Sexual Health

Anogenital warts are usually benign HPV-related epithelial lesions, most often associated with low-risk types 6 and 11; diagnose them clinically, biopsy atypical or treatment-resistant lesions, and choose observation, topical treatment or ablation by site, morphology, pregnancy status and patient preference.

Epididymo-orchitis is acute inflammation of the epididymis with or without testicular involvement, usually from ascending sexually transmitted or urinary pathogens; the first decision is whether the acute scrotum could be testicular torsion, because imaging and antibiotics must never delay urgent exploration.

Genital herpes is a lifelong HSV infection with latent virus in sensory ganglia, causing painful first episodes and usually milder recurrences; diagnosis, partner counselling, antiviral treatment and pregnancy planning are the core UK pathway.

Neisseria gonorrhoeae is a sexually transmitted infection whose treatment is governed by antimicrobial resistance. The safe pathway is site-complete NAAT plus culture and susceptibility testing, ceftriaxone-led treatment, resistance-aware test of cure and urgent escalation for disseminated or ocular disease.

Pelvic inflammatory disease is an ascending upper-genital-tract syndrome, often polymicrobial; early empirical treatment limits tubal inflammation and the later risks of chronic pelvic pain, infertility, ectopic pregnancy and tubo-ovarian abscess.

Penile cancer is a rare malignancy, usually squamous cell carcinoma, presenting as a persistent penile lesion or unexplained foreskin or glans symptoms; suspected cases need prompt cancer-pathway referral and confirmed disease is managed through a specialist supra-urology MDT.

Phimosis is a foreskin that cannot be retracted over the glans; paraphimosis is a retracted foreskin trapped behind the glans and is a urological emergency because its constricting ring can cause progressive oedema and ischaemia.

Prostatitis ranges from acute bacterial infection with systemic illness and urinary symptoms to chronic bacterial prostatitis and chronic pelvic pain syndrome; the first priorities are to recognise sepsis or retention, obtain cultures without delaying treatment, and avoid confusing non-bacterial pain with an infection that needs antibiotics.

Syphilis is a sexually and vertically transmissible Treponema pallidum infection with primary, secondary, latent and late multisystem manifestations; stage accurately, recognise neurological/ocular/pregnancy complications, treat through a specialist sexual-health pathway and document serological response.

Trichomoniasis is a sexually transmitted infection caused by Trichomonas vaginalis; it is often asymptomatic, but may cause vaginitis or urethritis, and diagnosis requires appropriate laboratory testing followed by systemic treatment and partner management.