Presentation Vaginal foreign bodies occur in both children and adults. The patient presents for care with a foul-smelling, bloody or brown purulent discharge, or pain. Children may insert a foreign body and not tell their parents or may be the…
Presentation A young female presents with crampy, laborlike pains that began shortly before or at the onset of the visible bleeding of her menstrual period. The pain is focused in the lower abdomen, low back, suprapubic area, or thighs and…
Presentation A patient presents for evaluation of severe vulvar itching that may be accompanied by edematous swelling. Occasionally there will be tenderness, pain, burning, and dysuria severe enough to cause urinary retention. The vulvovaginal area is variably inflamed, erythematous, and…
Presentation Patients may complain of perineal itching, burning, pain, and tenderness, although they are commonly asymptomatic, especially with cervical and vaginal involvement. Distinctive fleshy warts can be found on the external genitalia or anus ( Figs. 87.1 and 87.2 ).…
Presentation A female of reproductive age presents for evaluation of vulvar pain and swelling that has developed over the past 2 to 3 days. Pain is increased when walking and sitting. On physical examination in the lithotomy position, there is…
Presentation The patient (usually female) complains of urinary frequency and urgency, internal dysuria, and suprapubic pain or discomfort. The onset of symptoms is generally abrupt, often causing her to seek care within 24 hours. There may have been some antecedent…
Presentation Urinary retention is a common problem encountered in the emergency department. Acute urinary retention (AUR) presents as a sudden inability to voluntarily void. The patient, usually male, may complain of increasing dull, low abdominal discomfort or pain and the…
Presentation A man complains of dysuria, a burning discomfort along the urethra, pruritus of the urethral meatus, and/or a urethral discharge. A copious, thick yellow-green discharge that stains underwear is characteristic of gonorrhea, whereas a thinner mucopurulent or white scant…
Presentation A man complains of acute onset of malaise, fever, chills, and perineal, rectal, or low back pain. He also may have dysuria, urinary urgency and frequency, and signs of obstruction to urinary flow, ranging from a weak stream to…
Presentation Phimosis is the inability to retract the foreskin over the glans and is usually the result of a contracted preputial opening ( Fig. 81.1 ). Patients with phimosis may seek acute medical care when they develop signs and symptoms…