The legal framework covering the practice of genitourinary medicine in the UK: the Venereal Diseases Regulations.

The legal framework governing the practice of genitourinary medicine is traced from 1916 to the present. The first legislation, the Public Health (Venereal Diseases) Regulations of 1916 was comprehensive, and accompanied by guidance on setting up outpatient clinics and their supporting laboratories with practical advice on taking samples to support clinical diagnosis. Confidentiality was emphasized.

Characteristics of those who repeatedly acquire sexually transmitted infections: a retrospective cohort study of attendees at three urban sexually transmitted disease clinics in England.

Background: Individuals who repeatedly acquire sexually transmitted infections (STIs) may facilitate the persistence of disease at endemic levels. Identifying those most likely to become reinfected with an STI would help in the development of targeted interventions.

Goal: To investigate the demographic and behavior characteristics of sexually transmitted disease (STD) clinic patients most likely to reattend with an STI.

Prostatitis.

Prostatitis, especially chronic prostatitis, is sometimes regarded as an obscure, ill-defined condition, perhaps because the anatomical location of the gland and ill-defined symptoms make diagnosis difficult. Treatment may appear time consuming and tiresome for doctor and patient, but by following established principles, diagnosis is often simple and management straightforward.

The chronic prostatitis syndromes.

Three chronic prostatitis syndromes are recognised, chronic bacterial prostatitis (CBP), chronic nonbacterial prostatitis (CNBP), and prostatodynia. All may occur in men of military age, and may tax the patience of medical officers and patients whose capacity for full duty will be impaired. Diagnosis depends on identifying micro-organisms in CBP and white cells in CNBP in prostatic secretion (EPS) expressed by prostatic massage.

Diagnosis of chronic prostatitis: overview and update.

Symptoms and signs are unhelpful in the diagnosis of chronic prostatitis which in many cases continues to rest on comparison of white cells and organisms in urine samples collected before (VB2) and after (VB3) prostatic massage to express prostatic secretion (EPS), and particularly in the EPS itself, if this is obtained. A series of 195 patients is reviewed, 38 with chronic bacterial prostatitis (CBP), 66 with chronic non-bacterial prostatitis (CNBP), 55 with prostatodynia, and 31 with a history of recurrent urethritis without prostatitis. Demographic characteristics and history of recurrent urethritis were similar in all groups indicating that recurrent urethritis alone does not predispose to prostatitis.

Genital herpes. A guide to pharmacological therapy.

The pharmacological therapy for genital herpes simplex virus (HSV) infection remains dominated by aciclovir, although a number of related compounds are currently under investigation. Recommended treatment for initial genital HSV infection is oral aciclovir 200mg 5 times daily for 5 days, with intravenous therapy reserved for complicated episodes. Although topical aciclovir may be of benefit, no improvement in the systemic symptoms is provided by this formulation.

Meatoscopy: an important technique for assessing meatal warts in men.

A total of 506 meatoscopic examinations showed this is a simple, safe, rapid, well-tolerated, useful procedure to assess the extent of warts at the meatus and in the distal urethra of men. The procedure was performed in 307 patients. Sixty-five (52.

Health of the nation: way forward in sexual health.

Sexual health is a wide concept encompassing education, health promotion and disease prevention, diagnosis and management of sexually transmitted diseases, screening and counselling for HIV antibodies, management of HIV infected patients, family planning, termination of pregnancy, psychosexual counselling, prevention of cervical and lower genital tract cancers, and sexual abuse. Implementation of The Health of the Nation (1992) will include assessing the current situation, views, alliances and interventions, need for research and development and within alliances setting challenging but achievable targets. The Health of the Nation includes a target for gonorrhoea which is a surrogate for partner change, sexually transmitted diseases in general and HIV infection, and a target for conceptions among those under 16 years of age.

Acyclovir vs isoprinosine (immunovir) for suppression of recurrent genital herpes simplex infection.

Objective: To compare the efficacy and safety of oral acyclovir (400 mg twice daily) with oral isoprinosine (500 mg twice daily) in the suppression of recurrent genital herpes.

Design: Double-blind, double-dummy, randomised, controlled, parallel group trial.

Setting: 13 centres in UK, Belgium and Germany.

Herpes simplex virus infection in pregnancy and its management.

Neonatal herpes simplex virus (HSV) infection is considered to be rare in the UK, affecting less than 3 per 100,000 live births, but the true incidence is probably higher due to under-reporting. In contrast, neonatal HSV infection is more common in the USA affecting 1 per 7500 live births overall. Infection in neonates is frequently serious and may be fatal.