Men’s Health

Men’s health refers to health issues specific to human male anatomy. These often relate to structures such as male genitalia or to conditions caused by hormones specific to, or most notable in, males. Andrology (from Ancient Greekἀνήρanērgenitive ἀνδρόςandros, “man”; and -λογία-logia) is the medical specialty that deals with male health, particularly relating to the problems of the male reproductive system and urological problems that are unique to men. It is also known as “The science of Men“. It is the counterpart to gynaecology, which deals with medical issues which are specific to the female reproductive system. Andrology has only been studied as a distinct specialty since the late 1960s: the first specialist journal on the subject was the German periodical Andrologie (now called Andrologia), published from 1969 onwards.[1] Male-specific medical and surgical procedures include vasectomy and vasovasostomy (one of the vasectomy reversal procedures) as well as intervention to deal with male genitourinary disorders such as the followed list :


Varicocele /ˈværɨkɵsl/ is an abnormal enlargement of the pampiniform venous plexus in the scrotum. This plexus of veins drains the testicles. The testicular blood vessels originate in the abdomen and course down through the inguinal canal as part of the spermatic cord on their way to the testis. Upward flow of blood in the veins is ensured by small one-way valves that prevent backflow. Defective valves, or compression of the vein by a nearby structure, can cause dilatation of the testicular veins near the testis, leading to the formation of a varicocele.

Signs and symptoms

Symptoms of a varicocele may include:

Testicular Torsion

Testicular torsion occurs when the spermatic cord (from which the testicle is suspended) twists, cutting off the testicle’s blood supply, a condition called ischemia. The principal symptom is rapid onset of testicular pain. The most common underlying cause is a congenital malformation known as a “bell-clapper deformity” wherein the testis is inadequately affixed to the scrotum allowing it to move freely on its axis and susceptible to induced twisting of the cord and its vessels. The diagnosis can be made clinically but an urgent ultrasound is helpful in evaluation. Irreversible ischemia begins around six hours after onset and emergency diagnosis and treatment is required within this time in order to minimize necrosis and to improve the chance of salvaging the testicle.

Testicular Cancer

Testicular cancer is cancer that develops in the testicles, a part of the male reproductive system.

In the United States, between 7,500 and 8,000 diagnoses of testicular cancer are made each year.[1][2] In the UK, approximately 2,000 men are diagnosed each year,[3] and over his lifetime, a man’s risk of testicular cancer is roughly 1 in 200 (0.4%).[4] It is the most common cancer in males aged 20–39 years, the period of peak incidence, and is rarely seen before the age of 15 years.[5]

Testicular cancer has one of the highest cure rates of all cancers: If the cancer hasn’t spread outside the testicle, the 5-year relative survival rate is 99%. Even if the cancer has grown into nearby structures or has spread to nearby lymph nodes, the rate is 96%. If it has spread to organs or lymph nodes away from the tumor, the 5-year relative survival rate is around 74%. (metastasized).[6] Even for the relatively few cases in which malignant cancer has spread widely, modern chemotherapy offers a cure rate of at least 80%.[7]

Not all lumps on the testicles are tumors, and not all tumors are malignant (cancerous). There are many other conditions, such as testicular microlithiasisepididymal cysts, and appendix testis (hydatid of Morgagni), which may be painful but are non-cancerous.

Signs and symptoms

One of the first signs of testicular cancer is often a lump or swelling in the testes. The U.S. Preventive Services Task Force (USPSTF) recommends against routine screening for testicular cancer in asymptomatic adolescent and adults including routine testicular self-exams.[8] However, the American Cancer Society suggests that some men should examine their testicles monthly, especially if they have a family history of cancer, and the American Urological Association recommends monthly testicular self examinations for all young men.[9][10]

Symptoms may also include one or more of the following:

  • lump in one testis which may or may not be painful[11][12]
  • sharp pain or a dull ache in the lower abdomen or scrotum[12]
  • a feeling often described as “heaviness” in the scrotum[12]
  • breast enlargement (gynecomastia) from hormonal effects of β-hCG[11][12]
  • low back pain (lumbago) tumor spread to the lymph nodes along the back[11][12]

It is not very common for testicular cancer to spread to other organs, apart from the lungs. However, if it has, the following symptoms may be present:


Prostatitis (less commonly prostatosis) is inflammation of the prostate gland. Prostatitis is classified into acute, chronic, asymptomatic inflammatory prostatitis, and chronic pelvic pain syndrome.


