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PubMed2003

Genital morphology and fertilization success in the dung beetle Onthophagus taurus: an example of sexually selected male genitalia.

In animals with internal fertilization and promiscuous mating, male genitalia show rapid and divergent evolution. Three hypotheses have been suggested to explain the evolutionary processes responsible for genital evolution: the lock-and-key hypothesis, the pleiotropy hypothesis and the sexual-selection hypothesis. Here, we determine whether variation in male genital morphology influences fertilization success in the dung beetle Onthophagus taurus, as predicted by the sexual-selection hypothesis. Variation in four out of five genital sclerites of the endophallus influenced a male's fertilization success, supporting the general hypothesis that male genitalia can evolve under sexual selection. Furthermore, different genital sclerites were found to enhance first versus second male paternity, indicating that different sclerites serve offensive and defensive roles. Genital-trait variability was comparable to that in other species but was less variable than a non-genital sexually selected trait (head horns). We suggest that directional selection for genital elaboration may be countered by natural selection, which should favour genitalia of a size and shape necessary for efficient coupling and sperm transfer.

Animals↗

PubMed2004

A case of foul genital odor treated with botulinum toxin A.

BACKGROUND: Genital odor is an uncommon condition characterized by an offensive and malodorous smell in the genital area. Although the etiology of foul genital odor is multifactorial, an important cause is sweat secretion and decomposition of sweat components by bacteria. Different methods are effective in reducing body odor secondary to bromhidrosis. Conservative methods only act for a short period of time, and more invasive surgical methods carry risk of complications or are inapplicable for the genital region. METHODS: A patient with localized foul odor in the genital hair bearing area was treated with botulinum toxin A. RESULTS: Botulinum toxin A was effective in creating an odorless and anhydrous response in the genital region, and no major adverse effects were noted during a follow-up of 9 months after injection. CONCLUSION: Local injection of botulinum toxin A appears to be a useful treatment for foul genital odor related to sweat glands activity.

Adult↗

PubMed2004

Prevalence of hypospadias and other genital anomalies among singleton births, 1988-1997, in Scotland.

BACKGROUND: Considerable debate exists on the epidemiology of genital anomalies. METHODS: All genital anomalies, excluding undescended testes, were identified from neonatal returns, stillbirth and infant death survey records, and returns relating to hospital admissions and linked to form infant profiles on a cohort of singleton births between 1988 and 1997 with follow up for a minimum of three years. FINDINGS: The mean genital anomaly prevalence rate in Scotland was calculated at 4.6 per 1000 births varying from 4.0 per 1000 births in 1988 to 5.9 per 1000 births in 1996. However, there was no evidence of a clear trend to an increasing prevalence of hypospadias, which constituted 73% of the anomalies studied. Logistic regression analysis of the data also showed this rate to be independently associated with being relatively small for gestational age (odds ratio (OR) 1.43, p < 0.001) and increasing maternal age (OR 1.2, p < 0.05). Infants born in deprived areas, as judged by the Carstairs deprivation score, were least likely to have a genital anomaly (OR 0.73, p < 0.01). INTERPRETATION: A new linked register of congenital genital anomalies in Scotland suggests that over a decade, the birth prevalence of genital anomalies has changed little. The associations between genital anomalies, maternal age, and socioeconomic deprivation require further study.

Cohort Studies↗

PubMed2005

The epidemiology of genital infection with herpes simplex virus types 1 and 2 in genitourinary medicine attendees in inner London.

