Conclusion
Premature ejaculation is one of the most common sexual problems in men. The condition is most often described as being an inability to delay ejaculation to a point when it is mutually desirable for both partners. The definition of when ejaculation is premature is subjective. While some men have difficulty controlling their orgasm before entry, females think 1-5 minutes of copulation is too little time (women like to have the time increased to at least 15-30 minutes). How long a man is able to last is not the important factor in diagnosing premature ejaculation. The crucial issue is if both partners are satisfied with the length of coitus.
In some cases, premature ejaculation may be caused by poor communication between partners and unrealistic expectations. Many men and women have little knowledge of their partner’s sexual needs and what satisfies them. Women typically require more foreplay and prolonged stimulation than men do to reach orgasm, and this lack of understanding causes tension and undue stress. For many men, feeling anxiety and the pressure to perform frequently leads to premature ejaculation. Drug treatment is not always the answer, and a visit to a psychologist or sex therapist may help resolve the problem.
Thursday, March 26, 2009
Premature Ejaculation” Prevalent but Poorly understood- Part 9
Prostate massage
Of all therapies, this takes the piece of cake for being the most stupid idiotic idea. Based on the technique of squeezing the tip of the penis prior to ejaculation, some even recommend squeezing the prostate or pulling the testis downwards. The testis and prostate gland do play a very important role in sexual arousal. The glands do get engorged and become sensitive during intercourse. The advocates of prostate squeezing claim that the prostate should be massaged just prior to ejaculation. The squeezing of the prostate is done to decrease the pleasurable sensations and prevent the ejaculation. This completely fool hardy idea should not be propagated. Prostate squeezing and testicle pulling is not safe and can cause serious injuries to internal organs and be very painful. The advocates for this technique, have obviously, never had their prostate/testes squeezed.
Nutrition supplements
Today, in all of medicine and general life, people seem to think that health supplements are the answer. Everyday on the internet and glossy magazines, there are ads about nutrition supplements to treat premature ejaculation. The majority of these supplements are based on the science of quackery and do not work. Further, many of these health supplements come from China and other countries where the quality and quantity is never known. With these unknown supplements, you may temporarily cure your premature ejaculation if you are lucky but chances are you may end up having no libido or sexual desire.
If one is interested in getting adequately treated, the best advice is to avoid this hodgepodge of non tested chemicals and see a physician. Not only are these supplements expensive but a large percentage of them are fake pills. Like most things in America- buyer beware.
Of all therapies, this takes the piece of cake for being the most stupid idiotic idea. Based on the technique of squeezing the tip of the penis prior to ejaculation, some even recommend squeezing the prostate or pulling the testis downwards. The testis and prostate gland do play a very important role in sexual arousal. The glands do get engorged and become sensitive during intercourse. The advocates of prostate squeezing claim that the prostate should be massaged just prior to ejaculation. The squeezing of the prostate is done to decrease the pleasurable sensations and prevent the ejaculation. This completely fool hardy idea should not be propagated. Prostate squeezing and testicle pulling is not safe and can cause serious injuries to internal organs and be very painful. The advocates for this technique, have obviously, never had their prostate/testes squeezed.
Nutrition supplements
Today, in all of medicine and general life, people seem to think that health supplements are the answer. Everyday on the internet and glossy magazines, there are ads about nutrition supplements to treat premature ejaculation. The majority of these supplements are based on the science of quackery and do not work. Further, many of these health supplements come from China and other countries where the quality and quantity is never known. With these unknown supplements, you may temporarily cure your premature ejaculation if you are lucky but chances are you may end up having no libido or sexual desire.
If one is interested in getting adequately treated, the best advice is to avoid this hodgepodge of non tested chemicals and see a physician. Not only are these supplements expensive but a large percentage of them are fake pills. Like most things in America- buyer beware.
Premature Ejaculation” Prevalent but Poorly understood- Part 8
Condoms
Wearing ultra thick condoms has also been suggested as a remedy for premature ejaculation. The condom reduces the sensitivity of the penis and prevents rapid arousal. Some claim that wearing two condoms may be required at times to decrease the penile sensitivity. Condom use also protects against STDs. However, many individuals do claim that frequently they ejaculate while trying to get the condom on.
Sexual positions
Some sexologists maintain that the entire problem can be solved by changing the position for sex. It is said that the "missionary" position (man on top of the female) is not the best position while attempting to control ejaculation. One should reverse the position by letting the female be on top. Everyone agrees that ejaculation is delayed in this position, but females claim that they have a difficult reaching orgasm in this position. So alternating the position and squeezing the tip of the penis may be part of the answer.
Hypnosis
Some individuals indicate that hypnosis has been helpful in the treatment of premature ejaculation. However all these data are anecdotal and have no scientific basis. As to how hypnosis prevents premature ejaculation remains a mystery. Some claim that in the lethargic or sedated state they are no longer able to have an erection nor have any sexual desire. I always believed hypnosis was to induce sleep and not stimulate sex! In any case, hypnosis is not a recommended therapy today.
Wearing ultra thick condoms has also been suggested as a remedy for premature ejaculation. The condom reduces the sensitivity of the penis and prevents rapid arousal. Some claim that wearing two condoms may be required at times to decrease the penile sensitivity. Condom use also protects against STDs. However, many individuals do claim that frequently they ejaculate while trying to get the condom on.
Sexual positions
Some sexologists maintain that the entire problem can be solved by changing the position for sex. It is said that the "missionary" position (man on top of the female) is not the best position while attempting to control ejaculation. One should reverse the position by letting the female be on top. Everyone agrees that ejaculation is delayed in this position, but females claim that they have a difficult reaching orgasm in this position. So alternating the position and squeezing the tip of the penis may be part of the answer.
