An appointment three months after the postnatal visit is usually given to check the coil or give further supplies of contraceptive pills. For physical reasons, the method chosen may be no longer appropriate. Bleeding with a coil or with the injectable contraceptive may be unacceptable, and a decision to stop breast feeding may mean a [...]

Control is an important theme in psychosexual medicine. The matter of who is in control colours many psychosexual problems. Impotence may be a dumb protest against a controlling partner. Desire for sex can evaporate when advances are rebuffed, or one partner demands attention in circumstances that they know are unevenly disempowering. Vaginismus enters self-perpetuating cycles [...]

The patient who brings someone to the clinic may give valuable information about herself. She may feel too immature or helpless to cope alone, or she may anticipate a battle and bring a friend to fight on her behalf. Partners may come out of true caring but they may also come to make sure she [...]

In a specialist psychosexual clinic, those under 20 years comprise less than 10% of the total workload. However, they are an important group. Some patients in this age group are able to tell their doctor openly about the problem (see Miss A., Chapter 12, p. 181). However, others do not find it easy to raise [...]

By this time Mrs H. had stopped taking the Pill as she said it made her depressed. Soon she left home again, returning pregnant a few months later. While discussing what she wanted to do she began to talk about her own childhood, when her mother had often left home, eventually for good when Mrs [...]

The technique here is often used in operations on other tissue—in eye surgery, for example—and now doctors have begun applying it to BPH. It uses a special ultrasound probe that works through an endoscope, a lighted “periscope” used in exploration and treatment of many diseases. The ultrasound targets tissues high in water content, like BPH [...]

Your doctor may want to do these studies if your history or the physical exam suggests that the primary cause of your symptoms—perhaps from a neurologic condition—is bladder dysfunction, not BPH. Cystometry is a means of measuring bladder pressure and function. It’s performed by threading a small catheter into the penis, through the urethra and [...]

A new approach to bone pain has arrived with the development of a compound called radioactive strontium-89—a radioactive isotope that is injected into the body as an outpatient procedure. Strontium-89 is specially tailored for bone pain. Like calcium, it is taken up immediately by bone, as water is absorbed by a sponge—except this compound tends [...]

One day, as new and better drug therapies and combinations are developed, it may be possible to cure prostate cancer at any stage—or at least to restrain it, to make sure that it never leaves the prostate, or that it stays well-differentiated and slow-growing rather than becoming an aggressive, lethal invader of tissue and bone. [...]

PSA GOES UP AFTER SURGERY? You will be given general anesthesia, which means you’ll be unconscious during the procedure. To reach the prostate, surgeons make an incision just above the rectum. The prostate is gradually separated from the rectum, bladder, urethra and vas deferens. The seminal vesicles are removed along with the prostate, and then [...]