[Skip to Navigation]
Teachable Moment
October 7, 2019

The Importance of Obtaining Sexual History in Older Adults: A Teachable Moment

Author Affiliations
  • 1Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles
JAMA Intern Med. 2019;179(12):1708-1709. doi:10.1001/jamainternmed.2019.4480

A man in his 70s with a medical history of noninvasive bladder cancer presented to his primary care clinic with significant weight loss. He had lost 30 pounds unintentionally during the previous 6 months, which he attributed to poor appetite. He denied dysphagia, abdominal pain, diarrhea, melena, hematochezia, and urinary abnormalities; the remainder of his review of systems yielded negative results. Bladder cancer had been diagnosed 9 years prior and treated surgically; surveillance cystoscopy with biopsy 1 year prior had yielded normal results. Subsequently, he was lost to follow-up.

Add or change institution
Limit 200 characters
Limit 25 characters
Conflicts of Interest Disclosure

Identify all potential conflicts of interest that might be relevant to your comment.

Conflicts of interest comprise financial interests, activities, and relationships within the past 3 years including but not limited to employment, affiliation, grants or funding, consultancies, honoraria or payment, speaker's bureaus, stock ownership or options, expert testimony, royalties, donation of medical equipment, or patents planned, pending, or issued.

Err on the side of full disclosure.

If you have no conflicts of interest, check "No potential conflicts of interest" in the box below. The information will be posted with your response.

Not all submitted comments are published. Please see our commenting policy for details.

Limit 140 characters
Limit 3600 characters or approximately 600 words
    1 Comment for this article
    Hematuria in this elderly patient
    Meenu Jindal, Internal Medicine | Department of Internal Medicine, Prisma Health, Greenville, South Carolina.
    Many thanks to Dr. Pedley and Dr. Khalili for this great ' teachable moment' article. I agree with the importance of obtaining sexual history especially in the elderly. As I was reading this scenario, I wondered if extensive work up to evaluate for recurrence of bladder cancer could have been avoided with a detailed sexual history in this patient, though persistent or recurrent hematuria as noted on his urinalysis perhaps led to that path.