Hypnosis
Some individuals indicate that hypnosis has been helpful in the treatment of premature ejaculation. However all these data are anecdotal and have no scientific basis. As to how hypnosis prevents premature ejaculation remains a mystery. Some claim that in the lethargic or sedated state they are no longer able to have an erection nor have any sexual desire. I always believed hypnosis was to induce sleep and not stimulate sex! In any case, hypnosis is not a recommended therapy today.
Premature Ejaculation” Prevalent but Poorly understood- Part 7
Psychotherapy
Psychotherapy or counseling, with the partner is an essential component of treatment. With understanding and emotional support, the male is likely to obtain the level of relaxation required for sexual satisfaction. Both the male and partner are encouraged to communicate freely and with sensitivity. While the premature ejaculation is being treated, the male is encouraged to satisfy the partner orally, or if the partner wants, anally.
By increasing knowledge of both partners about their sexual responses and responsibilities, the sexual tension can greatly be reduced. All sexual activity should be done without any pressure or tension and performed in a private relaxed environment.
Latex sheaths
Today, various types of external latex rigid sheathes are available. Basically these devices are worn over the penis and fastened around the pelvis with a belt. The penis is placed inside a plastic dildo and it is the actual sheath which is placed inside the vagina. The sheath prevents the penis from getting stimulated from the vagina walls and helps regain control of their ejaculation. This technique has not been useful as many women claim that they would rather use a “dildo” instead- and millions do.
Psychotherapy or counseling, with the partner is an essential component of treatment. With understanding and emotional support, the male is likely to obtain the level of relaxation required for sexual satisfaction. Both the male and partner are encouraged to communicate freely and with sensitivity. While the premature ejaculation is being treated, the male is encouraged to satisfy the partner orally, or if the partner wants, anally.
By increasing knowledge of both partners about their sexual responses and responsibilities, the sexual tension can greatly be reduced. All sexual activity should be done without any pressure or tension and performed in a private relaxed environment.
Latex sheaths
Today, various types of external latex rigid sheathes are available. Basically these devices are worn over the penis and fastened around the pelvis with a belt. The penis is placed inside a plastic dildo and it is the actual sheath which is placed inside the vagina. The sheath prevents the penis from getting stimulated from the vagina walls and helps regain control of their ejaculation. This technique has not been useful as many women claim that they would rather use a “dildo” instead- and millions do.
Premature Ejaculation” Prevalent but Poorly understood- Part 6
Medications
Numerous antidepressant drugs have been shown to delay ejaculation in men treated for various psychiatry disorders. The SSRIs class are considered the most effective treatment for premature ejaculation. The drugs include paroxetine, fluoxetine and sertraline. The prolonged use of these drugs is only limited by their side effects. Recently a new SSRI (dapoxetine) that can be taken only when needed is undergoing going clinical trials.
Other medical agents known to delay ejaculation are opioids, cocaine, and marijuana. However, this may not be appropriate as the drugs are addictive and have legal implications.
The majority of these medications do not have to be taken on a daily basis to prevent premature ejaculation. One takes the medication an hour before planning to have sexual intercourse. For those who initially do not respond to these drugs, the dose may be adjusted or another medication can be tried.
Topical creams
Various topical anesthetic creams are available that may help improve premature ejaculation. The local anesthetic work by decreasing the sensation in the penis. One usually applies the local anesthetic 30-45 minutes before sex. The local anesthetic causes the penis to loose sensation. One has to wipe the anesthetic off before intercourse. Using the anesthetic cream as a lubricant will also cause numbness of the female vagina and cervix. This is a poor man’s version of drug treatment. The effect of the local anesthetic is very short lived and it often fails to work. Most women hate these creams because it numbs their genitalia and takes away the pleasurable sensations. Best to leave these topical anesthetic creams to numb the painful hemorrhoids.
Numerous antidepressant drugs have been shown to delay ejaculation in men treated for various psychiatry disorders. The SSRIs class are considered the most effective treatment for premature ejaculation. The drugs include paroxetine, fluoxetine and sertraline. The prolonged use of these drugs is only limited by their side effects. Recently a new SSRI (dapoxetine) that can be taken only when needed is undergoing going clinical trials.
Other medical agents known to delay ejaculation are opioids, cocaine, and marijuana. However, this may not be appropriate as the drugs are addictive and have legal implications.
The majority of these medications do not have to be taken on a daily basis to prevent premature ejaculation. One takes the medication an hour before planning to have sexual intercourse. For those who initially do not respond to these drugs, the dose may be adjusted or another medication can be tried.
Topical creams
Various topical anesthetic creams are available that may help improve premature ejaculation. The local anesthetic work by decreasing the sensation in the penis. One usually applies the local anesthetic 30-45 minutes before sex. The local anesthetic causes the penis to loose sensation. One has to wipe the anesthetic off before intercourse. Using the anesthetic cream as a lubricant will also cause numbness of the female vagina and cervix. This is a poor man’s version of drug treatment. The effect of the local anesthetic is very short lived and it often fails to work. Most women hate these creams because it numbs their genitalia and takes away the pleasurable sensations. Best to leave these topical anesthetic creams to numb the painful hemorrhoids.
Wednesday, March 25, 2009
Premature Ejaculation” Prevalent but Poorly understood- Part 5
Treatment
There are varied treatments for this condition and like everything in medicine- one treatment may not be helpful for all individuals. Occasionally a combination of treatments is used. The essence of all treatments is to combine sexual therapy, medications and psychotherapy for the best results.
Sex therapy
Some sexologists recommend that individuals masturbate an hour or two before the sexual intercourse. This enables one to delay the ejaculation during sex. Other sexual activities such as foreplay are encouraged to relieve the anxiety of the actual process of sexual intercourse. Masturbation is in fact, used by normal men to prolong their sexual activity. It is believed that masturbation before sexual activity decreases the amount of desire/intensity the individual feels, thereby giving him more control over the penis. However, the results in men with premature ejaculation are variable. Some claim that there is no benefit and others claim that after masturbation, they lose the desire to have sex.
