Taboos in medicine? For us, there are no embarrassing problems.

Author: Łukasz Piwowarski, CEO of Wyspa Medycyny Przyjaznej · Editorial work: Editorial team of Wyspa Medycyny Przyjaznej · Expert opinions: lek. Kamil Smok, MD. Arthur Abbazov, MD Katarzyna Przekazińska-Boager, M.D. Piotr Rak · Date of creation: 07.08.2026 · Date of review: 07.08.2026 · Updated: 07.08.2026

The article describes the way the clinic works and is of informative nature. It does not replace consultation or serve as self-diagnosis. Disturbing symptoms - bleeding, fever, severe pain, rapidly increasing symptoms - require urgent medical evaluation, regardless of how embarrassing the topic seems.

The most important information at a glance

• Shame actually delays diagnosis - we treat it like any other risk factor.
• Before the examination, we explain each step; the patient can stop the test at any time.
• You can request a doctor of a specific gender and the presence of an accompanying person.
• We do not assume anything about the patient's life and we do not judge his choices.
• Testing for sexually transmitted infections is prevention, not an admission of anything.
• When submitting applications in the field of aesthetic medicine, we distinguish between a functional problem, an aesthetic problem and one that is not related to the anatomy.
• We do not perform the procedure if the patient does not want it - even if his partner insists.
• Consent signed under pressure is not informed consent.
• Dysmorphophobia is a condition in which treatment will not bring relief - because the problem is not in the body.
• Refusing to perform a procedure may be the best thing a clinic can do for a patient.

1. Shame is a risk factor

Let me start with something that does not sound like a sentence from a clinic brochure, but is simply a clinical truth: shame delays diagnosis. Not figuratively. A patient who notices bleeding in March and comes back in September has a completely different situation than the one who came right away.

In proctology, urology, andrology, venereology and dermatology of intimate areas, we see this mechanism every day. It doesn't apply to particularly shy people - it applies to most people. This is not a character trait, but a result of what we have all learned about "what is not talked about."

That's why we treat shame like any other factor that worsens the prognosis: as something that can be influenced. Not an appeal not to be ashamed - because it doesn't work - but the way the visit is conducted. This is what the next point is about.

2. What does a visit to us look like when the topic is embarrassing

Declarations are cheap, so instead - specifics. Here's what we actually do:

• First the conversation, then the examination. The patient sits dressed, says what he came with, and only then do we proceed to the examination.
• We explain every step before we do it. No surprises.
• You can stop the test at any time - just say so. This requires no justification.
• You can ask for a doctor of a specific gender. You don't have to explain why.
• You can come with an accompanying person - and you can ask them to leave.
• We do not assume anything about your life, orientation, practices or choices. We ask about what is medically important and explain why we ask.
• We do not comment on the appearance of or judge how long someone waited to visit.

The last point can be the most important. A patient who comes back after a year knows perfectly well that he should come earlier. Telling him this won't change anything and will effectively discourage him from visiting again. We start with what is, not with what should have been.

We write more about how we approach patients for whom the visit can be particularly difficult: LGBT+ friendly clinic.

3. Proctology - what patients talk about most quietly

Bleeding, itching, pain, prolapse, gas incontinence. Symptoms that are not discussed at the table and that patients do not tell even their loved ones. The most common sentence opening a visit is: "I thought it was hemorrhoids."

Very often these are indeed hemorrhoids. But there is also a fissure, a fistula, an inflammatory lesion or something that requires a completely different procedure - and this cannot be determined without an examination.

"The worst thing in this field is not that patients are ashamed. The worst thing is that shame forces them to make a diagnosis on their own - usually the most optimistic possible one - and be treated with an ointment from the pharmacy for half a year. A proctological examination takes a few minutes. This half a year can be irretrievable."
- MD. Kamil Smok, surgeon, proctologist

We write more about proctological symptoms and when they require urgent assessment in separate articles. Proctology consultation is usually the shortest way to an answer.