OBJECTIVE: To characterise the epidemiological and clinical features of genital herpes and the diagnostic role of HSV-2 specific serology in an ethnically diverse cohort of genitourinary medicine (GUM) attendees in inner London. METHODS: Genital swabs (n = 186) were tested by real time polymerase chain reaction (PCR) and serum samples (n = 70) by HSV-2 specific enzyme linked immunoassay (ELISA). RESULTS: Among 186 patients (median age 29 years), 104/186 (56%) were male and 176/186 (95%) heterosexual; ethnicity was predominantly black Caribbean (76/186, 41%), white (65/186, 35%), or black-African (41/186, 22%). The most common lesion sites were penis (85/104 men, 82%) and vulva (63/82 women, 77%); 114/186 (61%) patients were diagnosed clinically with first episode disease. Women were more likely to present <5 days of onset (p = 0.008). Black Caribbean patients were more likely to present > or = 5 days (p = 0.04) and decline HIV testing (p = 0.03). By PCR, 108/186 (58%) swabs tested positive for HSV-1 (7/108, 6.5%) or HSV-2 (101/108, 93.5%). Independent predictors of a positive PCR were heterosexual group, <5 days of onset, and visible genital ulceration on examination. HSV-2 was associated with black Caribbean and black African ethnicity; HSV-1 with white ethnicity (p = 0.006). By HSV-2 specific serology, 16/42 (38%) first episodes caused by HSV-2 were recurrent infections, and 7/19 (37%) patients with recurrent genital disease but negative PCR had genital herpes. CONCLUSIONS: Epidemiological trends in genital HSV-1 and HSV-2 infection appear to vary between ethnic groups in the United Kingdom. HSV-2 specific serology improves diagnostic accuracy in GUM populations where most genital infections are caused by HSV-2.

Adolescent↗

PubMed1993

Genital HPV infection not a local but a regional infection: experience from a female teenage group.

OBJECTIVES: To investigate the prevalence of human papillomavirus (HPV) infections in a group of female teenagers, and to analyse to what extent HPV DNA was also detectable, in urethra and cervix samples among the patients with macroscopic genital warts compared with those without. DESIGN: The patients were interviewed about their sexual habits and history of venereal diseases. They underwent a gynaecological health control examination, including macroscopic inspection for genital warts and collection of a cytological vaginal smear (Pap smear). Cell samples were also taken from endocervix and urethra and from vulva lesions, when found. These samples were tested for HPV DNA of the types 6, 11, 16, 18 and 33 using the polymerase chain reaction (PCR) technique. SETTING: An adolescence out-patient clinic in Malmö, Sweden. SUBJECTS: Forty-nine female teenagers consulting for gynaecological complaints, some of them for genital warts. RESULTS: Twenty patients had present and four had a history of genital warts (group A). The other 25 patients had no visible lesions (group B). In the first group (A) 18 of the 24 patients were positive for HPV DNA in one or more of the three locations studied. More patients were positive in urethra (17) than in cervix (15). In group B four of the 25 patients were positive for HPV DNA in urethra, three of these also in cervix. In the two groups 11 and four patients, respectively, showed pathological Pap smears. CONCLUSIONS: The finding of HPV DNA in urethra, both from women with and without visible genital warts, indicates that there is a high probability that the infection is also present in cervix, suggesting that the genital HPV infections are multifocal. Thus, patients with genital warts are most likely to have cervical HPV infections and will more often have pathological Pap smears than patients without warts.

Adolescent↗

PubMed1999

Intrauterine sonographic visualization of embryonic genital tubercle.

OBJECTIVE: To visualize embryonic genital tubercle using intrauterine sonography with a 20-MHz flexible catheter-based high-resolution real-time miniature transducer in early first-trimester pregnancy. DESIGN: Randomized prospective study. METHODS: A total of 39 women about to undergo therapeutic abortion from 7 to 10 weeks' gestational age were studied with specially developed catheter-based high-resolution real-time miniature (2.4 mm in outer diameter) ultrasound transducer (20 MHz). Before the intrauterine sonographic procedure was performed, transvaginal sonographic assessment of the embryo was conducted. The percentage of embryonic genital tubercle (or phallus) visualized at each gestational age using intrauterine and transvaginal sonography is presented. RESULTS: The genital tubercle could not be identified at 7 weeks of gestation with intrauterine sonography. The genital tubercle was visualized in 30% of embryos at 8 weeks' gestation, and in 100% of embryos at 9 and 10 weeks. The genital tubercle was situated somewhat cranially to the sacral prominence at this gestational age. The genital tubercle could not be depicted with transvaginal sonography between 7 and 10 weeks of gestation. CONCLUSIONS: Intrauterine sonography provides a novel means for visualization of genital tubercle of the embryo. These results suggest that intrauterine sonography can become an important modality in future embryological research and in detection of embryonic developmental disorders in the early first-trimester pregnancy.