Squeezing techniques
Various squeezing techniques have been developed to prevent premature ejaculation and some have helped. It is recommended that the partner can squeeze the end of the penis when the male is just about to ejaculate. The partner has to maintain the squeeze for a few seconds until the urge to ejaculate diminishes. After the urge is over, the individual can resume the sexual activity and repeat the process. The theory is that by repeating this maneuver numerous times, the male will finally be able to have sexual intercourse without ejaculation. This technique is believed to train the penis to delay ejaculation.
However, follow-up of patients who have used this technique claim that is a poor method to manage premature ejaculation. In short, it sucks.
There are varied treatments for this condition and like everything in medicine- one treatment may not be helpful for all individuals. Occasionally a combination of treatments is used. The essence of all treatments is to combine sexual therapy, medications and psychotherapy for the best results.
Sex therapy
Some sexologists recommend that individuals masturbate an hour or two before the sexual intercourse. This enables one to delay the ejaculation during sex. Other sexual activities such as foreplay are encouraged to relieve the anxiety of the actual process of sexual intercourse. Masturbation is in fact, used by normal men to prolong their sexual activity. It is believed that masturbation before sexual activity decreases the amount of desire/intensity the individual feels, thereby giving him more control over the penis. However, the results in men with premature ejaculation are variable. Some claim that there is no benefit and others claim that after masturbation, they lose the desire to have sex.
Squeezing techniques
Various squeezing techniques have been developed to prevent premature ejaculation and some have helped. It is recommended that the partner can squeeze the end of the penis when the male is just about to ejaculate. The partner has to maintain the squeeze for a few seconds until the urge to ejaculate diminishes. After the urge is over, the individual can resume the sexual activity and repeat the process. The theory is that by repeating this maneuver numerous times, the male will finally be able to have sexual intercourse without ejaculation. This technique is believed to train the penis to delay ejaculation.
However, follow-up of patients who have used this technique claim that is a poor method to manage premature ejaculation. In short, it sucks.
Premature Ejaculation” Prevalent but Poorly understood- Part 4
When to seek medical advice
The major problem with premature ejaculation and treatment is that many males never seek treatment or see a doctor. For whatever reason, the treatment and diagnosis of premature ejaculation is always delayed. Treatment is much easier in the early stages of the disorder and pretty complex when a male presents at much older age.
Screening and diagnosis
The diagnosis of premature ejaculation is based on the individual’s history. The history and the initial interview are the most difficult part of the entire process as intimate sexual details are obtained. However, frank details about the problem, can lead to the most effective treatment. In order to diagnose the cause, sexually intimate questions may involve your:
• religious upbringing
• early sexual experiences
• past and present sexual relationships
• when premature ejaculation started
• conflicts or concerns within your current relationship
• feelings of guilt, anxiety as related to performance
• use of medications
• illicit drug use
Complications
Premature ejaculation is not a life threatening disorder. However, the disorder can have severe repercussions in one‘s personal life and relationship. Sometimes, premature ejaculation can make conceiving difficult if one continues to spurt sperm on the bed or the floor instead of the vagina.
The major problem with premature ejaculation and treatment is that many males never seek treatment or see a doctor. For whatever reason, the treatment and diagnosis of premature ejaculation is always delayed. Treatment is much easier in the early stages of the disorder and pretty complex when a male presents at much older age.
Screening and diagnosis
The diagnosis of premature ejaculation is based on the individual’s history. The history and the initial interview are the most difficult part of the entire process as intimate sexual details are obtained. However, frank details about the problem, can lead to the most effective treatment. In order to diagnose the cause, sexually intimate questions may involve your:
• religious upbringing
• early sexual experiences
• past and present sexual relationships
• when premature ejaculation started
• conflicts or concerns within your current relationship
• feelings of guilt, anxiety as related to performance
• use of medications
• illicit drug use
Complications
Premature ejaculation is not a life threatening disorder. However, the disorder can have severe repercussions in one‘s personal life and relationship. Sometimes, premature ejaculation can make conceiving difficult if one continues to spurt sperm on the bed or the floor instead of the vagina.
Premature Ejaculation” Prevalent but Poorly understood- Part 3
Signs and symptoms
There are no set guidelines to determine what early ejaculation is. The question remains: “Is the man having an orgasm at his regular time or is the female taking too long to have an orgasm”? The primary sign of the disorder is that ejaculation occurs before either the male or the female can reach orgasm, causing anxiety/distress in one or both the partners. Premature ejaculation is not always a problem associated with sexual intercourse, but may also occur during foreplay, masturbation and even simply fondling or cuddling and may not even involve a partner.
Causes
The majority of causes of premature ejaculation are thought to be psychological. Early sexual experiences, family upbringing, rigid family social life an upbringing where sex is always thought of as dirty, taboo or evil, leads to guilty feelings which eventually may express as premature ejaculation.
Premature ejaculation can be caused by temporary depression, financial stress, unrealistic performance anxiety, history of sexual repression and an overall lack of confidence. Conflicts in interpersonal relationship, emotional torment, unresolved conflicts and dynamics strongly contribute to sexual dysfunction such as premature ejaculation.
Others have claimed that perhaps the genitalia of some men are ultra sensitive to the touch of the female genitalia and perhaps there may be altered levels of hormones. No scientific data supports such theories. Finally, some individuals may be taking some certain medications (anti psychotics) which may cause premature ejaculation.