4. Urology and andrology - a symptom, not an "embarrassing problem"

Erectile dysfunction, ejaculation problems, decreased libido, testicular problems. Men present with these symptoms later than with any others - and very often only after someone tells them to.

Meanwhile, this is one of those situations in which delaying has consequences that go far beyond the intimate sphere. Erectile dysfunction is an early symptom of vascular and metabolic diseases - sometimes it appears before the patient knows about hypertension, diabetes or lipid disorders.

"The patient comes in embarrassed that he is talking about an erection. And at that moment I am thinking about his blood vessels, blood pressure and sugar. This is not a conversation about sex life - it is a conversation about health, which just happens to start with a symptom that is difficult to talk about."
- MD. Arthur Abbazov, urologist, andrologist

Therefore, at urological consultation we ask not only about the symptom, but about the entire health situation. Not to change the subject, just because that's where the answer usually lies.

5. Venereology - the examination is not an accusation

This is probably the most shameful area of ​​all medicine. Patients postpone testing for sexually transmitted infections not because they do not know about its existence, but because they are afraid of what the doctor will think.

So I'll say it straight: the doctor doesn't think anything. Orders the examination, assesses the result and implements the procedure. Diagnostics in this direction are a regular element of health care - just like a blood count or blood pressure measurement. Some infections do not cause any symptoms for a long time, so waiting for a warning signal is, by definition, an unreliable strategy.

"I ask about intimate things not out of curiosity, but because the answer will determine what tests I will order and what I will look for. I do not judge anyone's choices. My task is to determine what is happening to the patient's skin and mucous membranes - and help."
- MD. Katarzyna Przekazińska-Boager

One practical note: do not try to self-medicate before the visit. Preparations used "just in case" can change the picture of changes so much that diagnosis becomes more difficult - and sometimes make it impossible to perform tests that were supposed to provide an answer.

6. Gynecology and aesthetic urology - three different matters under one name

Here we make a distinction that is very often not made at all. The term "aesthetic treatment of intimate areas" actually covers three completely different situations:

• Functional problem - discomfort when walking, sports, wearing clothes, pain, abrasions, recurrent irritations. This is a medical indication and we treat it as such.
• Aesthetic problem - the patient does not like the appearance, although he does not feel any pain. This is a valid reason, as long as the decision is his own and conscious.
• A problem that is not in the anatomy - the patient is looking for a solution in the procedure, but the source is elsewhere: in the relationship, in external pressure, in how he perceives himself. The procedure will not help here.

Determining which situation we are dealing with is our task, not the patient'stask. Therefore, the consultation begins with the question "what is bothering you and since when" and not with "what treatment are you signing up for?"

I will also say something that is rarely said in this industry: a huge part of the reports concern anatomy that is completely within the norm. There is a lot of diversity in this area and most of what patients consider a defect is not. This information was sometimes all they needed.

7. Dysmorphophobia - a taboo within aesthetic medicine itself

This is the topic about which the aesthetic industry is most silent - because talking about it means admitting that some patients should not get what they came for.

Dysmorphophobia is a disorder in which a person experiences very strong, persistent anxiety about some detail of their appearance - most often one that others do not notice at all or consider it completely ordinary. This is not vanity or oversensitivity. This is real sufferingthat can dominate everyday life.

The key thing is this: in this situation the treatment does not bring relief. Not because it was poorly made, but because the anxiety does not come from appearance. After the procedure, the attention usually shifts to another detail and the suffering remains. Performing the procedure is then literally an act to the detriment of the patient - even if everything technically goes well.

"I learned that the most difficult moment in aesthetic medicine is not the technically difficult procedure. It is the conversation in which I have to say that what the patient really needs cannot be done with a scalpel. It is a conversation after which sometimes you lose the patient. But performing such a procedure would be doing him harm."
- Piotr Rak, MD, oncologist surgeon

I want to say one thing clearly: it is not a reason to be ashamed and it is not an accusation against anyone. We are not diagnosing anyone in this text - the diagnosis is made by a specialist after a conversation, not an article on the clinic's website. However, if thoughts about appearance take up a large part of the day and affect work, relationships and well-being, then this is something that can be helped - just in a different way than surgery. Psychological or psychiatric support can be much more effective in such situations and it is worth knowing about it before spending money on a procedure that will not bring peace.