Catheterization↗

PubMed2001

The heterogeneous clinical spectrum of genital herpes.

BACKGROUND AND OBJECTIVE: Most data of genital herpes have been collected in STD clinics in the USA where unrecognized forms accounted for 80% of HSV-2 infections. Our aim was to study the clinical features in an outpatient clinic of dermatology. METHODS: The charts of 170 patients, previously monitored prospectively for a HIV prevalence study, with culture-confirmed genital herpes or herpetic infection with HSV-2 at any other site presenting between 1995 and 1999 were analyzed. RESULTS: 111 (65%) men and 59 (35%) women were identified with a mean age of 44 years. Only 49% had a typical cluster of genital lesions. Eighty-six (51%) presented with either lesions at extragenital sites [mostly the buttocks 33/170 (19%), thigh 10/170 (6%), anal region 9/170 (5%) and fingers 8/170 (5%)] or showed morphologically atypical forms of isolated genital lesions [single ulcer 16/170 (9%), erosion 6/170 (4%), crust 3/170 (2%) and fissure, edema or erythema each 1/170 (1%)]. Women significantly presented more often with extragenital infections of HSV-2 [36/59 (61%)] than men [18/111 (16%)]. CONCLUSIONS: More than half of the patients with genital herpes of a mainly immunocompetent population presented with atypical manifestations. The underdiagnosis of genital herpes seems largely due to misinterpretation of atypical genital and extragenital lesions.

Adolescent↗

PubMed1990

Genital ridges exert long-range effects on mouse primordial germ cell numbers and direction of migration in culture.

The functional gametes of all vertebrates first arise in the early embryo as a migratory population of cells, the primordial germ cells (PGCs). These migrate to, and colonise, the genital ridges (GR) during the early organogenesis period, giving rise to the complete differentiating gonad. PGCs first become visible by alkaline phosphatase staining in the root of the developing allantois at 8.5 days post coitum (dpc). At 9.5 dpc they are found in the wall of the hind-gut and, during the following three days, they migrate along the hind-gut mesentery to the dorsal body wall, and then to the genital ridges. By 12.5 dpc, the great majority of PGCs have colonised the genital ridges. During this period the number of PGCs increases from less than 100 to approximately 4000. In a previous paper (Donovan et al. 1986), we showed that 10.5 dpc PGCs can be explanted from the hind-gut mesentery, and will spread and migrate on feeder cell layers. We showed also that the intrinsic ability of PGCs to spread and migrate changes as they colonise the genital ridges. In this paper, we examine extrinsic factors that control PGC behaviour in vitro. Using PGCs taken from 8.5 dpc embryos, at the beginning of their migratory phase, we show that culture medium conditioned by 10.5 dpc genital ridges causes an increase in the number of PGCs in these cultures. We also show that PGCs migrate towards 10.5 dpc genital ridges in preference to other explanted organs. These experiments show that genital ridges exert long-range effects on the migrating population of PGCs.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗

PubMed1997

Compartmental organization of the Drosophila genital imaginal discs.

We have investigated the anterior and posterior compartmental organization of the genital imaginal disc. Unlike the thoracic discs, the genital disc is a compound disc consisting of three primordia--the female genital, male genital, and anal primordia. Here we provide evidence that each primordium is divided into anterior and posterior compartments. Genes that are known to be expressed in compartment-specific manners in other discs (engrailed, hedgehog, patched, decapentaplegic, wingless and cubitus interruptus) are expressed in analogous patterns in each primordium of the genital disc. Specifically, engrailed and cubitus interruptus are expressed in complementary domains, while patched, decapentaplegic and wingless are expressed along the border between the two domains. Mitotic clones induced at the beginning of the second larval instar do not cross the boundary between the engrailed-expressing and cubitus interruptus-expressing domains, indicating that these domains are true genetic compartments. Furthermore, we examined the phenotypes of mutant clones of the cAMP-dependent protein kinase A and engrailed-invected, genes that are known to play compartment-specific functions in other discs. These experiments demonstrate that the anterior/posterior patterning functions of these genes are conserved in the genital disc. The adult clonal phenotypes of protein kinase A and engrailed-invected mutants also provide a more detailed map of the adult genitalia and analia with respect to the anterior/posterior compartmental subdivision. Our results lead us to propose a new model to describe the anterior and posterior compartmental organization of the genital disc.

