Document Detail


Redefining urological history taking - anal intercourse as the cause of unexplained symptoms in heterosexuals.
MedLine Citation:
PMID:  18634737     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
INTRODUCTION: Symptoms suggestive of genito-urinary infection are frequent reasons for visits to general practitioners and account for approximately 15% of referrals to out-patient urology. The symptoms may be non-specific, and patients can undergo multiple investigations in an attempt to identify a cause. PATIENTS AND METHODS: We have seen several such patients, all of whom had engaged in unprotected heterosexual anal intercourse prior to the onset of their symptoms. Presenting complaints included urethral discomfort, acute epididymitis resistant to standard antibiotics, and sudden onset of overactive bladder symptoms. RESULTS: These patients illustrate the importance of careful history taking. Whilst some questions may be difficult to ask, they may reveal precipitating factors that the patient will be reluctant to volunteer. The repetitive nature of the behaviour may explain the chronicity of symptoms experienced by the patients, and avoidance of this activity may be the only management needed to improve them. For those with infective symptoms, the clinician's choice of antibiotic can be altered to provide anaerobic cover. CONCLUSIONS: A history of anal intercourse should be sought in patients with unexplained genito-urinary symptoms.
Authors:
Nadine Coull; Heleni Mastoroudes; Rick Popert; Timothy S O'Brien
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Annals of the Royal College of Surgeons of England     Volume:  90     ISSN:  1478-7083     ISO Abbreviation:  Ann R Coll Surg Engl     Publication Date:  2008 Jul 
Date Detail:
Created Date:  2008-07-18     Completed Date:  2008-09-02     Revised Date:  2009-11-18    
Medline Journal Info:
Nlm Unique ID:  7506860     Medline TA:  Ann R Coll Surg Engl     Country:  England    
Other Details:
Languages:  eng     Pagination:  403-5     Citation Subset:  IM    
Affiliation:
Department of Urology, Guy's Hospital, London, UK. nquatan@hotmail.com
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MeSH Terms
Descriptor/Qualifier:
Adult
Anti-Infective Agents / therapeutic use*
Condoms / utilization
Female
Female Urogenital Diseases / diagnosis,  drug therapy,  etiology*
Heterosexuality / statistics & numerical data*
Humans
Male
Male Urogenital Diseases / diagnosis,  drug therapy,  etiology*
Medical History Taking / standards*
Risk Factors
Sexual Behavior*
Sexual Partners
Chemical
Reg. No./Substance:
0/Anti-Infective Agents
Comments/Corrections
Comment In:
Ann R Coll Surg Engl. 2009 Mar;91(2):178; author reply 178   [PMID:  19317944 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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