The term prostatitis refers, in its strictest sense, to histological (microscopic) inflammation of the tissue of the prostate gland. Like all forms of inflammation, it can be associated with an appropriate response of the body to an infection, but it also occurs in the absence of infection.

In 1999, the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) devised a new classification system.[2][3] For more specifics about each type of prostatitis, including information on symptoms, treatment, and prognosis, follow the links to the relevant full articles.

IyesyesyesAcute prostatitisAcute prostatitis is a bacterial infection of the prostate gland that requires urgent medical treatment.Acute bacterial prostatitis
II±yesyesChronic bacterial prostatitisChronic bacterial prostatitis is a relatively rare condition that usually presents as intermittent urinary tract infections.Chronic bacterial prostatitis
IIIayesnoyesInflammatory CP/CPPSChronic prostatitis/chronic pelvic pain syndrome, accounting for 90%-95% of prostatitis diagnoses,[4] used to be known as chronic nonbacterial prostatitis.Nonbacterial prostatitis
IIIbyesnonoNoninflammatory CP/CPPSProstatodynia
IVnonoyesAsymptomatic inflammatory prostatitisAsymptomatic inflammatory prostatitis patients have no history of genitourinary pain complaints, but leukocytosis is noted, usually during evaluation for other conditions. Between 6-19% of men have pus cells in their semen but no symptoms.[5]


Prostate Cancer

Prostate cancer is a form of cancer that develops in the prostate, a gland in the male reproductive system. Most prostate cancers are slow growing;[1] however, there are cases of aggressive prostate cancers.[2] The cancer cells may metastasize (spread) from the prostate to other parts of the body, particularly the bones and lymph nodes. Prostate cancer may cause pain, difficulty in urinating, problems during sexual intercourse, erectile dysfunction, or death. Other symptoms can potentially develop during later stages of the disease.

Rates of detection of prostate cancers vary widely across the world, with South and East Asia detecting less frequently than in Europe, and especially the United States.[3] Prostate cancer tends to develop in men over the age of fifty.[4] Globally it is the sixth leading cause of cancer-related death in men[5] (it is now the first in the UK and second in the United States).[4] Prostate cancer is most common in the developed world with increasing rates in the developing world.[5] However, many men with prostate cancer never have symptoms, undergo no therapy, and eventually die of other unrelated causes. Many factors, including genetics and diet, have been implicated in the development of prostate cancer. Recently the prevalence of light pollution has been implicated in the development of prostate cancer.[6]

The presence of prostate cancer may be indicated by symptomsphysical examinationprostate-specific antigen (PSA), or biopsy. Prostate-specific antigen testing increases cancer detection but does not decrease mortality.[7] The United States Preventive Services Task Force in 2012 recommended against screening for prostate cancer using the PSA testing, due to the risk of over-diagnosis and over-treatment with most prostate cancer remaining asymptomatic.[8] The USPSTF concludes that the potential benefit of testing does not outweigh the expected harms.[8]

Management strategies for prostate cancer should be guided by the severity of the disease. Many low-risk tumors can be safely followed with active surveillance. Curative treatment generally involves surgery, various forms of radiation therapyproton therapy or, less commonly, cryosurgeryhormonal therapy and chemotherapy are generally reserved for cases of advanced disease (although hormonal therapy may be given with radiation in some cases). Several studies suggest that masturbation reduces the risk of prostate cancer, but the results are controversial.[9][10][11]

The age and underlying health of the man, the extent of metastasis, appearance under the microscope and response of the cancer to initial treatment are important in determining the outcome of the disease. The decision whether or not to treat localized prostate cancer (a tumor that is contained within the prostate) with curative intent is a patient trade-off between the expected beneficial and harmful effects in terms of patient survival and quality of life.