There are no set guidelines to determine what early ejaculation is. The question remains: “Is the man having an orgasm at his regular time or is the female taking too long to have an orgasm”? The primary sign of the disorder is that ejaculation occurs before either the male or the female can reach orgasm, causing anxiety/distress in one or both the partners. Premature ejaculation is not always a problem associated with sexual intercourse, but may also occur during foreplay, masturbation and even simply fondling or cuddling and may not even involve a partner.
Causes
The majority of causes of premature ejaculation are thought to be psychological. Early sexual experiences, family upbringing, rigid family social life an upbringing where sex is always thought of as dirty, taboo or evil, leads to guilty feelings which eventually may express as premature ejaculation.
Premature ejaculation can be caused by temporary depression, financial stress, unrealistic performance anxiety, history of sexual repression and an overall lack of confidence. Conflicts in interpersonal relationship, emotional torment, unresolved conflicts and dynamics strongly contribute to sexual dysfunction such as premature ejaculation.
Others have claimed that perhaps the genitalia of some men are ultra sensitive to the touch of the female genitalia and perhaps there may be altered levels of hormones. No scientific data supports such theories. Finally, some individuals may be taking some certain medications (anti psychotics) which may cause premature ejaculation.
Premature Ejaculation” Prevalent but Poorly understood- Part 2
The Pathology
The majority of men have experienced premature ejaculation at least once in their lives. Frequently, adolescent teenagers and young men experience "premature" ejaculation during their initial sexual encounters. The vast majority learn how to control the problem and a few start experimental home based therapies.
One episode of premature ejaculation is never a problem, however, if it occurs on a very regularly basis than one wishes (usually before intercourse or orgasm), then one has a disorder known as premature ejaculation. Premature ejaculation is the most common male sexual disorder. In the United States, premature ejaculation affects nearly 20% of males between the ages of 18-60. The major cause of premature ejaculation is believed to be psychological, but occasionally some organic causes are also responsible.
In a number of cases, premature ejaculation is secondary –mainly due to anxiety, mental stress, preoccupation with satisfying a female and fears about maintaining an erection during sex. Over the years numerous treatments have been postulated to help treat this condition. Some of these are outright based on quack medicine whereas others may help to some extent.
The majority of men have experienced premature ejaculation at least once in their lives. Frequently, adolescent teenagers and young men experience "premature" ejaculation during their initial sexual encounters. The vast majority learn how to control the problem and a few start experimental home based therapies.
One episode of premature ejaculation is never a problem, however, if it occurs on a very regularly basis than one wishes (usually before intercourse or orgasm), then one has a disorder known as premature ejaculation. Premature ejaculation is the most common male sexual disorder. In the United States, premature ejaculation affects nearly 20% of males between the ages of 18-60. The major cause of premature ejaculation is believed to be psychological, but occasionally some organic causes are also responsible.
In a number of cases, premature ejaculation is secondary –mainly due to anxiety, mental stress, preoccupation with satisfying a female and fears about maintaining an erection during sex. Over the years numerous treatments have been postulated to help treat this condition. Some of these are outright based on quack medicine whereas others may help to some extent.
Premature Ejaculation” Prevalent but Poorly understood- The facts
Premature ejaculation is a common disorder in men of all ages. Because the condition is often not reported, surveys of premature ejaculation reveal a low prevalence. Almost all males report of having had an episode(s) of premature ejaculation at some point in their lives. Generally, these premature ejaculation occur more often in the teens and early 20s and subside.
Unfortunately, for some men the problem is long lasting. The sensitive nature of the disorder means all data are underestimates as most men are unlikely to brag about this ailment.
Most data falsely indicate that the disorder is common only in Caucasians. However, because of cultural values, social taboos and lack of medical access, Blacks, Hispanics and Asians are underrepresented in most studies.
Anecdotal reports indicate that premature ejaculation is present in all cultures and communities. As men start to come out of their closets, it is becoming realized that premature ejaculation is much more common than previous estimates.
Unfortunately, for some men the problem is long lasting. The sensitive nature of the disorder means all data are underestimates as most men are unlikely to brag about this ailment.
Most data falsely indicate that the disorder is common only in Caucasians. However, because of cultural values, social taboos and lack of medical access, Blacks, Hispanics and Asians are underrepresented in most studies.
Anecdotal reports indicate that premature ejaculation is present in all cultures and communities. As men start to come out of their closets, it is becoming realized that premature ejaculation is much more common than previous estimates.
Monday, March 16, 2009
Legal implications of testes torsion
Legal implications
Law suits are quite common when it comes to the testes. No one is happy to lose their testes. Any evidence of a missed or delayed diagnosis is a sure bet that a law suit may result. There may be a risk of litigation even if the patient has delayed seeking medical attention. Any time there is a poor outcome, the probability of a lawsuit is real.
Summary
The most significant and feared complication of testicular torsion is loss of the testis, which may lead to permanent infertility. Common causes of testicular loss after torsion are a delay in seeking medical attention, incorrect initial diagnosis and delay in treatment of the condition.
Testicular torsion is one of the few emergencies in urologic practice. Any delay in the diagnosis by more than 4-8 hours severely reduces the chances of salvaging the testes. Some surgeons claim that there is a direct correlation between the duration of torsion and abnormal semen findings.
Some authorities even suggest that retention of an injured testis can induce pathologic changes to the contralateral testis. This creates a major dilemma when evaluating patients who present to the surgeon late. Removing one testis is fine; removing two testes is a nightmare-for both the surgeon and the patient.
Law suits are quite common when it comes to the testes. No one is happy to lose their testes. Any evidence of a missed or delayed diagnosis is a sure bet that a law suit may result. There may be a risk of litigation even if the patient has delayed seeking medical attention. Any time there is a poor outcome, the probability of a lawsuit is real.
Summary
The most significant and feared complication of testicular torsion is loss of the testis, which may lead to permanent infertility. Common causes of testicular loss after torsion are a delay in seeking medical attention, incorrect initial diagnosis and delay in treatment of the condition.
