The importance of recognizing the distress behind Mrs B. ’s difficult exterior cannot be emphasized too much. If the damage that she believed that the birth had done to her body had not been explored and dealt with at that stage, she could well have continued with pain and possibly sexual difficulties for months or [...]

Not all complaints about condoms should be taken at face value.

Mr D. complained that using a condom often left him soft with no erection and his wife was disappointed. He was married with two children and the doctor felt surprised by the complaint. Later he told how he had recently led a discussion about contraception [...]

One learns that all is not what it may initially seem. The patient who is in a great hurry to get everything over and done with, or who asks a lot of technical questions may be afraid of allowing herself to feel. The angry patient may not necessarily be angry at the clinic staff but [...]

An unhurried, gentle approach is valued by this age group during what is often their first genital examination. The doctor should give some thought to minimizing discomfort. Choosing a warm, small speculum for the first smear is one obvious kindness. The question ‘Will it hurt?’ should alert the doctor to the possiblity that the patient [...]

Mrs H., 24 years old and mother of four children born in five years, was referred for domiciliary family planning. Though her husband worked as a carpenter, the family was in debt and social services were involved. At the first visit Mrs H. gave the impression of someone without any cares. She opted for the [...]

Ultrasound energy can be focused with exquisite precision to produce temperatures hotter than 65 degrees within a few seconds. The focus is so sharp that areas outside it—even those a fraction of an inch away—are not heated or damaged. The ultrasound works like a scalpel (and in this precision, HIFU has a key advantage over [...]

Uroflowmetry. Your doctor may decide to measure the speed of your urinary stream and the amount of urine you pass. This is accomplished as you urinate into an electronic machine (while you’re alone in a testing room). To ensure an accurate result, it’s important that you urinate at least five or six ounces. This test [...]

Until recently, a widespread treatment called “hemi-body” irradiation was commonly used to ease pain in prostate cancer patients with metastases to bone in several places. Hemi-body irradiation involved what radiologists call “wide fields” of radiation—large expanses of the body, and comparatively high doses of radiation. The problem was that this often wiped out key blood-forming [...]

Interstitial brachytherapy is basically hand-to-hand combat, instead of missiles launched from far away. The idea here is that the farther energy gets from its source—the more tissue a radiation beam has to pass through to reach its target-—the less effective it will be in killing cancer. And that implanting tiny sources of radiation directly in [...]

Similar to the retropubic procedure in terms of before-surgery preparation and recovery, the radical perineal approach offers some advantages over that technique: There’s less bleeding, because the major vein system that overlies the prostate (the dorsal vein complex) is not removed with the prostate. However, this also means that surgeons aren’t able to cut out [...]