Let’s talk about Men’s Health

From time to time men are brought up with ideas like not to cry, not to complain and always show they are strong. This could also be the reason as to why a lot of men have a lazy attitude towards their health. Even amongst general talk, the most conversations lean towards women’s health and issues, how much do we really talk or know about men’s health?

A recently conducted survey revealed that men would rather talk about sports, current affairs, their jobs, kids etc. and not about health. [1] Women are always advised to get regular screenings and tests done in order to make sure they are healthy, but don’t men need to follow the same?

There is a need to create awareness among men about the various health conditions that could affect them in order to urge them to visit a healthcare professional regularly in order to get tested and treated. Urological conditions are rather common in men, they affect a variety of diseases affecting the urinary tract or the reproductive organs. Below listed are 5 of the most common urological conditions in men, their causes, symptoms and treatment options:

1. Prostate Cancer

Prostate cancer is one of the most prevalent cancers among adult men in the UAE. Part of the male reproductive system, the prostate is a small gland located under the bladder in front of the rectum and surrounding the beginning of the urethra. The prostate gland is small and size and has limited function, like production and secretion of fluid into the semen. However, the prostate gland too can become cancerous.

Just like other forms of cancer, prostate cancer begins when the cells in the prostate gland begin to grow uncontrollably. Individuals with prostate cancer inhibit various urinary issues and symptoms. The symptoms include difficulty in urinating, pain during urination, loss of bladder control, hematuria or blood in urine etc. These are not definitive symptoms that guarantee that a man suffers from prostate cancer.

Prostate cancer is not widely discussed given the lack of awareness about it. Men often tend to disregard the symptoms of prostate cancer as signs of a less harmful condition.

There is no definite causative factor of prostate cancer, although there are risk factors identified that increase one’s chances of developing the condition. The associated risk factors are;

  • Age – Prostate cancer is predominant in men above 40 years of age. Various studies prove that the incidence of prostate cancer increases with age and nearly 75% of men above 80 years display some evidence of latent disease. It is estimated that in while the incidence of prostate cancer is about 1 in 55 men in the age group 40-60 years, this increases by almost 8 times, to 1 in 7men, in the age group of 60-80 years.[2]
  • Family History – Family history of the disease is another major risk factor for prostate cancer, which has a high probability of heritability. This is also supported by epidemiological studies in a Swedish cohort, which indicated about 11.6% of prostate cancer cases could be accounted by familial factors and that the risk is much greater for men with brothers suffering from prostate cancers.
  • Diet – Consumption of diets low in fat and high in vegetables and plant-based foods have a negative impact on the incidence of prostate cancer according to few epidemiological studies. Thus, a reduced intake of high caloric foods, in particular, fatty foods such as red meat and dairy products, and lower calcium intake along with adequate intake of vitamin D or exposure to sunlight and lycopene have been suggested to lower the risk of prostate cancer.

Treatment of the condition depends on various factors. Treatment methodologies include surgery, radiation therapy, hormone therapy, chemotherapy etc.

  • In most cases, if cancer has spread around the area, a prostatectomy is performed in order to remove the prostate. The critical nerves that are nearby and control various functions are left untouched in most cases. Surgery may not be advisable in patients who are very aged and suffer from complex underlying conditions. Some surgeries may also need to be followed by radiation therapy.
  • Radiation therapy is the procedure when cancer has not spread. It is also used to relieve any pain and spread of cancer to the bones.
  • The testosterone hormone can aid in the spread of prostate cancer, hence hormone therapy is used in order to stop the production of testosterone. This technique is majorly used in treating patients with advanced prostate cancer. In cases where hormone therapy doesn’t show positive results, chemotherapy is the technique of treatment.

The goal of treating prostate cancer is to increase an individual’s chance of survival, for which early diagnosis of the condition is extremely crucial. Men should ensure to get screened for the condition in order to rule out the possibilities of developing it. Men with a history of prostate cancer should also be examined regularly to monitor their PSA levels.

 

2. Erectile Dysfunction

This is a condition in which a male is unable to achieve or sustain an erection for intercourse. Most men have concerns with erections from time to time. However, if the incidence of this increases greatly you could be suffering from erectile dysfunction. This condition, if prevalent, needs to be treated as soon as possible because it can cause relationship issues, depression, loss of confidence etc. This condition is often not spoken about because it is considered taboo or rather a matter of shame.

The condition can be caused due to factors including;

  • Age
  • Uncontrolled diabetes/blood pressure/cholesterol
  • Unhealthy lifestyle practices combined with sedentary lifestyle
  • Heart diseases, resulting in reduced blood flow to the penis
  • Inability of the penis to store blood during an erection
  • Injury in the pelvic area damaging the nerves
  • Obesity

Symptoms

  • Reduced sexual desire
  • Inability to achieve and sustain an erection

Treatment

Upon experiencing any of the symptoms, the first step to take is to consult a specialist and speak to them about what you are experiencing. The treatment methodologies include lifestyle changes, medications, and surgery.

Treatment options for the condition depend on the causative factor. If the condition is caused due to underlying health conditions like diabetes or a heart condition, those conditions need to treated effectively first. In some cases, treatment of the underlying conditions may even cure erectile dysfunction.

The condition can also be significantly improved by making lifestyle changes like losing weight, quitting smoking, reducing the intake of alcohol, reducing stress etc. There are also some medications that are commonly used in order to treat erectile dysfunction.