Testicular torsion is one of the few emergencies in urologic practice. Any delay in the diagnosis by more than 4-8 hours severely reduces the chances of salvaging the testes. Some surgeons claim that there is a direct correlation between the duration of torsion and abnormal semen findings.
Some authorities even suggest that retention of an injured testis can induce pathologic changes to the contralateral testis. This creates a major dilemma when evaluating patients who present to the surgeon late. Removing one testis is fine; removing two testes is a nightmare-for both the surgeon and the patient.
Treatment of Testicular Torsion
Treatment
The treatment of testicular torsion is surgery and thus as soon as the diagnosis is confirmed the patient must be referred to a urologist for prompt surgery. Time is of essence and viability of the testes is highly dependent on prompt detorsion.
Manual detorsion
Manual detorsion is sometimes used to treat testicular torsion. However, this must only be done by the surgeon. The patient usually requires some form of IV sedation and also injection of a local anesthetic in the scrotum near the spermatic cord. The physician will manipulate the testes and try to rotate the testes into its original position. This is easier said than done. Frequently there is more than 360 degree of torsion and it is impossible to know how many turns to make for detorsion. After every manual detorsion, return of blood flow must be documented by ultrasound. Even if the detorsion is successful, elective surgery must be done to permanently repair the defect so that torsion does not recur.
A number of times this manual detorsion attempt fail and frequently the situation worsens. Most urologists prefer to take the patient straight to the operating room instead of mucking around blindly with a serious condition. When successful, manual detorsion results in immediate relief of pain. Data from some series reveal a success rate of only 20% and in some cases there has been an 80% success rate (more based on luck than any technical skill).
The surgeon should never persist and be obsessive about manual detorsion. If it fails, the patient should be hurried to surgery. Only surgery can provide the definite treatment.
In addition, given the risks of a missed diagnosis, scrotal exploration may be needed if a definitive diagnosis cannot be made. If the testicle is not viable, it must be removed. In many cases, when torsion of the testes occurs on one side, it is very likely that the same anatomical defect occurs on the other side and thus, most urologists will also fix the other testes to prevent future torsion.
Postoperative surgery
In individuals who required complete removal of the testis because of non viability, a testicular prosthesis is available. This can be placed in the scrotum at around 3-6 months, once healing is complete.
The treatment of testicular torsion is surgery and thus as soon as the diagnosis is confirmed the patient must be referred to a urologist for prompt surgery. Time is of essence and viability of the testes is highly dependent on prompt detorsion.
Manual detorsion
Manual detorsion is sometimes used to treat testicular torsion. However, this must only be done by the surgeon. The patient usually requires some form of IV sedation and also injection of a local anesthetic in the scrotum near the spermatic cord. The physician will manipulate the testes and try to rotate the testes into its original position. This is easier said than done. Frequently there is more than 360 degree of torsion and it is impossible to know how many turns to make for detorsion. After every manual detorsion, return of blood flow must be documented by ultrasound. Even if the detorsion is successful, elective surgery must be done to permanently repair the defect so that torsion does not recur.
A number of times this manual detorsion attempt fail and frequently the situation worsens. Most urologists prefer to take the patient straight to the operating room instead of mucking around blindly with a serious condition. When successful, manual detorsion results in immediate relief of pain. Data from some series reveal a success rate of only 20% and in some cases there has been an 80% success rate (more based on luck than any technical skill).
The surgeon should never persist and be obsessive about manual detorsion. If it fails, the patient should be hurried to surgery. Only surgery can provide the definite treatment.
In addition, given the risks of a missed diagnosis, scrotal exploration may be needed if a definitive diagnosis cannot be made. If the testicle is not viable, it must be removed. In many cases, when torsion of the testes occurs on one side, it is very likely that the same anatomical defect occurs on the other side and thus, most urologists will also fix the other testes to prevent future torsion.
Postoperative surgery
In individuals who required complete removal of the testis because of non viability, a testicular prosthesis is available. This can be placed in the scrotum at around 3-6 months, once healing is complete.
Diagnosis of testicular torsion
Diagnostic tests
Despite all the physical signs and clinical acumen of the physician, most doctors order some type of radiological test to confirm the diagnosis of testicular torsion. Only in the rare exceptional cases, where the diagnosis is unequivocal is surgery done without further studies. In all cases where the diagnosis is in doubt, diagnostic testing is highly recommended.
The most commonly used radiological tests to asses the scrotum are Doppler ultrasonography, radionuclide imaging, and surgical exploration.
Ultrasound
Blood flow in the testes can easily be evaluated by ultrasound. In patients with testicular torsion, the blood flow in the affected testis is decreased or absent compared with the asymptomatic testis. In addition, the affected testicle appears to be enlarged. Initially, the testicle may also reveal increased echogenicity once the testes is twisted and starts to die.
Doppler ultrasonography also can differentiate between ischemia of the testes and inflammation of the epididymis. Ultrasound also can reveal the presence of other testicular disease (e.g., torsion, tumor, hydrocele, hematoma, and varicocele).
In some cases, the Doppler ultrasound can miss the diagnosis of testicular torsion, especially when the torsion is only partial. In addition, the technique can also show falsely suggest testicular torsion, when none is present. This is particularly so in younger teenagers and children with smaller prepubescent testicle. Doppler ultrasonography is not 100% sensitive for testicular torsion.
Radionuclide study
Radionuclide studies are 100% sensitive for the diagnosis of testicular torsion. Individuals with suspected torsion are injected with a small amount of a radioactive chemical which flows into the blood vessels. When the blood flow to the testes is obstructed, the radionuclide will not show up in the testes. In cases of inflammation or infection, there is more flow of the tracer to the testis.
