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Does the history indicate that the difficulty is on penetration? Difficulties on penetration usually point to a vulval or vaginal origin for the problem. In that case, bartholinitis, vulvitis, vulval ... DIAGNOSTIC WORKUP
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Is there a history of alcohol or drug ingestion? A host of antihypertensive drugs, including the beta-blockers, may cause impotence. In addition, tricyclic drugs, nicotine, and alcohol intoxication may ... DIAGNOSTIC WORKUP
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Is it purulent? A purulent vaginal discharge suggests nonspecific bacterial vaginitis and gonorrhea.
Is it frothy and yellow? This type of discharge is very often due to trichomoniasis vaginitis.
Is it ... DIAGNOSTIC WORKUP
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Dyspareunia is defined as painful and/or difficult sexual intercourse. There is a large differential requiring detailed history and physical exam. Distinguish primary dyspareunia (dyspareunia occurs from the outset of sexual experience) from secondary dyspareunia (dyspareunia was... Differential Diagnosis ... Workup and Diagnosis ... Treatment
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Vaginal discharge is a common complaint that is often accompanied by concerns about the presence of a sexually transmitted disease. Candida may present with extremely intense, often unbearable itch. Whenever one sexually transmitted disease is identified, a search for all... Differential Diagnosis ... Workup and Diagnosis ... Treatment
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Skin lesions in the genital area are common, and the etiology can range from simple irritation to sexually transmitted diseases to malignancy. The appearance of the lesion, the presence of pain and/or itching, and a description of how the lesion has changed over time... Differential Diagnosis ... Workup and Diagnosis ... Treatment
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The pubertal vaginal flora is primarily lactobacillus, and the vagina has an acidic pH with a thick, estrogenized epithelium acting as a protective mechanism. The prepubertal vagina is less estrogenized and has a thinner epithelium, predisposing it to irritation.... Differential Diagnosis ... Workup and Diagnosis ... Treatment
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... Painful introduction of the male organ or pain during intercourse are both considered under this title. The mnemonic to use here is MINT. This can then be applied to the anatomic structures as we explore the genital tract. Of course, psychologic disturbances are
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... Impotence may be due to local end-organ disease, dysfunction of the peripheral nerve pathways, disease of the spinal cord or brain, pituitary and other endocrine disorders, and “supratentorial” disorders. Thus recall of the various
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... Again, the female genital tract can be infected by all sizes of organisms, thus a useful method for recalling the causes of a purulent vaginal discharge is to work from the smallest to the largest organism. Thus, we begin with herpes progenitalis and
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... Among the diverse lesions that may affect the male genitalia are warts, papules, ulcers, scales, and pustules. These common lesions may be painful or painless, singular or multiple. They may be limited to the genitalia or may also occur elsewhere on the... History and physical examination ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Geriatric pointers ... Pictures
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... Impotence is the inability to achieve and maintain penile erection sufficient to complete satisfactory sexual intercourse; ejaculation may or may not be affected. Impotence varies from occasional and minimal to permanent and complete. Occasional impotence... History and physical examination ... Medical causes ... Other causes ... Special considerations ... Geriatric pointers ... Pictures
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... Common in women of childbearing age, physiologic vaginal discharge is mucoid, clear or white, nonbloody, and odorless. Produced by the cervical mucosa and, to a lesser degree, by the vulvar glands, this discharge may occasionally be scant or profuse due... History and physical examination ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Geriatric pointers ... Pictures
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... Aging
Psychogenic causes
Testicular causes (primary or secondary)
Congenital hypogonadism (especially Froehlich's syndrome, Klinefelter's syndrome,
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... Dyspareunia is genital pain associated with intercourse. It may be mild, or it may be severe enough to affect enjoyment of intercourse. Dyspareunia is commonly associated with physical problems; less commonly, with a psychological disorder. The prognosis is good if the underlying disorder... Causes ... Signs and symptoms ... Diagnosis ... Treatment ... Special considerations
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... Sexuality is an integral human function that’s inevitably colored and influenced by a host of interrelated factors. Its expression reflects the interaction of all the biological, psychological, and sociologic ingredients that affect a person... Hazards to sexual health ... Physical assessment ... Sexual history ... Types of sex therapy ... Pictures
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... Genital herpes is an acute inflammatory disease of the genitalia. The prognosis varies, depending on the patient’s age, the strength of his immune defenses, and the infection site. Primary genital herpes is usually self-limiting but may cause painful local or... Causes and incidence ... Signs and symptoms ... Diagnosis ... Treatment ... Special considerations ... Pictures
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... Genital warts (also known as venereal warts or condylomata acuminata) consist of papillomas with fibrous tissue overgrowth from the dermis and thickened epithelial coverings. They’re uncommon before puberty or after menopause. Certain types of... Causes ... Signs and symptoms ... Diagnosis ... Treatment ... Special considerations
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... A major obstacle to sexual enjoyment, dyspareunia is painful or difficult coitus. Although most sexually active women occasionally experience mild dyspareunia, persistent or severe dyspareunia is cause for concern. Dyspareunia may occur with attempted penetration or during or after... History and physical examination ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Geriatric pointers ... Patient counseling ... Pictures
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... Among the diverse lesions that may affect the male genitalia are warts, papules, ulcers, scales, and pustules. These common lesions may be painful or painless, singular or multiple. They may be limited to the genitalia or may also occur elsewhere on the body. (See Recognizing common... History and physical examination ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Geriatric pointers ... Patient counseling ... Pictures
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... Impotence is the inability to achieve and maintain penile erection sufficient to complete satisfactory sexual intercourse; ejaculation may or may not be affected. Impotence varies from occasional and minimal to permanent and complete. Occasional impotence occurs in... History and physical examination ... Medical causes ... Other causes ... Special considerations ... Geriatric pointers ... Patient counseling ... Pictures
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... Common in women of childbearing age, a physiologic vaginal discharge is mucoid, clear or white, nonbloody, and odorless. Produced by the cervical mucosa and, to a lesser degree, by the vulvar glands, this discharge may occasionally be scant or profuse because of... History and physical examination ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Geriatric pointers ... Pictures
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... Louis Kuritzky
Approach Impotence, defined as the consistent inability to get or maintain an erection sufficient for intercourse, is a patient-defined diagnosis. Because up to one-third of men aged more than 65 years have erectile... History ... Physical examination ... Testing ... Diagnostic assessment
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... Albert A. Meyer
Vaginal symptoms, especially discharge, are responsible for 10% of all physician visits by women. Each year, approximately 12 million women in the United States are treated for vaginitis (1).
