What's up with the willy?

By admin
02 September 2009

Men are much less likely to consult a doctor than women, experts say. But when it comes to caring for their crown jewels, guys avoid medical check-ups at their peril. Learn to recognise the most common problems…

By Mike Behr

Here’s the naked truth: after age 40 men start dying up to three times more frequently than women. The reason? Instead of treating their bodies like well-oiled machines they tend to scrimp on repairs and maintenance.

“Women play it safe,” says Dr Shingai Mutambirwa, consultant urologist and researcher at George Mukhari Hospital in Pretoria. “They don’t think twice when it comes to consulting a doctor and they see their gynaecologists regularly. “Men on the other hand are five times less likely to consult a doctor – especially a urologist.”

But whether a guy steers clear of the consulting room due to denial, ignorance or embarrassment, ignoring a problem with his package is like playing Russian roulette.

“Neglecting your health could be a death sentence,” says Dr Mutambirwa, who also runs a private practice in Dobsonville, Soweto. “All it takes to keep you safe is a regular check-up with your doctor and your urologist.” This is his tireless message to up to 200 patients treated every week – as well as listeners of 567 Cape Talk and Talk Radio 702, where he’s a regular guest on Redi Direko’s weekday morning show and Leigh Bennie’s A Word on Medical Matters.

Dr Mutambirwa is clearly a man on a male-health mission. So he hastens to add that in addition to threatening your life, neglecting your check-ups could lead to life without an erection or even (horror of horrors) a penis – a potential extreme consequence of untreated penile cancer.

“The encouraging news is that most male genital problems can be treated successfully,” Dr Mutambirwa says. “So if you notice a lump or a sore take it to your doctor. You might walk out of his rooms laughing but at least you’re giving yourself the chance of nipping a condition in the bud before it becomes serious.”

Of course your real aim is to catch the problem before there’s even a bud to nip. That’s why – with or without any current concerns – a regular check-up should be on every man’s to-do list.

“The only way to pick up prostate cancer is by having an annual check-up, involving a rectal examination of the prostate gland,” Dr Mutambirwa says. “Unfortunately this is a source of embarrassment for a lot of men. But I promise you it’s painless.”

True, the probing prostate exam is an awkward moment. It can strike fear in the heart of the manliest of men. But it’s worth it if a well-timed check-up spares you a health crisis of mammoth proportions. Right? Of course!

So, in the spirit of choosing prevention over cure, here’s Dr Mutambirwa’s advice on 10 potential issues down under – and how to catch them before it’s too late.

1 Male menopause

Men have to face the change too.

Facts and frequency From the age of 30 about 12 per cent of men experience a decline in the level of the hormone testosterone, which controls libido and is essential for maintaining an erection. This decline leads to a build-up of fat cells in the penis.

Early warning signs Below-par erections, waning libido, bone pain and an expanding waistline in spite of a healthy diet and exercise.

Best medicine Consult a doctor because low testosterone also increases your risk of a heart attack and diabetes. Exercise, a balanced diet and appropriate medication such as a testosterone supplement injection every three months will help to keep you hormonally balanced – and harder.

2 Enlarged prostate

A problem with the pipes.

Facts and frequency After 40 a man’s prostate begins to grow bigger, which can constrict the bladder’s plumbing, restrict the flow of urine and prevent the bladder from emptying properly. It’s usually benign but if left untreated it could cause kidney damage and erection problems.

Early warning signs Waking up frequently during the night to pee.

Best medicine Consult a urologist. Prescribed medication, usually alpha blockers, will have you peeing with ease once again.

3 Prostate cancer

The big, bad package deal.

Facts and frequency Prostate cancer is the second deadliest cancer after lung cancer. The real danger is that it’s painless and there are no obvious physical signs – in fact you could still be an ace between the sheets while the cancer is growing. But there is good news: it’s curable if detected early.

Early warning signs None.