Radionuclide study is the gold standard and 100% sensitive for the diagnosis of torsion. However, the test is not always readily available and does take a few hours to perform. In contrast, ultrasonography is faster and more readily available. This is important to know when dealing with testicular torsion- a condition that depends on rapid diagnosis for a positive outcome.
Despite all the physical signs and clinical acumen of the physician, most doctors order some type of radiological test to confirm the diagnosis of testicular torsion. Only in the rare exceptional cases, where the diagnosis is unequivocal is surgery done without further studies. In all cases where the diagnosis is in doubt, diagnostic testing is highly recommended.
The most commonly used radiological tests to asses the scrotum are Doppler ultrasonography, radionuclide imaging, and surgical exploration.
Ultrasound
Blood flow in the testes can easily be evaluated by ultrasound. In patients with testicular torsion, the blood flow in the affected testis is decreased or absent compared with the asymptomatic testis. In addition, the affected testicle appears to be enlarged. Initially, the testicle may also reveal increased echogenicity once the testes is twisted and starts to die.
Doppler ultrasonography also can differentiate between ischemia of the testes and inflammation of the epididymis. Ultrasound also can reveal the presence of other testicular disease (e.g., torsion, tumor, hydrocele, hematoma, and varicocele).
In some cases, the Doppler ultrasound can miss the diagnosis of testicular torsion, especially when the torsion is only partial. In addition, the technique can also show falsely suggest testicular torsion, when none is present. This is particularly so in younger teenagers and children with smaller prepubescent testicle. Doppler ultrasonography is not 100% sensitive for testicular torsion.
Radionuclide study
Radionuclide studies are 100% sensitive for the diagnosis of testicular torsion. Individuals with suspected torsion are injected with a small amount of a radioactive chemical which flows into the blood vessels. When the blood flow to the testes is obstructed, the radionuclide will not show up in the testes. In cases of inflammation or infection, there is more flow of the tracer to the testis.
Radionuclide study is the gold standard and 100% sensitive for the diagnosis of torsion. However, the test is not always readily available and does take a few hours to perform. In contrast, ultrasonography is faster and more readily available. This is important to know when dealing with testicular torsion- a condition that depends on rapid diagnosis for a positive outcome.
How does Testicular Torsion Present?
Signs and Symptoms
Symptoms of testicular torsion include:
- Blood in semen
- Pain in the groin and lower abdomen
- Hard testicle and redden testicle
- Swelling of the testicle
- Nausea and vomiting
- Sudden, severe testicular pain
Clinical Examination
When an individual presents with testicular torsion, pain is a common feature. The patient may not allow the examiner to touch the testes because of the pain. The spermatic cord is shortened because it is twisted and the testes may be higher compared to the unaffected testes. This finding of an elevated testes is quite specific and provides strong evidence for testicular torsion. The affected testes will also appear swollen and engorged.
Another important finding which may provide a clue to the diagnosis of testicular torsion is the absence of what is called the cremasteric reflex. This reflex is elicited by stroking or pinching the skin on the medial thigh, causing contraction of the cremasteric muscle, which elevates the testis. The cremasteric reflex is considered positive if the testicle moves at least 5 mm. This reflex is almost always present in healthy young males and the loss of the cremasteric reflex is at least 99% sensitive for testicular torsion.
Symptoms of testicular torsion include:
- Blood in semen
- Pain in the groin and lower abdomen
- Hard testicle and redden testicle
- Swelling of the testicle
- Nausea and vomiting
- Sudden, severe testicular pain
Clinical Examination
When an individual presents with testicular torsion, pain is a common feature. The patient may not allow the examiner to touch the testes because of the pain. The spermatic cord is shortened because it is twisted and the testes may be higher compared to the unaffected testes. This finding of an elevated testes is quite specific and provides strong evidence for testicular torsion. The affected testes will also appear swollen and engorged.
Another important finding which may provide a clue to the diagnosis of testicular torsion is the absence of what is called the cremasteric reflex. This reflex is elicited by stroking or pinching the skin on the medial thigh, causing contraction of the cremasteric muscle, which elevates the testis. The cremasteric reflex is considered positive if the testicle moves at least 5 mm. This reflex is almost always present in healthy young males and the loss of the cremasteric reflex is at least 99% sensitive for testicular torsion.
What happens during testicular torsion?
When torsion occurs the testes rotates along the spermatic cord. During the rotation, it obstructs the blood flow. The stoppage in blood flow results in ischemia and no oxygen supply to the testes. The degree of damage to the testes depends on the duration of the torsion and the degree of twisting of the spermatic cord. Changes are evident in the testes soon after torsion and are reversible up to 4 hours. However, after 24 hours of torsion, the testes is almost always non functional and salvage is impossible.
Differential Diagnosis
Testicular torsion is a surgical emergency and if there is going to be any hope of salvage; it must be rapidly diagnosed and treated. Any delay in the diagnosis almost always leads to loss in the testes. Over diagnosis of the condition leads to unnecessary surgery. Data from hospital records indicate that testicular pain is quite frequent in teenagers and young adults. At least 20-40% of young males complain of some type of testicular pain at some point.
- Conditions which can mimic testicular torsion include
- trauma to the scrotum
- epididymitis (infection of the spermatic cord)
- orchitis (infection of the testis)
- incarcerated hernia
- varicocele
- idiopathic scrotal edema
- torsion of the appendix testis
Whenever there is trauma to the groin area, there is a general tendency to always attribute the scrotal pain entirely to trauma and become oblivious to the presence of testicular torsion. However, if the pain lasts more than one hour after the trauma, the testicle should always be evaluated for possible trauma-induced torsion.