8. Partner pressure – our big no

This is a point where there is no room for negotiation, so I will write it without any words.

We do not perform a procedure that the patient does not want. We do not agree to meet our partner's expectations at someone else's expense. If someone comes because "the other party wants it so", "because my husband says it will be better", "because my partner compared me to someone else" - the answer is no. Don't "let's talk about alternatives." Just no.

The body belongs to the patient. The risk of the procedure is borne by the patient. The patient is convalescing. The patient lives with a possible complication. The person who pushes suffers none of these consequences — and this is reason enough for her expectations not to be the basis for medical decisions.

What does it look like in practice:

• if we have any doubt, we talk to the patient separately, without an accompanying person,
• we ask directly whose idea it is,
• we ask what the patient would do if no one found out about it,
• in case of any doubts, we suggest postponing the decision rather than the date of the procedure,
• We do not exert price, promotional or time pressure.

If you are reading this and recognize this as your situation - come alone or by yourself. You can also tell us about it directly during your visit. You won't hear the judgement, and the conversation stays between us.

9. Consent under pressure is not informed consent

The consent form is signed before each treatment. But informed consent is not a signature – it is a decision made on your own, after understanding what will happen, what the risks are and what the alternatives are, including the alternative of doing nothing.

A few questions that are worth asking yourself before any decision about surgery - not only aesthetic ones:

• Would I want it if no one else knew about it?
• Had I thought about this before someone suggested it to me?
• Can I say what exactly needs to change and why?
• Do I know what possible complications are and what will happen if they occur?
• Would the decision be the same in six months?
• Do I feel pressure - time, price, expectations, promotion?
• Can I withdraw and do I know how?

The last question is in practice the most important. You can change your mind at any stage, including after signing the consent and on the day of the procedure. Resignation does not require justification and is not anyone's failure. No one will be treated worse here because they changed their mind.

10. When we say no — and why it's good news

We refuse to perform the procedure, among others, when:

I know how it sounds from a business perspective — every "no" is a service not provided. But I run a clinic, not a store, and I look at it differently: a facility that never refuses is not a safe facility. It is for sale. And a patient who has heard an honest "no" once comes back with confidence when he really needs something.

Most common patient concerns

• "The doctor will evaluate me." No. The doctor determines what is happening and suggests a course of action.
• "That's probably a stupid reason to visit." There are no stupid reasons. There are symptoms worth checking out.
• "I've waited so long I'll be ashamed of myself." We do not comment on this. We start with what is now.
• "I don't want to be tested." You can stop the test at any time and you do not have to justify it.
• "I would prefer a doctor of a different gender." Tell us when registering - we will try to take it into account.
• "Someone will find out." Medical confidentiality applies.
• "They'll convince me to do more." We do not persuade. We present the options and leave you to decide.
• "Since I have come, I must decide on this." You don't have to. The consultation does not oblige you to anything.

Are you postponing your visit because the topic seems embarrassing?

For us it is not. Come with what is difficult to come with anywhere else - and if after the conversation it turns out that nothing needs to be done, we will tell you that too.

Island of Friendly Medicine in Gdańsk

The name of our clinic was not created by accident. "Friendly" does not refer to the decor or the coffee in the waiting room - it refers to the fact that the patient has to tell us what he really came for, not what can be said without embarrassment.

We deal with urology, andrology, proctology, surgery, dermatology and aesthetic medicine - that is, the fields where there are the most embarrassing topics. That is why we treat the way of conducting a conversation as part of the treatment, not as an addition to it. The current scope of services, availability of dates and prices must be confirmed during registration.

