jeffrey Isaac, PA-C and David E. Johnson, MD

Chapter 29: Genitourinary Problems

As the name implies, the genitourinary (GU) sys- tem is really two systems sharing some common structures in both men and women. It can be dif- ficult to distinguish between problems that lie in reproductive organs and those affecting the uri- nary system. In the absence of a specific diagnosis, the generic assessment of serious or not serious is still possible. Anything that interferes signifi- cantly with the normal body functions of eating, drinking, and excretion can be considered serious. This includes any GU problem with significantly impaired urination. Problems within the GU system are likely to be either obstruction to infection or ischemia to infarction. The common examples are urinary tract infection (UTI) and vaginitis in the female, and kidney stones. Often the patient will have a history of similar problems and will know what it is. Less common are urinary obstruction or infec- tion in men, testicular torsion, ovarian torsion, and ectopic pregnancy. Vaginitis Infection of the vagina occurs when something upsets the normal balance between yeast and bacteria, allowing one of the species to grow out of control. Antibiotics taken for a strep throat, for example, will kill many of the bacteria in

the vagina, allowing for an overgrowth of yeast. Changes in the vaginal environment can also be caused by clothing, sexual activity, stress, dehy- dration, and other factors.

Yeast infection is more common than bacterial infection. Signs and symptoms include itching