Differential Diagnosis
Testicular torsion is a surgical emergency and if there is going to be any hope of salvage; it must be rapidly diagnosed and treated. Any delay in the diagnosis almost always leads to loss in the testes. Over diagnosis of the condition leads to unnecessary surgery. Data from hospital records indicate that testicular pain is quite frequent in teenagers and young adults. At least 20-40% of young males complain of some type of testicular pain at some point.
- Conditions which can mimic testicular torsion include
- trauma to the scrotum
- epididymitis (infection of the spermatic cord)
- orchitis (infection of the testis)
- incarcerated hernia
- varicocele
- idiopathic scrotal edema
- torsion of the appendix testis
Whenever there is trauma to the groin area, there is a general tendency to always attribute the scrotal pain entirely to trauma and become oblivious to the presence of testicular torsion. However, if the pain lasts more than one hour after the trauma, the testicle should always be evaluated for possible trauma-induced torsion.
Twisting of the Testes- painful!
In the USA, the annual incidence of testicular torsion affects about one in 4,000 males younger than 25 years. In testicular torsion, the testes twist (rotate) around the spermatic cord. The spermatic cord is the life line of the testes and carries with it important blood vessels and duct that carries sperm.
When the testis twists around the spermatic cord, the blood supply to the testes is cut off. Within a few hours, the testes can be severely damaged and infertility is a common end result if there is any delay in treatment. Surgery is the mainstay of treatment.
Testicular torsion primarily affects teenagers and young adults in the 2nd decade of life, but it can also occur at any age. Males with one or both testicles which have not descended into scrotum (cryptorchidism) develop testicular torsion more often than the general population.
Torsion may occur spontaneously. In about 5-10% of males, it may result from direct trauma to the groin. Other factors that may increase the risk of torsion include an increase in testicular size (volume), presence of a testicular tumor, testis which lies along a horizontal plane, a history of failure of the testes to descend into the groin and a long spermatic cord. Torsion often occurs during sleep.
When the testis twists around the spermatic cord, the blood supply to the testes is cut off. Within a few hours, the testes can be severely damaged and infertility is a common end result if there is any delay in treatment. Surgery is the mainstay of treatment.
Testicular torsion primarily affects teenagers and young adults in the 2nd decade of life, but it can also occur at any age. Males with one or both testicles which have not descended into scrotum (cryptorchidism) develop testicular torsion more often than the general population.
Torsion may occur spontaneously. In about 5-10% of males, it may result from direct trauma to the groin. Other factors that may increase the risk of torsion include an increase in testicular size (volume), presence of a testicular tumor, testis which lies along a horizontal plane, a history of failure of the testes to descend into the groin and a long spermatic cord. Torsion often occurs during sleep.
Friday, March 13, 2009
Male Boobs: Embarrassing but harmless Part 6
Diagnosis
In the majority of cases, the diagnosis of gynecomastia is made by the physician by just simple observation and the presenting history. The breast is always palpated (felt with hands) to ensure there are no hard masses present. Infection of the male breast is almost unheard of, except in those males who pierce their nipples.
However, the physical examination should also be done to ensure that the scrotum does not have any abnormal mass that may be responsible for the gynecomastia. There are a few testicular cancers that can make female sex hormones and Gynecomastia may be initial presenting feature.
In some cases, there is no real breast tissue and the breast is infiltrated with a fatty tissue. In these cases a diagnosis of pseudo-gynecomastia is made. This is a common finding in obese individuals. Breast cancer in males does occur but is seen in the older males and typically presents as a hard mass in a single breast. Both breasts having a cancer is very unusual.
The majority of the younger individual do not require any tests, either radiological or blood tests.
Mammogram has no role in the evaluation of breast mass in males. Unless the male has undergone a sex change and undergone a size 44 C breast enlargement, it is impossible to place a male breast on a mammogram machine. A mammogram requires fairly decent sized breasts to be placed between two metal plates.
A chest x ray of an ultrasound of the scrotum may be obtained in the rare individual with Gynecomastia.
Biopsy of the breast is very unusual and is only done if there is a great suspicion of a breast cancer, or if the physician is clueless
In the majority of cases, the diagnosis of gynecomastia is made by the physician by just simple observation and the presenting history. The breast is always palpated (felt with hands) to ensure there are no hard masses present. Infection of the male breast is almost unheard of, except in those males who pierce their nipples.
However, the physical examination should also be done to ensure that the scrotum does not have any abnormal mass that may be responsible for the gynecomastia. There are a few testicular cancers that can make female sex hormones and Gynecomastia may be initial presenting feature.
In some cases, there is no real breast tissue and the breast is infiltrated with a fatty tissue. In these cases a diagnosis of pseudo-gynecomastia is made. This is a common finding in obese individuals. Breast cancer in males does occur but is seen in the older males and typically presents as a hard mass in a single breast. Both breasts having a cancer is very unusual.
The majority of the younger individual do not require any tests, either radiological or blood tests.
Mammogram has no role in the evaluation of breast mass in males. Unless the male has undergone a sex change and undergone a size 44 C breast enlargement, it is impossible to place a male breast on a mammogram machine. A mammogram requires fairly decent sized breasts to be placed between two metal plates.
A chest x ray of an ultrasound of the scrotum may be obtained in the rare individual with Gynecomastia.
Biopsy of the breast is very unusual and is only done if there is a great suspicion of a breast cancer, or if the physician is clueless
Male Boobs: Embarrassing but harmless Part 6
Complications
Gynecomastia has no medical or physiological consequences. The major problem is cosmetic and may create emotional stress due to embarrassment. Despite claims by some that gynecomastia is a risk factor for breast cancer, there is no scientific data to prove such a claim. In fact, if this was true, there would be thousands of cases of male breast cancer each year, and this is not true. Male breast cancer is a rare condition.
Could the breast lump be cancer?