Łukasz Piwowarski, CEO Meet the team About us

What can you ask when registering?

• Can I make an appointment with a doctor of a specific gender?
• Will the examination be performed during the visit and what does it involve?
• Can I come with an accompanying person?
• Can I ask the companion to leave during the interview?
• How long does the visit last and will there be time for a conversation?
• Does the consultation oblige you to do anything?
• Can I cancel the procedure after making a decision?
• How to prepare for the visit?
• Can I describe the problem in advance, by e-mail or text message?
• Who will have access to my documentation?

FAQ

I'm ashamed to go to the doctor with this problem - what should I do?

Make an appointment. Shame is understandable, but it actually delays diagnosis. We start the visit with a conversation, and the examination is performed only after explaining what it involves - and it can be interrupted at any time.

Can I request a doctor of a specific gender?

Yes, just mention it when registering. There's no need to justify it. Availability depends on the schedule and is confirmed by registration.

Will the doctor evaluate my choices?

NO. We only ask questions about intimate matters when they are important for diagnosis, and we explain why we are asking. Medical confidentiality applies.

Is testing for sexually transmitted infections something shameful?

No - it is an element of prevention, the same as other tests. Some infections do not cause symptoms for a long time, so waiting for a warning signal is unreliable.

My partner wants me to have the procedure. Will you do it?

No, if you don't want it. We do not perform procedures undertaken under pressure. If we have any doubts, we talk to the patient separately, without an accompanying person.

Can I cancel the procedure after signing the consent?

Yes, at every stage, also on the day of the procedure. Resignation does not require justification and does not affect the way you will be treated during subsequent visits.

What is body dysmorphia?

This is a disorder characterized by persistent, very intense anxiety about a detail of one's appearance that others usually do not notice. The procedure does not bring relief in this situation because the source of anxiety is not in appearance. Psychological or psychiatric support can be effective.

Do you refuse to perform treatments?

Yes - in the absence of indications, in the case of a decision made under pressure, in case of unrealistic expectations, in case of contraindications and when the treatment does not solve the reported problem. We always explain why and propose a different course of action.

Does the consultation oblige me to undergo the procedure?

No. The consultation aims to find out what is happening and what the possibilities are. A common result is that nothing needs to be done.

I waited a long time to visit - will I hear remorse?

No. We start with the situation now. Commenting on the delay does not change anything and effectively discourages further visits.

Sources

• Wyspa Medycyny Przyjaznej, about us: https://www.wyspamedycynyPrzyjaznej.pl/pl/o-nas
• Wyspa Medycyny Przyjaznej, team: https://www.wyspamedycynyPrzyjaznej.pl/pl/zespol
• The Island of Friendly Medicine, proctological consultation: https://www.wyspamedycynyPrzyjaznej.pl/pl/konsultacja-proktologiczna-gdansk
• The Island of Friendly Medicine, urological consultation: https://www.wyspamedycynyPrzyjaznej.pl/pl/konsultacja-urologiczna
• NHS, Consent to treatment: https://www.nhs.uk/conditions/consent-to-treatment/
• NHS, Body dysmorphic disorder (BDD): https://www.nhs.uk/mental-health/conditions/body-dysmorphia/
• NHS, Cosmetic procedures: https://www.nhs.uk/conditions/cosmetic-procedures/
• NHS, Erection problems (erectile dysfunction): https://www.nhs.uk/conditions/erection-problems-erectile-dysfunction/
• NHS, Sexually transmitted infections (STIs): https://www.nhs.uk/conditions/sexually-transmitted-infections-stis/
• NHS, Piles (haemorrhoids): https://www.nhs.uk/conditions/piles-haemorrhoids/
• NHS, Anal fissure: https://www.nhs.uk/conditions/anal-fissure/
• NICE, Body dysmorphic disorder (CG31): https://www.nice.org.uk/guidance/cg31
• NICE, Patient experience in adult NHS services (CG138): https://www.nice.org.uk/guidance/cg138