HOMO SAPIENS DISEASES - REPRODUCTIVE APPARATUS
(see also physiology of reproductive apparatus)

Table of contents :


  • diseases of female reproductive apparatus
  • diseases of male reproductive apparatus
  • sexually-transmitted diseases (STD)
  • infertility
  • contraception

  • diseases of female reproductive apparatus (see also physiology of female reproductive apparatus)
  • Web resources :
  • diseases of male reproductive apparatus (see also physiology of male reproductive apparatus)
  • genitourinary fistula : an abnormal communication between organs of the urogenital system or between organs of the urogenital system and some other system
  • sexually transmitted diseases (STD) : any of a diverse group of infections caused by biologically dissimilar pathogens and transmitted by sexual contact, which includes both heterosexual and homosexual behavior
  • Management : anonymous notification, try to convince the patient to tell his/her partner(s) about the STD(s) (the physician cannot tell them directly) as often therapy has to be extended to partner(s). Expedited treatment of sex partners reduces the rates of persistent or recurrent gonorrhea or chlamydial infectionref
    Prevention : officials from the United Nations AIDS programme on Apr 21 2005 implored the new Pope, Benedict XVI, to consider permitting the use of condoms. The election of conservative Joseph Ratzinger as Pope has led many to predict that the Roman Catholic Church, which forbids the use of condoms, will not consider lifting the ban to prevent the spread of disease. Ratzinger was a top official in the Vatican when discussion on condom use reopened within the past few years and although the Church's teachings on human-embryo research and contraception are governed by dogma, it does not have an official opinion on the use of condoms as a means to prevent disease, according to Maurizio Calipari, a bioethicist at the state's Pontifical Academy for Life. Ratzinger developed a reputation as an 'enforcer' while heading the Congregation for the Doctrine of the Faith, the body that succeeded the Roman Inquisition. In this role, which he held for > 25 years, he stamped out dissidence within the Church and fired several US theologians who questioned the Church's stance on certain topics. But some note that Ratzinger's approach may change now he is Pope. The Church's consideration of condom use in the context of HIV has been prompted in part by pressure from the Church's African bishops, but some thinks the bishops will have a lesser say in the governance of the Church under Ratzinger.
    Web resources :
  • rape : nonconsensual sexual penetration of an adolescent or adult, obtained by force or threat, or in cases in which the victim is not capable of consent.
  • Infertility / infecundity / relative sterility : diminished or absent capacity to produce offspring due to defect in nidation of blastocyst or embryo development; the term does not denote complete inability to produce offspring as does sterility
  • Epidemiology : prevalence = 13-18% of couples
    Aetiology : Web resources :
  • cancrum pudendi : gangrenous erosion of the genitalia; see erosive balanitis and erosive vulvitis
  • Contraceptionref

