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Serodiscordance between partners implies risks that couples who are seroconcordant don't face. The second paper, by Chun and associates, 13 compared sphincter function in 14 MSM who had anoreceptive sex with 10 age-matched controls who did not. There was no difference between groups in minimum sensory volume, rectoanal inhibitory reflex volume, or maximum tolerable volume. Or you may prefer to preface this portion of the history by informing the patient that you need to ask personal questions—questions that you ask all your patients. High-risk behaviors among men who have sex with men in 6 U. In fact, the physical examination often confirms the diagnosis we made with the history. Department of Surgery, Mt.

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In addition to the inherent risks of tearing, perforation, or losing the object, patients must also be aware of the risk of STIs that can spread when partners share toys.

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The gay bowel syndrome: clinico-pathologic correlation in 260 cases.

Many MSM were taught by religious leaders, family members, physicians, and society in general that their sexual practices will ultimately cause harm. Centers for Disease Control and Prevention. The test is more sensitive than standard culture methods, but does not test for quinolone resistance as the standard culture does, so patients must be retested to insure cure. Men who have sex with men have special health-care issues and are at high risk for sexually transmitted infections. Nonoxynol-9 as a vaginal microbicide for prevention of sexually transmitted infections. Had these patients not been screened for STIs, most infections would have been missed. In evaluating proctologic problems in the gay male, all of the known sexually transmitted diseases should be considered.

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Rectal applications of nonoxynol-9 cause tissue disruption in a monkey model. They did report that those who had anoreceptive sex were more likely to complain of minor defects of anal continence. Two papers have examined the effect of receptive anal intercourse on sphincter function. A clinical pattern of anorectal and colon diseases encountered with unusual frequency in these homosexual patients is termed the gay bowel syndrome. Concurrent HIV testing of both partners is important as recent studies have documented that many MSM have never been HIV tested and merely assume that they are not infected. While this may work for most patients, some may request minor surgery to remove a tag or hemorrhoid for cosmetic reasons because they or their partners don't like the way it looks. Behavioral patterns, including recreational drug use, unprotected sex, and HIV infection, can increase the likelihood that they will have either symptomatic or asymptomatic infections.