Genito-urinary medicine (GUM)
This pages introduces the medical specialty of genito-urinary medicine.
The core work of genito-urinary medicine (GUM) relates to sexually transmitted infections. A large part of the work in many areas is now involved in the clinical management of patients with HIV infection at all stages of disease, possibly including inpatient management. The work involves a number of non-infectious medical genital problems such as dermatoses. In recent years it has also expanded into other areas of sexual health, such as the provision of contraception, management of sexual dysfunction, health promotion and colposcopy (for the diagnosis and treatment of cervical dysplasia).
The people most at risk from STIs are the young adult population. This specialty is therefore almost unique in dealing largely with this age group who are otherwise fit and ambulatory. Bacterial STIs can be treated, which makes this a particularly satisfying branch of medicine. Viral STIs cannot always be treated but can be managed effectively and patients are usually extremely grateful for explanation and advice. HIV medicine is one of the most high profile, fascinating and rapidly developing fields in the whole of medicine. It is a particularly challenging and satisfying area in which to practice.
Quelle: http://www.nhscareers.nhs.uk/details/Default....Royal College of Physicians
Overview of Genitourinary Medicine
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.