Free Module 10 · STIs and Urology

Sexual history

Author and medical review: Dr. Leonardo Romeo, urologist (physician) · Last updated:

1

Introduction

Learning objectives
  • Take a professional, respectful and nonjudgmental sexual history.
  • Know the history and practices that should be systematically asked about.
  • Recognize the relevant symptoms that point toward an STI.
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Video lesson

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Video pending upload (embedded YouTube)
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Summary

The sexual history should be taken in a professional, respectful and nonjudgmental manner.

It is important to ask about:

  • onset and evolution of symptoms;
  • new sexual partners;
  • number of partners;
  • sexual practices;
  • condom use;
  • history of STIs;
  • known STIs in partners;
  • previous treatments;
  • hepatitis B and HPV vaccination when appropriate.

Relevant symptoms

Ask specifically about:

  • urethral discharge;
  • dysuria;
  • genital ulcers;
  • vesicles;
  • warts;
  • genital pain;
  • pruritus;
  • skin lesions;
  • lymphadenopathy;
  • fever;
  • testicular pain.

Key concept

Asking about sexual practices has a medical purpose: it helps determine which anatomical sites were exposed and which tests may be needed.

4

PDF

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5

Practical algorithm

  1. Urethral discharge + dysuria → think of urethritis → gonococcus/Chlamydia among the main causes.
  2. Painless genital ulcer → consider syphilis.
  3. Painful vesicles or ulcers → consider genital herpes.
  4. Anogenital warts → consider HPV/condylomata.
  5. Epididymal pain in a sexually active patient → consider STIs depending on age and context, but rule out torsion in an acute scrotum.
  6. Diagnosis of an STI → consider testing for other STIs + partner management + prevention.
  7. Recent high-risk HIV exposure → promptly assess the indication for PEP.

An STI is not managed only by treating the patient. The approach includes correct diagnosis, screening for coinfections when appropriate, partner management and prevention of further transmission.

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Clinical case

Content pending upload Progressive clinical case focused on decision-making.
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Self-assessment

Questions pending upload 5–10 multiple-choice questions on this lesson.
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References

Links pending upload References to PubMed, DOI, scientific society guidelines and journals.

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