Men's Health

I

Introduction

Men's Health, an area of medicine that recognizes that certain medical conditions are either unique to men or are much commoner in men than in women. Although it is not a formal field of medicine, like gynaecology, it is arousing a growing interest among the public, particularly in the wider aspects of men's health, such as heart problems (which are more common among men than women).

II

Disorders of the Male Reproductive System

In medicine, male reproductive disorders are generally covered by the specialities of urology, endocrinology, and genito-urinary medicine (formerly known as venereology—see Sexually Transmitted Diseases).

A

Prostate Enlargement

Prostate gland enlargement appears to be an almost inevitable effect of ageing. About a quarter of men over 65 have moderate to severe symptoms from this condition. Enlargement interferes with the flow of urine from the bladder by narrowing that part of the urethra that passes through the prostate gland. The result is a reduction in the force of the urine stream and an inability to empty the bladder completely. This causes increased frequency of urination, most noticeable by the repeated necessity to get up at night. If the prostate enlarges greatly, acute stoppage may occur—a painful emergency situation urgently needing the insertion of a catheter (tube) to drain away the urine.

The treatment of prostatic enlargement is to remove part or all of the gland. This is most commonly done through the urethra, using a special viewing and cutting instrument known as a resectoscope. The results are generally excellent. Various drugs can also be used to shrink the gland, but these are far less effective than surgery.

B

Prostate Cancer

At the beginning of the 21st century cancer of the prostate was the most common cancer in men in the UK and the United States, and is on the increase in younger men. In 2000 almost 22,000 cases were reported in the UK, with about 10,000 deaths. The immediate symptoms are similar to those of simple enlargement, but the implications of the disease are usually far more serious. Spread of the cancer to the bones, lungs, and other parts is common. Treatment involves removal of the prostate and elimination of the male sex hormones, such as testosterone, on which prostate cancer is dependent. This may involve castration or the use of female sex hormones. Because of the possibility of cancer, men who suffer any obvious problems with urination should always report it for medical investigation. In recent years the introduction of a simple blood test (the prostate-specific antigen test) has allowed the detection and treatment of the cancer at an early stage.