Animals↗

PubMed2002

Information-giving to patients with genital warts at a genitourinary medicine clinic: a baseline assessment.

Aspects of information-giving to patients with a first episode of genital warts attending a large UK genitourinary medicine clinic on three or more occasions were assessed using a questionnaire survey employing correlational and between-groups analyses. The main outcomes measured were levels of, and interrelationships between, patients' perceptions of information received about genital warts, accuracy of knowledge, quality of interaction with clinic personnel, written information, patients' level of anxiety and demographic variables. Patients with genital warts have good basic knowledge about this condition, although understanding about several complex issues is poor. Educational level was positively correlated with accuracy of knowledge about genital warts. Although ease of communicative interaction with information-givers was positively correlated with perceived information given, no relationship was found between the latter and actual knowledge about genital warts. Anxiety levels and receiving written information were largely uncorrelated with accuracy of knowledge about genital warts. This study suggests that while patients' perception of information received may relate to more satisfactory interaction with information-givers, actual knowledge may be a more important measurable outcome. More interventional work is needed to determine how the information-giving process for genital warts can be optimized.

Adolescent↗

PubMed1998

An international survey of patients with genital warts: perceptions regarding treatment and impact on lifestyle.

Our aim was to determine country-specific attitudes and perceptions of patients with genital warts and to understand the psychosexual impact of the disease and its treatment. We used a standardized discussion guide to interview patients with genital warts in Canada, France, Germany, the UK, and the USA about their perceptions and concerns regarding the diagnosis, treatment, and psychosexual impact of the disease. Interviews were conducted in person and lasted approximately 30 min. The study group included 80 men and 86 women with genital warts. Forty-seven per cent were currently undergoing treatment. Overall, 49% of the men had first consulted a general or family practitioner, and 52% of the women had first consulted a gynaecologist. Although all the patients eventually consulted a physician about their warts, one-third delayed seeing a doctor because they thought the condition would resolve on its own or that the problem was not serious. Most patients reported that treatment was associated with pain, discomfort, and embarrassment. Sixty per cent of patients experienced a recurrence after initial clearance with treatment. More than 80% stated that they had had little or no involvement in the selection of treatment. Globally, 52% of men and 61% of women were 'quite concerned' or 'very concerned' about having genital warts, although there were significant variations by country. Approximately two-thirds of patients had made lifestyle changes regarding sexual relationships. In addition, two-thirds believed that there were risks associated with having genital warts; the most common risk identified was a link to cancer (cervical and unspecified). A high level of anxiety is associated with the diagnosis and treatment of genital warts. Patients with genital warts require understanding and an acknowledgement of their concerns. A better understanding of the psychosexual aspect of the disease by health-care providers is pivotal to effective disease management and patient counselling.

Adolescent↗

PubMed1986

Ano-genital distance as a factor in determining puberty acceleration in mice.

The daily exposure of newly born female mice to the urine of lactating mice with a small ano-genital distance accelerated the onset of first oestrus while the urine from donors with a large ano-genital distance was without effect in advancing puberty. The rate of growth of the mice exposed to the urine of lactating mothers was greater than that of a control sample but it was only those mice exposed to the urine of lactating females with a small ano-genital distance which continued to grow, after the cessation of treatment at 21 days of age, at a faster rate. There was no difference in the mass of the uterus when the mice were killed when adult but there were significant age-dependent differences in the mass of the ovaries and adrenal glands. The mice exposed to the urine from lactating mothers (with both large and small ano-genital indices) had smaller ovaries than the control mice while the adrenal glands of mice exposed to the urine of lactating mothers with a large ano-genital index were of greater mass than those of the control mice and mice exposed to mothers with a small ano-genital distance. Exposure to the urine of lactating mothers had no effect on the subsequent activity of the mice when tested in an automated activity recorder. The results confirm that urine from lactating mothers accelerates the onset of puberty and suggests that the effects are restricted to the urine from mothers with a small ano-genital index.