 

3. Testicular cancer

In comparison to the various other cancers known, the incidence of testicular cancer is rather low. However, testicular cancer is one the most common types of cancer in men between the ages of 20-35 years of age. In this condition, malignant cancer cells are developed in one or both of the testicles. Testicles are male sex glands that produce sperm and testosterone.

Causes of testicular cancer still remain unknown. Although, there are identified risk factors that are considered to increase the risk of developing the condition. They are;

  • Cryptorchidism or a undescended testicle – the testes form during the initial days of development and descend into the scrotum before birth. Men with a testicle that has not dropped into the scrotum have higher chances of developing the condition. In some cases men surgically relocated into position, the risk still remains. However, men without cryptorchidism can also develop the condition.
  • Abnormal development of testicle – underlying health conditions that may hamper the development of testicles.
  • Family History of the condition – the risk of developing the condition increases if a close family member has been diagnosed with it.
  • Age – testicular cancer occurs mainly in young men, aged between 20-35.

Symptoms

  • A swelling or lump in the testes is the most common symptom
  • Enlargement or shrinking of the testes
  • Change in the look and feel of the testicle
  • Pain or discomfort in the testicle

Diagnosis

Cancer of the testes can be diagnosed by men themselves. Feeling of a lump or swelling in the testes, unusual pain or a change in shape or size of the testes should make one cautious enough to visit a specialist. The condition can be confirmed by a specialist upon performing an ultrasound to determine the location of the lumps or a blood test to understand the tumor level in the blood.

Upon confirmation of diagnosis, a specialist will next determine the stage of cancer. Testicular cancer is staged into 3 levels;

  • Stage 1 is when the cancer is limited to the testicle
  • Stage 2 is when the cancer has spread to the lymph nodes
  • Stage 3 is when the cancer has spread to the lungs/liver.

Treatment;

Testicular cancer can be treated and cured effectively if diagnosed during the initial stages. The treatment methodologies depend on the stage of cancer, the overall health of the individual and also personal choice to a great extent. Surgery, chemotherapy, and radiation therapy are the commonly used treatment modes.

Surgery is performed to remove the testicles or the affected lymph nodes. Radiation therapy and chemotherapy are used to kill the cancer cells. Both of these are recommended only post a surgery.

 

4. Prostatitis

The prostate is a small gland found in men that is located below the bladder. The prostate gland produces semen that transports the sperm. Prostatitis is the inflammation of the prostate gland and is not cancerous. Prostatitis is different from prostate cancer and affects men of all ages, although it is more common in men over 20 years of age. The condition may either appear suddenly or over the course of time.

Causes

In most cases of prostatitis, the cause of the condition is unidentified. However, the most common established cause of prostatitis is when bacteria from the urine leaks into the prostate.

Risk Factors;

  • Men over 20 years of age
  • Men who have had prostatitis previously
  • Those who have had urinary tract infection
  • Those who use a urinary catheter
  • Decreased sexual activity (no masturbation/sex for a long time)
  • Urinary Retention

Symptoms

  • Painful urination or a burning sensation
  • Difficulty in urinating
  • Frequent urination
  • Bloody urine
  • Painful ejaculation
  • Pain at the tip or shaft of penis

Treatment

Prostatitis usually gets cured with medication and sometimes even without it. However, visiting a specialist on experiencing any of the symptoms is a must. Treatment includes antibiotics which is the most common and primary mode of treatment to kill the bacteria causing the infection. If the condition doesn’t get better and recurs, the course of medication may need to be made longer. In some cases, treatment of prostatitis is rather frustrating, particularly that of Type 4 where only pain management and symptom control may be possible.

 

5. Male Infertility

Male infertility refers to issues that lower the chances of a man’s female counterpart of conceiving. There are various causes of infertility in men and women. In the UAE in particular, male infertility is a major causative factor for the overall rates of infertility.

Causes

There are various medical, environmental and lifestyle factors that cause the condition.

  • Genetic causes
  • Prostate-related problems
  • Infections
  • Surgeries like vasectomy
  • Erectile Dysfunction
  • Tumors
  • Undescended testicles
  • Drug and alcohol abuse
  • Smoking
  • Obesity

 

Symptoms

 Most men with infertility issues do not notice any other symptom other than inability in conceiving a child. Other signs and symptoms associated with male infertility include;

  • Pain in the testicle or surrounding areas
  • Feeling or a lump or swelling in the testicle
  • Difficulty in ejaculation
  • Lower than normal sperm count
  • Low sexual drive

Treatment

Diagnosis of infertility in men often results in their female counterparts also being tested for the condition in order to determine if any specific treatment techniques are required when going for Assisted Reproductive Techniques.

Lifestyle modifications like leading a healthy lifestyle by eating healthy, working out regularly in order to maintain a healthy body weight and quitting smoking help in reducing the chances of male infertility. Other treatment methodologies include;

  • Surgery
  • Infections
  • Hormone treatments
  • Medications
  • Counseling in case of certain sexual concerns
  • Assistive Reproductive Techniques

[1] https://www.aarp.org/health/healthy-living/info-2016/men-dont-talk-about-health-cs.html

[2] http://www.europeanreview.org/wp/wp-content/uploads/805-812.pdf

 

 

 

 

 

 

 

 

 

 

 

Dr. Prasanth Sreedharan Nair

Specialist Urologist

Aster Clinic, Al Muteena (DMPC)

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