Urologic sequelae of childhood genitourinary trauma and abuse in men: principles of recognition with fifteen case illustrations.
Providing urologic care to men who have been traumatized during childhood may be especially challenging because of the extent, severity, and unusual character of their urogenital problems. Recognition of past trauma entails attentiveness to patients' background and behaviors. As illustrated through these 15 cases, patients who present with too many past surgeries, too many unremitting urologic complaints, too little sexual function and too few genital parts, sexual impulses that are too strong, sexualized conduct in clinical settings, and self-destructive behaviors surrounding sexuality may have experienced trauma in the past. While empirical studies are necessary to demonstrate the ultimate utility of these categories, appreciation of these clinical indications improves the urologic care provided to traumatized men in four ways: by elucidating unusual and unusually recalcitrant urologic complaints, thereby clarifying clinical decisions; by allowing for appropriate use of psychiatric consultation; by promoting a better understanding of the sequelae of trauma in men; and by alleviating the discomfort naturally felt by urologists and their staff when caring for these difficult, multiproblem patients.
McCarty
T
T
Department of Psychiatry, University of New Mexico School of Medicine, Albuquerque, 87131-5326, USA.
Roberts
L W
LW
Hendrickson
K
K
D000328:Adult; D002650:Child Abuse, Sexual; D002675:Child, Preschool; D006801:Humans; D008297:Male; D008875:Middle Aged; D016728:Self-Injurious Behavior / Q000209:etiology*; D012735:Sexual Dysfunction, Physiological / Q000209:etiology*; D014566:Urogenital System / Q000293:injuries*; D014570:Urologic Diseases / Q000209:etiology*