Anal Canal↗

PubMedDate not supplied

Genital dysplasia in women infected with human immunodeficiency virus.

BACKGROUND: Women infected with human immunodeficiency virus (HIV) are at increased risk for the development of dysplastic genital lesions. Traditionally, markers of immunosuppression were predictive of the development of dysplasia. Recent advances in antiretroviral medications allow restoration of a once-depressed CD4+ cell count and suppression of HIV replication. In this new era, additional predictive markers of genital dysplasia are needed for management of women infected with with HIV. OBJECTIVE: To find predictive markers of genital dysplasia in women infected with HIV. DESIGN: Observational study of a consecutive sample of 200 women infected with HIV from an urban university clinic. Measurements of histopathology, CD4+ count, CD4+ nadir, HIV viral load, human papillomavirus (HPV), and usage of highly active antiretroviral therapy (HAART) were evaluated for an association with genital dysplasia. RESULTS: There was a trend toward a protective effect against any genital dysplasia when HAART had been prescribed [relative risk = 0.77, 95% confidence interval (CI) 0.56, 1.06] and HAART therapy resulted in an immune response (relative risk, 0.61; 95% CI, 36, 1.02). High-risk HPV DNA was a strong predictor of dysplasia (P =.0003). A lower CD4+ count nadir was strongly associated with genital dysplasia (P =.0003). CONCLUSION: A history of greater immunosuppression, as measured by the nadir of a patient's CD4+ count, is the strongest predictor of genital dysplasia in women infected with HIV.

AIDS-Related Opportunistic Infections↗

PubMed2003

[Bacterial flora in the genital tract the last trimester of pregnancy].

UNLABELLED: Very widespread in our clinical setting, early-onset sepsis is due to organisms that commonly colonize or infect the maternal genital tract; identifying such organisms would help improve prevention and treatment. OBJECTIVE: To determine the bacterial ecology and the pathological status of the genital organs during the last trimester of pregnancy, in order to evaluate the risk of materno-fetal infections and to improve the present prophylactic measures based on monitoring bacterial carriage during the first trimester. METHOD: Vaginal and endocervical samples, usually taken during the first trimester of pregnancy were delayed and taken during the last trimester of pregnancy, in patients with no signs of sepsis and not taking antibiotics. A macroscopic examination described the aspect of the vagina, the cervix uteri, leukorrhea and possible inflammatory lesions or ulcerations. A microscopic examination searched for parasites, epithelial cells, Clue cells and leukocytes. The appropriate bacteriological cultures were performed after reading the Gram stain and scoring the vaginal flora. The clinical and cytobacteriological aspects were used to identify the bacterial ecology and the pathological genital states. RESULTS: Genital samples were collected from 306 pregnant women. Among them 118 were at 29-32 weeks of gestation, 104 at 33-36 and 84 at 37-40. The most frequent germs were C. albicans (33.3%), Enterobacteriaceae (20.3%) including E. coli (10.9%), S. aureus (15.4%), Gardnerella (13.6%), and Trichomonas (10.6%), in monomicrobian (79.2%) or polymicrobian carriage (20.8%). Lower genital tract pathological states such as vaginitis (29.4%), bacterial vaginosis (21.5%) or cervicitis (10.4%) and asymptomatic bacterial carriage (23.5%) and normal genital flora (15%) were identified. CONCLUSION: This is the first report of genital bacterial carriage in African women during the last trimester of pregnancy. Larger studies are required to evaluate the risk of maternofetal infections and to improve current prophylaxis measures.

Adolescent↗

PubMed2005

Prevalence of genital prolapse in Thai menopausal women (using new standardization classification).