Best medicine Prostate cancer can be detected only through a physical examination of the prostate via the rectum and a blood test measuring prostate-specific antigen, a protein produced by the prostate in higher than normal amounts when there’s a problem. These tests need to be performed annually from the age of 40 – but earlier and more frequently if you have a family history of prostate cancer.

4 Priapism

Too much of a good thing?

Facts and frequency Turning a blind eye to prolonged erections can lead to blood-vessel damage and eventually total erection failure. For about two per cent of men suffering from this problem it’s a side effect of erectile dysfunction injection therapy.

Early warning signs Prolonged erection lasting more than two hours. The pain can be intense enough to make your eyes water.

Best medicine If an ice pack to the perineum – the area between the testicles and the anus – doesn’t bring you down see a doctor straight away and brace yourself for a small shot of adrenaline in your penis. Treatment may also include oral doses of the stimulant pseudoephedrine such as Sudafed, which forces the blood vessels in the penis to contract.

5 Sexually transmitted infections (STIs)

When pleasure leads to pain.

Facts and frequency Sex without a condom puts you at risk of contracting a number of STIs including gonorrhoea, syphilis, Chlamydia and genital herpes. About a quarter of South African men have or have had an STI. Left untreated STIs can result in serious complications such as infertility. They can even kill.

Early warning signs Sores or ulcers on your penis, burning sensation when you pee, discharge and itching.

Best medicine Consult a doctor as soon as possible. These days STIs are relatively easy to treat with antibiotics.

6 Tinea cruris

Got an itch to scratch?

Facts and frequency Better known as jock itch, it’s like athlete’s foot of the groin. The cause is either an opportunistic bacterial infection or a fungus that thrives in warm, damp conditions and loves tight, sweaty clothing.

Early warning signs Itching, burning, a rash and even blisters or sores in the groin area.

Best medicine Antifungal creams will do the trick once you’ve seen a doctor to confirm that it’s not an STI.

7 Boils

They’re too hot to handle.

Facts and frequency A boil starts when an infected hair follicle swells into a pimple-like lump that eventually ruptures and discharges pus. Boils usually occur when your immune system is low and most often appear on the back and buttocks but they can also occur in the genital area.

Early warning signs Angry red swelling, intense pain and tenderness.

Best medicine Corticosteroid cream and an antibiotic will work wonders but consult your doctor to make sure it’s just a boil.

8 Pubic lice

Feeling a little crabby?

Facts and frequency Commonly known as crabs these irritating little lice are sexually transmitted parasites that suck your blood and lay eggs in your pubic hair.

Early warning signs Almost unbearable itchiness and tiny insects infesting your pubic area.

Best medicine A medicated shampoo from your pharmacy will bring instant relief. Then find the source. You also need to sterilise your linen and towels to prevent reinfestation. Your nearest and dearest won’t thank you if the critters spread to her.

9 Penile cancer

Better face the truth, fast.

Facts and frequency This rare cancer affecting 35 out of 100 000 South African men is aggressive and has been linked to the same virus that causes cervical cancer. The cause is unknown but there’s a higher incidence in uncircumcised men who don’t keep the area under their foreskin clean. It can spread into the lymph nodes of the groin and other parts of the body.

Early warning signs A painless ulcer that doesn’t heal, usually on the tip of the penis or foreskin.

Best medicine Circumcision at birth is the best preventive measure. If the cancer is detected early and surgically removed the survival rate is about 65 per cent. Conversely ignoring the condition could lead to loss of the penis or death.

10 Testicular torsion

Twist and shout.

Facts and frequency The root cause is an anatomical abnormality that occurs in about 12 per cent of males. It involves the twisting of a testicle on the spermatic cord which supplies the testicle with blood and usually occurs spontaneously or after strenuous physical activity in teenagers or men under 30 – although it can occur at any age. The rotation cuts off the blood supply leading to loss of blood and potential damage to the testes.

Early warning signs Excruciating pain, sudden swelling, abdominal pain, nausea and vomiting.

Best medicine It should be treated as an emergency because delaying medical attention can result in permanent damage or loss of the testicle. The only treatment is surgery particularly to prevent torsion from happening again.

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