|Year : 2016 | Volume
| Issue : 1 | Page : 5
Changing paradigm of men's health
Scott Department of Urology, Baylor College of Medicine, Houston, Texas 77030, USA
|Date of Web Publication||4-Jan-2016|
Scott Department of Urology, Baylor College of Medicine, Houston, Texas 77030
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Khera M. Changing paradigm of men's health. Indian J Urol 2016;32:5
Over the past decade, there has been increasing interest in men's health conditions. Numerous men's health clinics have emerged throughout many countries, and they continue to expand. Many common men's health conditions include hypogonadism, erectile dysfunction, and benign prostatic hyperplasia. However, this issue of the journal contains reviews on some men's health conditions that are commonly encountered but not as commonly discussed. These conditions include nonobstructive azoospermia (NOA), chronic orchialgia, Peyronie's disease, chronic pelvic pain, and urethral stricture disease. The diagnosis and management of these conditions can be challenging. The five reviews on topics related to men's health provide an excellent resource for state-of-the-art diagnosis and management of these conditions.
Peyronie's disease can affect up to 7% of the male population. Currently, collagenase is the only FDA-approved treatment in the USA for this condition. Most treatment options are not effective and many are unproven. Many men with Peyronie's disease are severely depressed and are significantly bothered by their condition. The review article in this issue offers further insight not only on the diagnosis of Peyronie's disease but also current surgical and nonsurgical treatment options.
The incidence of chronic orchialgia is on the rise, and it is believed that, in the USA, as many as 100,000 men per year will develop chronic orchialgia. Treatment options thus far have been limited, and many clinicians and patients are left frustrated with the results. NOA affects approximately 10% of infertile men. The only option for many of these men is sperm retrieval followed by in vitro fertilization with intracytoplasmic sperm injection. There are numerous causes of NOA with the most common cause being idiopathic. Obtaining sperm from these patients can be challenging, and the success rate is often predicated on the surgical technique implored and the etiology of the azoospermia. Reviews in this issue discuss the uses of Microdissection Testicular Sperm Extraction technique and other novel techniques to obtain sperm in patients with NOA and current strategies on the management of orchialgia.
Chronic prostatitis and chronic pelvic pain account for nearly 90% of prostatitis cases. These conditions have a worldwide prevalence of approximately 2-16% and are the most common urologic conditions seen in men below 50 years of age. Chronic prostatitis and chronic pelvic pain in men is one of the more challenging conditions that clinicians face in their practice. Over the past decade there have been numerous advances in the treatment of these conditions such as the use of onabotulinum toxin A, physical therapy, sono-electro-magnetic therapy, and other forms of neuromodulation, all of which are discussed in detail.
Finally, while there are numerous causes and variations of urethral strictures, most of these strictures can be easily managed. In fact, overall success for surgical management of urethral strictures has been reported as high as 93.8% with &<5% complication rate. Not all urethral strictures require surgical management. Furthermore, the decision on when to operate and which surgical technique to implore can be challenging. The review in this issue offers an excellent guide for the clinician on the current diagnosis and management of urethral strictures.
| References|| |
Lindsay MB, Schain DM, Grambsch P, Benson RC, Beard CM, Kurland LT. The incidence of Peyronie's disease in Rochester, Minnesota, 1950 through 1984. J Urol 1991;146:1007-9.
Strebel RT, Leippold T, Luginbuehl T, Muentener M, Praz V, Hauri D. Chronic scrotal pain syndrome: Management among urologists in Switzerland. Eur Urol 2005;47:812-6.
Krieger JN, Nyberg L Jr, Nickel JC. NIH consensus definition and classification of prostatitis. JAMA. 1999;282:236-7.
Morey AF, Watkin N, Shenfeld O, Eltahawy E, Giudice C. SIU/ICUD consultation on urethral strictures: Anterior urethra – Primary anastomosis. Urology 2014;83 3 Suppl: S23-6.