INTRODUCTION

Some common problems encountered in a urological practice are discussed using case-based presentations. The material is arranged in a manner to make it more accessible to medical students and educators. Each of the conditions discussed is introduced by a letter from the referring physician outlining the issues of concern followed by my response.

Many diagnostic and therapeutic measures have attendant risks which may actually be more damaging than the underlying medical problem itself. Indeed, not all problems require active therapy. The risk/benefit ratio of any proposed study or therapy must be weighed against the natural course of the disease and the patient must be actively involved in any planning process.

The material presented herein is not intended to provide a thorough analysis of the issues since details of diagnostic and therapeutic modalities can be found in other medical publications. It is important, however, that the medical student be very aware that all options must be made available to the patient and be sensitive to the patient’s responses. Close observance of the patient’s verbal and body language is critical. There should be an interactive discourse between the patient and physician, conducted in a relaxed environment as free from time constraints as possible.