  • Epidemiology : > 25% (40 to 60%) of pregnancies in women between 15 and 45 are thought to be unplanned. And though 60-70% of couples in developed countries use an effective form of contraception, many people drop them after a year because of side-effects or inconvenience.
    Contraceptives are agents that diminish the likelihood of or prevents fertilization and hence conception.
    post-coital interceptives are agents that prevent nidation of embryo.
    Pearl's index (1932) : number of pregnancies in 100 females using the method in 1 year of use. A method is considered valid if its Pearl's index is < 2 10 years ago in Norfolk, 65% of male general practitioners and 95% of female general practitioners never or rarely used a chaperoneref. The figures for offering chaperones were almost identical. The General Medical Council advises offering a chaperone for intimate examinations (those involving the genitals, anus, or breasts)ref. The Royal College of Obstetricians and Gynaecologists advises using a chaperone for every intimate examinationref. A study of patients' preferences in Tyneside in 2001 found that 90% of women and 78% of men thought that a chaperone should be offered for intimate examinationsref. Half (51%) of women wanted a chaperone to be used if their own male doctor was examining them. In the past 10 years offering of chaperones by general practitioners has increased. The proportion of male general practitioners never or rarely offering chaperones when examining female patients has fallen from 65% to 23%. Norfolk is more rural than much of the United Kingdom, but these temporal changes may reasonably be extrapolated. We found high rates for offering of chaperones. The Tyneside study indicates that patients want to be offered a chaperone, so general practitioners may be responding to societal demandref. Merely offering a chaperone does not protect either the patient or the doctor. Stern said that even when a qualified nurse chaperone is present the patient is not protectedref. Given that in most cases (58%) the final decision as to whether or not to have a chaperone rests with the doctor it seems that ultimately the chaperone is there for the protection of the doctor rather than the patientref. The conduct of intimate examinations in medical settings has been a subject of controversy for many years, because of potential difficulties and pitfalls for both doctors and patients. The royal colleges, the General Medical Council, and the defence organisations now emphasise the importance of ensuring that these examinations are not done by unaccompanied doctors. Some studies have shown, however, that the attitudes and behaviour of medical professionals are often at odds with these recommendationsref1, ref2 and that patients may not always welcome the offer, let alone the presence, of a third person in the consultationref. We describe the attitudes and practices of general practitioners regarding the involvement of chaperones during intimate examinations and identify barriers and concerns affecting their use. The use of chaperones by male doctors has substantially increased since the 1980s and '90s and a continuing low level of use by female doctors despite one third of practices having a policy. Record keeping about the offer and use of chaperones is poor, and significant barriers to the use of appropriate chaperones in general practice still undoubtedly exist. The recommendations of the royal colleges and other bodies are, therefore, difficult to implement fully. Their advice may be appropriate in most secondary care settings, but such recommendations may be difficult to translate into primary care practice. We suggest that more flexible guidance is needed for general practice, which must recognise the realities of current staffing and space arrangements, and take greater account of the wider context of the relationship between patients, their doctors, and the practiceref. Further research is needed into patients' views and wishes. We also need to gain more understanding of the circumstances in which problems might arise in this delicate arearef. 10 years ago in Norfolk, 65% of male general practitioners and 95% of female general practitioners never or rarely used a chaperoneref. The figures for offering chaperones were almost identical. The General Medical Council advises offering a chaperone for intimate examinations (those involving the genitals, anus, or breasts)ref. The Royal College of Obstetricians and Gynaecologists advises using a chaperone for every intimate examinationref. A study of patients' preferences in Tyneside in 2001 found that 90% of women and 78% of men thought that a chaperone should be offered for intimate examinationsref. Half (51%) of women wanted a chaperone to be used if their own male doctor was examining them. In the past 10 years offering of chaperones by general practitioners has increased. The proportion of male general practitioners never or rarely offering chaperones when examining female patients has fallen from 65% to 23%. Norfolk is more rural than much of the United Kingdom, but these temporal changes may reasonably be extrapolated. We found high rates for offering of chaperones. The Tyneside study indicates that patients want to be offered a chaperone, so general practitioners may be responding to societal demandref. Merely offering a chaperone does not protect either the patient or the doctor. Stern said that even when a qualified nurse chaperone is present the patient is not protectedref. Given that in most cases (58%) the final decision as to whether or not to have a chaperone rests with the doctor it seems that ultimately the chaperone is there for the protection of the doctor rather than the patientref. The conduct of intimate examinations in medical settings has been a subject of controversy for many years, because of potential difficulties and pitfalls for both doctors and patients. The royal colleges, the General Medical Council, and the defence organisations now emphasise the importance of ensuring that these examinations are not done by unaccompanied doctors. Some studies have shown, however, that the attitudes and behaviour of medical professionals are often at odds with these recommendationsref1, ref2 and that patients may not always welcome the offer, let alone the presence, of a third person in the consultationref. We describe the attitudes and practices of general practitioners regarding the involvement of chaperones during intimate examinations and identify barriers and concerns affecting their use. The use of chaperones by male doctors has substantially increased since the 1980s and '90s and a continuing low level of use by female doctors despite one third of practices having a policy. Record keeping about the offer and use of chaperones is poor, and significant barriers to the use of appropriate chaperones in general practice still undoubtedly exist. The recommendations of the royal colleges and other bodies are, therefore, difficult to implement fully. Their advice may be appropriate in most secondary care settings, but such recommendations may be difficult to translate into primary care practice. We suggest that more flexible guidance is needed for general practice, which must recognise the realities of current staffing and space arrangements, and take greater account of the wider context of the relationship between patients, their doctors, and the practiceref. Further research is needed into patients' views and wishes. We also need to gain more understanding of the circumstances in which problems might arise in this delicate arearef.
    Web resources : Reproductive Health Technology Project

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