Use of chaperones in the urology outpatient setting: a patient's choice in a "patient-centred" service.

BACKGROUND: The use of a chaperone in the clinical setting is a much debated subject. There have been many guidelines and papers written on this topic, but always from the medical profession's point of view. For the first time, this survey focuses on the opinion of the patient. METHODS: 800 consecutive patients attending the urology outpatient clinic were asked to complete a questionnaire on basic patient demographics and their opinions on chaperones. RESULTS: Of 709 patients who completed the questionnaires, 553 (78%) were male. Overall, 535 (75.5%) patients did not want a chaperone present. Only 66 (42%) females stated a preference for the presence of a chaperone. Of the 174 patients requesting a chaperone, 102 (59%) patients wished the role to be taken by a friend or family member. 90% of these patients attended with the appropriate person. CONCLUSIONS: Most patients do not want a chaperone present for intimate examinations. Most women do not wish to have a chaperone present. Of those who do wish to have a chaperone present, more than half want a family member or friend to fill the role. This would be against current guidelines. However, in a "patient-centred" service, these results should be taken into consideration.

Embryology and adult urology - Not always mutually exclusive: A case report on true hermaphroditism at an adult urology clinic.

True hermaphrodite (TH) is one of the rarest varieties of disorders of sexual differentiation. Most patients present early in the life and are managed by pediatricians. We present a rare case of an adult TH which was first diagnosed by a urologist. We discuss the pathology of TH and its clinical relevance. Knowledge and awareness of embryology are vital to all specialties.

Chronic orchialgia: consider gabapentin or nortriptyline before considering surgery.

OBJECTIVE: To establish if there is a role for gabapentin or nortriptyline in the treatment of chronic orchialgia. METHODS: Twenty-six consecutive patients with chronic orchialgia were seen in the chronic pain clinic by a multidisciplinary team. A pain questionnaire was completed prior to commencing either gabapentin or nortriptyline. They were reviewed at 3 months and a repeat questionnaire completed. A 50% improvement in pain was considered successful. RESULTS: Complete data was available for 19 patients. Overall, 61.5% of patients commenced on gabapentin and 66.6% of patients commenced on nortriptyline had a greater than 50% improvement in pain. Patients with post-vasectomy testicular pain were considered as a subgroup. None of these patients had a greater than 50% improvement in pain. However, 80% of patients in the subgroup with idiopathic chronic orchialgia had a greater than 50% improvement in pain. CONCLUSION: Although this is a small study, it appears that gabapentin and nortriptyline are effective in the treatment of idiopathic chronic orchialgia but not post-vasectomy pain.