Signs and symptoms

Early prostate cancer usually causes no symptoms. Sometimes, however, prostate cancer does cause symptoms, often similar to those of diseases such as benign prostatic hyperplasia. These include frequent urination, nocturia (increased urination at night), difficulty starting and maintaining a steady stream of urine, hematuria (blood in the urine), and dysuria (painful urination). About a third of patients diagnosed with prostate cancer have one or more such symptoms, while two thirds have no symptoms.[12]

Prostate cancer is associated with urinary dysfunction as the prostate gland surrounds the prostatic urethra. Changes within the gland, therefore, directly affect urinary function. Because the vas deferens deposits seminal fluid into the prostatic urethra, and secretions from the prostate gland itself are included in semen content, prostate cancer may also cause problems with sexual function and performance, such as difficulty achieving erection or painful ejaculation.[12]

Advanced prostate cancer can spread to other parts of the body, possibly causing additional symptoms. The most common symptom is bone pain, often in the vertebrae (bones of the spine), pelvis, or ribs. Spread of cancer into other bones such as the femur is usually to the proximal part of the bone. Prostate cancer in the spine can also compress the spinal cord, causing leg weakness and urinary and fecal incontinence.[13]


Phimosis (/fɪˈmsɨs/ or /fˈmsɨs/[1][2]), from the Greek phimos (φῑμός [“muzzle”]), is a condition in males where the foreskin cannot be fully retracted over the glans penis. The term may also refer to clitoral phimosis in women, whereby the clitoral hood cannot be retracted, limiting exposure of the glans clitoridis.[3]

At birth, the foreskin is fused to the head of the penis and is not retractable. Huntley et al. state that “non-retractability can be considered normal for males up to and including adolescence.”[4]

Normal developmental non-retractability does not cause any problems. Phimosis is deemed pathological when it causes problems. For instance: trouble urinating, or performing normal sexual functions. There are numerous causes of so-called pathological phimosis. Common treatments include steroid creams, manual stretching, changing masturbation habits, preputioplasty, and circumcision.


There are three mechanical conditions that prevent foreskin retraction.:

1. The tip of the foreskin is too narrow to pass over the glans penis. This is normal in children and adolescents.[15][16]
2. The inner surface of the foreskin is fused with the glans penis. This is normal in children and adolescents but abnormal in adults.[16]
3. The frenulum is too short to allow complete retraction of the foreskin (frenulum breve).[16]

Pathological phimosis (as opposed to the natural non-retractability of the foreskin in childhood) is rare and the causes are varied. Some cases may arise from balanitis (inflammation of the glans penis),[17] perhaps due in turn to inappropriate efforts to retract an infant’s foreskin.

Beaugé noted that unusual masturbation practices, such as thrusting against the bed or rubbing the foreskin forward, do not stretch the foreskin and retard normal development of retraction in adolescents. Patients are advised to stop exacerbating masturbation techniques and are encouraged to masturbate by moving the foreskin up and down so as to mimic more closely the action of sexual intercourse. After giving this advice Beaugé noted not once did he have to recommend circumcision.[18][19]

Lichen sclerosus et atrophicus (thought to be the same condition as balanitis xerotica obliterans) is regarded as a common (or even the main[20]) cause of pathological phimosis.[21] This is a skin condition of unknown origin causes a whitish ring of indurated tissue (a cicatrix) to form near the tip of the prepuce. This inelastic tissue prevents retraction.