BACKGROUND: There is an increasing number of menopausal women in Thailand (estimation of 5 million women). There is no published data on the prevalence of genital prolapse among Thai menopausal woman. So the authors created this hospital based study to identify the magnitude of this problem in Thai menopausal women. OBJECTIVE: To study the prevalence and symptoms of genital prolapse in Thai menopausal women attending the menopausal clinic in King Chulalongkorn Memorial Hospital. STUDY DESIGN: Descriptive study (Cross-sectional study). MATERIAL AND METHOD: Two hundred and fifteen Thai menopausal women attending the menopause clinic at King Chulalongkorn Memorial Hospital from the 1st of January to the 28th of February 2004 were recruited. Urinary symptoms history taking and pelvic examination were done. The severity of any prolapse was classified using International Continence Society classification. RESULTS: Prevalance of Thai menopausal women having any type of genital prolapse was 43.3%. Anterior vaginal wall prolapse and superior vaginal prolapse were the two highest prevalences of genital prolapse (29.3% and 14.9%). The prevalence of genital prolapse increased by the menopausal age. The two leading symptoms were stress incontinence and vaginal outlet relaxation (89.3% and 51.6%). CONCLUSION: From the present study, the authors found the prevalence of any genital prolapse (43.3%) and stress incontinence(89.3%) among Thai women attending menopausal clinic in King Chulalongkorn Memorial Hospital. The authors strongly recommend pelvic examination and urinary-symptoms history taking to evaluate the severity of genital prolapse.

Adult↗

PubMed1991

[Asynchronous development of the genital tract in the snail, Helix aspersa, during growth and reproduction].

During the growth of laboratory-raised Helix aspersa, the development of the albumen gland and spermoviduct was studied in relation to age, weight and different stages of reproduction such as mating and egg-laying. The results showed that the population can be divided into 2 categories because of different growth rates and asynchronous development of the genital tract. The fast-growing snails are larger and reach sexual maturity (female type maturity) in a shorter period than slow growing snails (male type maturity). During growth, the maturation of the genital tract was not directly proportional to the weight of the animal. Within each class of similar weight and age of population, 2 groups were identified; in one group, the genital tract was significantly less developed than in the other. This asynchrony of genital tract development could still be found between mating partners of the same weight, the genital tract could be 3 times smaller in one than in the other partner. However, this difference disappeared between mating and egg-laying. These observations suggest: that asynchronous development of the genital tract could be a strategy for the developing population of Helix aspersa; and that (a) mating factor(s) is (are) involved in the regulation of the growth and function of the genital tract.

Animals↗

PubMed1990

Identification of people at high risk of genital HPV infections.

Clinical and subclinical genital HPV infection is most prevalent in people aged 20-24 years. HPV-infected women have an earlier debut of sex activity, more partners and more casual relationships and STD than age-matched controls without HPV; although data are not available, the same risk factors probably operate in men. There is no evidence that the presence of non-genital warts affects the incidence of genital lesions. Between 50 and 70% of sex partners of individuals with condylomatous or non-condylomatous genital HPV infection also have lesions. Nothing is yet known about any relationship between infectivity and the number of lesions or their viral content. The infectivity of non-condylomatous HPV infection is uncertain. Immunological factors affect the clinical behaviour of genital warts, and immunosuppression, for example by drugs, radiation and possibly cigarette smoking and the use of oral contraceptives, may increase liability to genital HPV infection. The main risk factors appear to be young age, sexual promiscuity, intercourse with a partner with HPV disease and perhaps deficient immune responses. The identification of people at high risk requires careful clinical examination supplemented by the use of a magnification system, histology and cervical cytology. The identification of HPV genotypes in genital epithelia does not seem to be useful in this context, because they are present in a proportion of normal epithelia.

Adult↗

PubMed1986

Current understanding of the natural history of genital herpes simplex infections.

Considerable variations in the disease make an accurate portrayal of genital herpes simplex virus (HSV) infections quite difficult. Primary genital HSV infections classically produce ulcerated lesions lasting a mean of 16-21 days in men and 10-16 days in women. HSV shedding has been documented for a mean of 9.1-11.6 days in men and 8.0-14.7 days in women. Probably many adults have a less severe initial genital infection, however, and it may be so mild as to be misdiagnosed or undetected. Studies of recurrent genital HSV infections are often misleading because they overestimate the frequency and severity of recurrences. By necessity, these studies have recruited and evaluated those adults with the worst and most frequent recurrences. Data from these studies show even greater variations than do data on initial episodes of genital HSV infection. The frequency and clinical importance of asymptomatic genital HSV shedding are being recognized and documented only now. Further studies of this phenomenon and of the natural history of all genital HSV infections are needed urgently.

Cervix Uteri↗