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PROSTATITIS CLASSIFICATION: CHRONIC BACTERIAL PROSTATITIS

admin — Sun, 13 Feb 2011 12:22:00 +0000

This is a subacute infection with milder symptoms and a more insidious onset than acute prostatitis. The NIH has developed a chronic prostatitis symptom index to measure the symptoms and their impact on daily life. Although produced for research purposes, the scale has been found to be useful in localizing urinary symptoms to the prostate gland. A score of more than 4 on the pain questions (the first four questions), has been found to be indicative of prostatitis. The remainder of the questions can be used to assess the severity of symptoms and gauge response to treatment.
Urine cultures should be performed to rule out UTI. If sexual history warrants, testing for gonorrhea and chlamydia should be performed. The physical examination findings in cases of chronic bacterial prostatitis are generally unremarkable except for the prostate gland, which may be boggy and slightly tender.
First-line treatment of chronic bacterial prostatitis is 4 to 12 weeks of therapy with a fluorquinolone. Alternatives include minocycline, doxycycline, trimethoprim, and co-trimoxazole.
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PSYCHOSEXUAL SKILLS – GENERAL INFORMATION

admin — Tue, 07 Apr 2009 07:24:28 +0000

A theoretical approach to the analysis of men’s aggressive progress through life could range into several different schools of thought. One could look at his self as viewed by Freud, Jung, Adler and Klein, or at the more fashionable methods of assessing congruence and actualization used in client-centred work.

Psychosexual medicine specifically does not do this. By concentrating on the ‘here and now’ the doctor is made to listen to the patient and to what is happening between them in the room. The doctor may detect assumptions projected onto him or her and feel how he himself or she herself, reacts. It may be that the doctor is able to use some of these features of the relationship only because of his/her own deficiencies. However, to look at these separately as elements of transference or counter-transference brings risks of trying to tackle difficulties too deeply rooted in the unconscious of the patient, or conversely putting doctors under pressure to change their beliefs without the support that analysis provides. The doctor concentrating on the immediate dynamics of the relationship can make interpretations of immediate relevance and look for changes that such interpretations facilitate at a later consultation.

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THE COUPLE – PROTECTING HUSBAND

admin — Tue, 07 Apr 2009 07:18:15 +0000

In this case the observation and interpretation of the wife’s need to protect her husband and others helped in the management of the infertile situation that the couple found themselves in.

Mrs F. marched into the clinic well ahead of her husband. She immediately launched into the story of how she was the most interesting case of polycystic ovaries that her GP had seen in years. Eventually the doctor managed to bring Mr F. into the discussion and made a comment about how important it was to hear both sides of the story. A short while later he felt able to reveal, for the first time ever to anyone, that he had undescended testes. He had read about it, and knew what the probable outcome would be, and now he wanted to be examined without his wife present. The anger that she felt was overwhelming, too much for the doctor to do other than acknowledge. Whether it was due to the sudden realization of ensuing childlessness with this man, fury at the secret he had kept or the fact that he was now the one with the interesting medical condition, the doctor was not sure. What was certain was that she had kept him out of the consultation, ignoring him in the room, and in the same way had kept him out of all investigations by the normally very efficient GP. After several more visits they decided not to return.

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THE DOCTOR AND THE UNPLANNED PREGNANCY – POSITIVE AND NEGATIVE ASPECTS

admin — Tue, 07 Apr 2009 07:11:42 +0000

Falling pregnant is no different and most women, even when the pregnancy has been planned and wanted, experience times of sadness or fear during their pregnancies, including some of the feelings listed below. Some positive feelings in pregnancy include:

Feeling truly feminine;

Feeling she has a role in life;

Looking forward to something to love and love her;

Following in mother’s footsteps;

A feeling of continuity and eternity;

An opportunity to give up an unfulfilling work role and take on a more comfortable domestic one;

Approval by family and society.