... History (2) ... Physical examination (4) ... Testing (5) ... Diagnostic assessment
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... Differential Overview
❑ Physiologic discharge
❑ Candida vulvovaginitis
❑ Bacterial vaginosis
❑ Trichomonas vaginitis ... Diagnostic Approach ... Clinical Findings
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Differential Overview
❑ Herpes simplex
❑ Trauma
❑ Syphilis
❑ Fixed drug eruption
❑... Diagnostic Approach ... Clinical Findings ... Pictures
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... Among the diverse lesions that may affect the male genitalia are warts, papules, ulcers, scales, and pustules. These common lesions may be painful or painless, singular or multiple. They may be limited to the genitalia or may also occur elsewhere on the body. (See Recognizing common... History ... Physical assessment ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Geriatric pointers ... Patient counseling ... Pictures
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... Common in women of childbearing age, physiologic vaginal discharge is mucoid, clear or white, nonbloody, and odorless. Produced by the cervical mucosa and, to a lesser degree, by the vulvar glands, this discharge may occasionally be scant or profuse due to estrogenic stimulation and... History ... Physical assessment ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Geriatric pointers ... Patient counseling ... Pictures
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...Vaginal discharge is abnormal except forphysiologic leukorrhea, which occurs during the first few weeksof life and with the onset of puberty. Principal Causes of Vaginal Discharge Prepubertalonset Physiologicleukorrhea ... Clinical Features and Diagnosis ... Diagnostic Approach ... References
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... Impotence is the inability to achieve and maintain penile erection sufficient to complete satisfactory sexual intercourse; ejaculation may be affected. Impotence varies from occasional and minimal to permanent and complete. Occasional impotence occurs in... History and physical examination ... Medical causes ... Other causes ... Nursing considerations ... Patient teaching ... Pictures
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... Common in women of childbearing age, physiologic vaginal discharge is mucoid, clear or white, nonbloody, and odorless. Produced by the cervical mucosa and, to a lesser degree, by the vulvar glands, this discharge may occasionally be scant or... History and physical examination ... Medical causes ... Other causes ... Nursing considerations ... Patient teaching ... Pictures
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... Among the diverse lesions that may affect the male genitalia are warts, papules, ulcers, scales, and pustules. These common lesions may be painful or painless, singular or multiple. They may be limited to the genitalia or may also occur elsewhere on the body. (See ... History and physical examination ... Medical causes ... Other causes ... Nursing considerations ... Patient teaching ... Pictures
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Painful introduction of the male organ or pain during intercourse are
both considered under this title. The mnemonic to use here is MINT.
This can then be applied to the anatomic structures as we explore the
genital tract. Of course, psychologic... Pictures
... READ EXCERPTS »
...
Impotence is now more commonly referred to as erectile dysfunction.
Impotence may be due to local end-organ disease, dysfunction of the
peripheral nerve pathways, disease of the spinal cord or brain, pituitary
and other endocrine disorders, and supratentorial... Pictures
... READ EXCERPTS »
...
Again, the female genital tract can be infected by all sizes of
organisms, thus a useful method for recalling the causes of a purulent
vaginal discharge is to work from the smallest to the largest organism.
Thus, we begin with herpes progenitalis and proceed to... Pictures
... READ EXCERPTS »
... Cindy W. Christian, MDMatthew J. Cox, MD Sexual Abuse - BASICS Sexual Abuse - description Sexual abuse is the involvement of children in sexual activities that they cannot understand, for which they are not... Sexual Abuse - DIAGNOSIS ... Sexual Abuse - TREATMENT ... Sexual Abuse - FOLLOW UP ... Sexual Abuse - bibliography ... Sexual Abuse - CODES ... Sexual Abuse - FAQ
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... J. Nina Ham, MDLorraine E. Levitt Katz, MD Sexual Ambiguity - BASICS Sexual Ambiguity - description Genitalia can be defined as ambiguous when it is not possible to categorize the gender of the child based on outward... Sexual Ambiguity - DIAGNOSIS ... Sexual Ambiguity - TREATMENT ... Sexual Ambiguity - FOLLOW UP ... Sexual Ambiguity - bibliography ... Sexual Ambiguity - CODES ... Sexual Ambiguity - FAQ
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