By Anthony Wisdom
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Extra info for A Colour Atlas of Sexually Transmitted Diseases
The conditions mentioned are more fully described later. No attempt has been made to include genitourinary disorders that mainly occur in paediatric or gynaecological practice. Ulcerative conditions have been discussed on page 20, lumps in the groin on page 22 and anogenital symptoms on page 24. I 36 Bleeding The most usual causes of the complaint of bleeding are trauma or lesions of the cervix. Less commonly, bleeding may result from gynaecological disorders (which are outside the scope of this book) or lesions of the vulva, urinary tract or vagina.
Dyspareunia caused by psychosexual problems is often much more difficult to evaluate. g. sexual assault) preceding onset of the symptoms. If evaluation suggests that this type of problem is the likely cause of the complaint it is best, after physical causes have been excluded, to refer the patient (often together with the partner) to an experienced psychosexual counsellor. Discharge complaint usually referring to an alteration of regarded as excessive (a very subjective term) or abnormal by the patient.
Symptoms may be caused by lesions of the vulva, urethra, bladder or upper urinary tract; a detailed history is most helpful in analysis. Pain or irritation on urination confined to the meatus or vulva is usually associated with vulval lesions, urethral caruncle or urethritis, whereas the same symptoms associated with frequency, urgency or strangury are more likely to be caused by cystitis or upper urinary tract infection or, occasionally, to referred symptoms in patients with cervicitis. Severe dysuria and acute retention may be caused by urethral or vulval ulceration and are most commonly seen in first attacks of herpes.
A Colour Atlas of Sexually Transmitted Diseases by Anthony Wisdom