ABSTRACT
The genitourinary system subserves complex and diverse functions: excretion, homeostatic regulation of metabolism, blood pressure control, endocrine secretion, and sexual and reproductive activity. A selective review is made of the areas in which psychiatric liaison is most required. Impaired renal function is signalled by reduced creatinine clearance and by uraemia. Female homosexuality seldom leads to liaison psychiatric involvement, although lesbians are rather more likely than the generality of women to drink heavily. Symptoms associated with renal dysfunction may be regarded as depressive: apathy, fatigue, reduced concentration span, anorexia and sometimes headache. Causes of renal insufficiency to consider are kidney, prostate and bladder problems, ureteric back pressure from any cause, analgesic excess, dehydration, bleeding from the gut, shock, and age-related deterioration. Patients and their relatives and the staff who work in renal units are subject to intense emotional strains and conflicts. There is a steady flow of patients to clinics for genitourinary disorders who are afraid they have contracted venereal disease.