Some negative feelings in pregnancy include:

Loss of freedom;

Loss of income;

Loss of a job, career prospects and status;

Fear of losing sex appeal;

Making her sexuality public;

Feeling she can no longer be a child herself and have to take a responsible role;

Fear of being an inadequate mother;

Disapproval of family and society.

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THE INJECTION – OUT OF SIGHT, OUT OF MIND – INTRODUCTION

admin — Tue, 07 Apr 2009 07:03:04 +0000

A woman who dislikes the coil can at least have it taken out. This option is not available with injectable contraceptives; it is just a question of waiting for the effect to wear off. British women strongly dislike injections, but for many the prospect of one injection and no need to see a doctor for three whole months, or indeed do anything else about contraception, is irresistible. For this freedom from medical interference, and the equal freedom of feeling like a ‘nothing’ user, women will risk irregular menstruation, or even amenorrhoea. Most of these women express few anxieties about the method, their main aim is to get ‘the jab’, and beat a retreat back to privacy.

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CONTRACEPTIVE SIGNS OF CONFLICT – CHOSEN METHOD (CONTRACEPTIVE)

admin — Tue, 07 Apr 2009 06:56:36 +0000

Complaints about a chosen method that had previously been satisfactory should not be taken at face value. Once medical reasons for the problem have been excluded the doctor must try to understand what other conflicts may be present. Similarly erratic use of a method, especially in a patient who has always been a regular user, should occasion concern and further exploration, in order to ascertain what is really going on in the patient’s life. Older women, for instance, can begin to realize that the biological time clock is ticking away, and that they may have left the decision to have a baby too late. Sometimes they only want to know that they can get pregnant, and once they have done so they may request termination. A change from a reliable to a less reliable method may also reflect a covert wish to get pregnant even although that is denied consciously.

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KEEP YOUR SEXUAL LIFE: RIGHT NUTRITION

admin — Fri, 27 Mar 2009 07:53:57 +0000

Saturated fats can raise the level of cholesterol in your blood. They tend to be found in the same foods that have cholesterol: red meats, dairy products (except for no-fat varieties] and different types of shortening. On the other hand, small amounts of polyunsaturated fats, found in vegetables such as corn, soybeans and safflower seeds, are good for your arteries. They can help reduce the level of cholesterol-depositing substances called low density lipoproteins (LDLs).

Lipoproteins come in two forms: low density lipoproteins (LDLs) and high density lipoproteins (HDLs).

Both substances carry cholesterol in the blood, but with a crucial difference. LDLs appear to clog the arteries by depositing cholesterol that narrows these essential pathways. But nature has provided a counterpart to LDLs: HDLs help clean cholesterol out of the body, opening the arteries.

The higher your level of HDLs, and the lower your level of cholesterol and LDLs, the better off you are.

Arteries don’t become clogged with fats and cholesterol overnight. Instead, the clogging takes place gradually—and silently. And this process can begin early in life. In fact, researchers have found fatty deposits in the arteries of children as young as 6, and in young men.

More evidence that impotence-causing arterial blockage can begin early in life comes from Czechoslovakia, where doctors examined the penile arteries of deceased men whose ages at death ranged from 19 to 85. All men 38 years of age and older had some blockage in these arteries.

This research makes it clear that a man who wants to keep enjoying intercourse must keep his penile arteries clean. The type of diet which will help to protect your penile arteries is one which will be healthy for your entire blood-flow system, including your heart.

But suppose you’ve spent most of your life enjoying hearty meals loaded with fat and cholesterol: bacon and eggs for breakfast, a double cheeseburger for lunch and, as one man put it, “anything for dinner, as long as ifs fried.” Will switching your diet do anything for potency and the health of your penile arteries?

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ERECTION PROBLEMS: SURGICAL SOLUTIONS

admin — Fri, 27 Mar 2009 07:16:51 +0000

Surgical methods to improve potency have undergone major advances in recent years. Blocked arteries that prevent blood from traveling to the penis can now be reopened or bypassed. Leaky veins that sabotage erection can be tied off, restoring potency. And penile prostheses, or implants, can restore potency to men who otherwise would have to resign themselves to a life without intercourse.