Phimosis may occur after other types of chronic inflammation (such as balanoposthitis), repeated catheterization, or forcible foreskin retraction.[22]

Phimosis may also arise in untreated diabetics due to the presence of glucose in their urine giving rise to infection in the foreskin.[23]

Phimosis in older children and adults can vary in severity, with some able to retract their foreskin partially (‘relative phimosis’), and some completely unable to retract their foreskin even in the flaccid state (‘full phimosis’).

Peyronie's Disease

Peyronie’s disease (/prnˈ/), also known as induratio penis plastica[1] or chronic inflammation of the tunica albuginea (CITA), is a connective tissue disorder involving the growth of fibrous plaques[2] in the soft tissue of the penis affecting 5% of men.[3] Specifically, scar tissue forms in the tunica albuginea, the thick sheath of tissue surrounding the corpora cavernosa causing pain, abnormal curvature, erectile dysfunction, indentation, loss of girth and shortening.[4][5][6][7] A variety of treatments have been used, but none have been especially effective.

Signs and symptoms


A certain degree of curvature of the penis is considered normal, as many men are born with this benign condition, commonly referred to as congenital curvature.

The disease may cause pain, hardened, big, cord-like lesions (scar tissue known as “plaques”), or abnormal curvature of the penis when erect due to chronic inflammation of the tunica albuginea (CITA). Although the popular conception of Peyronie’s Disease is that it always involves curvature of the penis, the scar tissue sometimes causes divots or indentations rather than curvature. The condition may also make sexual intercourse painful and/or difficult, though many men report satisfactory intercourse in spite of the disorder.[citation needed]

Although it can affect men of any race and age, it is most commonly seen in Caucasian males above the age of 40[citation needed], especially those of blood type A+, but has been seen in men as young as 18. The disorder is confined to the penis, although a substantial number of men with Peyronie’s exhibit concurrent connective tissue disorders in the hand, and to a lesser degree, in the feet. About 30 percent of men with Peyronie’s Disease develop fibrosis in other elastic tissues of the body, such as on the hand or foot, including Dupuytren’s contracture of the hand. An increased incidence in genetically related males suggests a genetic component.[8]

Penile Fracture

Penile fracture is rupture of one or both of the tunica albuginea, the fibrous coverings that envelop the penis’s corpora cavernosa. It is caused by rapid blunt force to an erect penis, usually during vaginal intercourse or aggressive masturbation.[1] It sometimes also involves partial or complete rupture of the urethra or injury to the dorsal nervesveins and arteries.[2]


A popping or cracking sound, significant pain, immediate flaccidity, and skin hematoma of various sizes are commonly associated with the event.[1]



Vaginal intercourse, anal intercourse, and aggressive masturbation are the most common causes[1] but the practice of taqaandan (also taghaandan) also puts men at risk of penile fracture. Taqaandan, which comes from a Kurdish word meaning “to click,” involves bending the top part of the erect penis while holding the lower part of the shaft in place, until a click is heard and felt. Taqaandan is said to be painless and has been compared to cracking one’s knuckles, but the practice of taqaandan has led to an increase in the prevalence of penile fractures in western Iran.[4] Taqaandan may be performed to achieve detumescence.[5]


Paraphimosis (/ˌpærəfˈmsɨs/ or /ˌpærəfəˈmsɨs/[1][2]) is an uncommon[3] medical condition where the foreskin becomes trapped behind the glans penis, and cannot be reduced (pulled back to its normal flaccid position covering the glans penis). If this condition persists for several hours or there is any sign of a lack of blood flow, paraphimosis should be treated as a medical emergency, as it can result in gangrene.[3][4][5]



Paraphimosis is usually caused by well-meaning medical professionals or parents who handle the foreskin improperly:[3][5] The foreskin may be retracted during penile examination, penile cleaning, urethral catheterization, or cystoscopy; if the foreskin is left retracted for a long period, some of the foreskin tissue may become edematous (swollen with fluid), which makes subsequent reduction of the foreskin difficult.