Of all these options, penile implants have received the most publicity—good and bad, informed and fabricated. It’s hard for the consumer to sort through the myths and misinformation to find the truth. Well, here are the facts.

There are three basic types of penile implants, made either of plastic or silicone. Each will provide an erection. Each makes it possible for a man to have intercourse. Each must be surgically inserted.

In most cases, the implant will leave your ability to have an orgasm and ejaculate unchanged. If you can ejaculate before you have the surgery, you’ll be able to afterwards; if you can’t, you won’t.

Implant surgery is a final commitment, because once you have the operation, your chances of ever having a natural erection are almost certainly lost. That’s because the surgery usually damages the sinuses within the corpora cavernosa that normally fill with blood during an erection. A man who gets partial erections or occasionally gets a full erection must realize that if he gets an implant his natural capability will in all likelihood be gone and he will be dependent on the prosthesis. That’s one of the important reasons why all prospective implant patients should explore other solutions before deciding on surgery. And they should decide exactly why they want an implant. Some people want them for the wrong reasons.

Just as important as knowing what an implant can do is knowing what it cannot do.

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ERECTILE DYSFUNCTION: THE IMPORTANCE OF CHOOSING THE RIGHT DOCTOR

admin — Fri, 27 Mar 2009 06:57:02 +0000

Jason learned a painful lesson about the importance of choosing the right doctor. It had taken this reserved and very private man a long time to finally decide to seek help for his persistent erection problem. He was too uncomfortable to really ask any questions when he made an appointment with a doctor he had picked out of his local telephone directory. Jason was a 48-year-old man, but he was quite nervous as he was ushered into the doctor’s office. He explained his problem with great difficulty and turned to the doctor for an answer. Suddenly the urologist took a penile prosthesis out of a drawer, slammed it down on his desk and announced triumphantly to his stunned patient, “We’ll just stick this in you!”

Not surprisingly, Jason left the office and never returned.

Fortunately, he later found help from a doctor who wanted to listen to his story, do a complete workup and then explain in detail the choices for treatment.

Jason’s experience also illustrates the importance of sensitivity. You’re going to be discussing some very intimate experiences, and if s essential that the doctor be at ease—and help you to feel the same way.

Ifs also important that the physician welcome—not just tolerate—the involvement of your wife or lover. Some doctors actively seek the participation of the partner; others just leave it up to the patient to decide whether she should be involved. Ideally, the physician should direct some of his attention to your partner and should try to make her feel comfortable and part of the process.

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ERECTION PROBLEMS: POTENCY AND WOMEN

admin — Fri, 27 Mar 2009 06:28:29 +0000

Some women, especially those in relationships where potency had been a long-standing unresolved problem, felt cheated. Some saw erection as proof that they were truly desire< by their husbands, and to them, the absence of erection meant rejection. As a child, Jenny, now 47, had learned rigid ideas about what constituted “normal” sexual behavior, and had never critically examined them. She never masturbated un she was well into her adult years, and then only allowed herself this pleasure after a doctor assured her it was acceptable Unfortunately, because of her husband’s long-standing erection problem, she was able to have successful intercourse wit him only a few times during their 25-year marriage. “I’ve bee deprived my whole life,” says Jenny. “I haven’t worked with hit as well as I could. I think if I knew we could have intercours then other kinds of sex would be all right-it’s almost a math of principle.” Fortunately, Jenny’s husband was able to benefit from recent research into blood-flow problems, and sine having surgery, he’s been able to get and maintain near normal erections.

A woman who sees an erection as a type of lie detector which reveals the man’s true feelings may be so concerned about her own self-worth that she may ignore her partner’s explanations and his pain. “I tried to explain my situation to one woman I cared for,” recalls Andy, a 34-year-old insurance agent whose potency problem is caused by his diabetes. “But she couldn’t accept what was happening.”

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