When both breasts are enlarged in a young male, the chances of breast cancer are almost nil. Breast cancer does occur in males. When it does occur, it occurs in one breast and the cancer is seen in older males. In the majority of cases of gynecomastia, there is no cancer associated. However, any male over the age of 50 with a sudden increase in a single breast, should definitely be seen by a doctor for further work up.
Breast cancer in males presents just like in females. A mass is identified in a single breast but there is generally no pain or nipple discharge but the mass may be hard to touch. The only way to tell if it is a cancer, is by a biopsy.
Symptoms
The male individual generally present with an increase in breast tissue which he has identified himself. Most of the individuals present late to the doctor, mainly due to embarrassment. The diagnosis of gynecomastia is in most cases made on physical examination. The breasts are enlarged on both sides. In most cases, the breast enlargement is mild to modest. There is no “Pamela Anderson –like Breast growth”- in males the breast enlargement is more a source of embarrassment-unlike a female who tends to have a sex appeal and in fact is willing to show off her boobs.
In the majority of cases, the enlargement is bilateral and in about 10-20%, only one breast is enlarged. The breasts are soft and the nipples and the areola area also well developed. A few males, especially, the younger ones will also complain of nipple sensitiveness. There is no real pain but an odd ache is a typical complaint. The breast enlargement is symmetrical in most cases. Nipple discharge is almost never seen. There is nothing specific about the breast examination.
There are several classifications of gynecomastia based on either size or the tissue component found in the breast. In simple, if the breasts are large, surgery may require not only removal of the breast tissue but also the excess redundant skin left over.
Gynecomastia has no medical or physiological consequences. The major problem is cosmetic and may create emotional stress due to embarrassment. Despite claims by some that gynecomastia is a risk factor for breast cancer, there is no scientific data to prove such a claim. In fact, if this was true, there would be thousands of cases of male breast cancer each year, and this is not true. Male breast cancer is a rare condition.
Could the breast lump be cancer?
When both breasts are enlarged in a young male, the chances of breast cancer are almost nil. Breast cancer does occur in males. When it does occur, it occurs in one breast and the cancer is seen in older males. In the majority of cases of gynecomastia, there is no cancer associated. However, any male over the age of 50 with a sudden increase in a single breast, should definitely be seen by a doctor for further work up.
Breast cancer in males presents just like in females. A mass is identified in a single breast but there is generally no pain or nipple discharge but the mass may be hard to touch. The only way to tell if it is a cancer, is by a biopsy.
Symptoms
The male individual generally present with an increase in breast tissue which he has identified himself. Most of the individuals present late to the doctor, mainly due to embarrassment. The diagnosis of gynecomastia is in most cases made on physical examination. The breasts are enlarged on both sides. In most cases, the breast enlargement is mild to modest. There is no “Pamela Anderson –like Breast growth”- in males the breast enlargement is more a source of embarrassment-unlike a female who tends to have a sex appeal and in fact is willing to show off her boobs.
In the majority of cases, the enlargement is bilateral and in about 10-20%, only one breast is enlarged. The breasts are soft and the nipples and the areola area also well developed. A few males, especially, the younger ones will also complain of nipple sensitiveness. There is no real pain but an odd ache is a typical complaint. The breast enlargement is symmetrical in most cases. Nipple discharge is almost never seen. There is nothing specific about the breast examination.
There are several classifications of gynecomastia based on either size or the tissue component found in the breast. In simple, if the breasts are large, surgery may require not only removal of the breast tissue but also the excess redundant skin left over.
Male Boobs: Embarrassing but harmless Part 5
Medical conditions which have been associated with Gynecomastia include:
- In children the most common condition known to cause gynecomastia is
kleinfelter’s. This is a genetically acquired condition which is
diagnosed in early childhood. The breast enlargement unfortunately
is persistent and does not always resolve.
- Pituitary failure: In some cases, the pituitary gland may fail and
there is failure to make hormones. This leads to a lack of the male
hormones. The condition is rare but can be treated with hormonal
supplements
- Obesity. In obese individual there is a lot of excess fat. The excess
fat contains a lot of cholesterol which is a precursor chemical for
the female sex hormones- and it is for this reason that many obese
individuals develop female characteristics
- Some cancers are known to generate precursors for the synthesis of
the female sex hormones. These cancers are generally lung, testes and
adrenal.
- Liver and Kidney Failure- when the liver fails, there is an accumulation
of the female sex hormone. This is due to the liver’s inability to
breakdown this hormone. So the excess hormone is known to cause
Gynecomastia
- In some individuals, an excess of the thyroid hormone may be responsible
for the condition
- Starvation is a common cause of gynecomastia in children. This condition
is typically seen in Africa where poverty is endemic.
- In children the most common condition known to cause gynecomastia is
kleinfelter’s. This is a genetically acquired condition which is
diagnosed in early childhood. The breast enlargement unfortunately
is persistent and does not always resolve.
- Pituitary failure: In some cases, the pituitary gland may fail and
there is failure to make hormones. This leads to a lack of the male
hormones. The condition is rare but can be treated with hormonal
supplements
- Obesity. In obese individual there is a lot of excess fat. The excess
fat contains a lot of cholesterol which is a precursor chemical for
the female sex hormones- and it is for this reason that many obese
individuals develop female characteristics
- Some cancers are known to generate precursors for the synthesis of
the female sex hormones. These cancers are generally lung, testes and
adrenal.
- Liver and Kidney Failure- when the liver fails, there is an accumulation
of the female sex hormone. This is due to the liver’s inability to
breakdown this hormone. So the excess hormone is known to cause
Gynecomastia
- In some individuals, an excess of the thyroid hormone may be responsible
for the condition
- Starvation is a common cause of gynecomastia in children. This condition
is typically seen in Africa where poverty is endemic.
Male Boobs: Embarrassing but harmless Part 4
Medications causing gynecomastia
A number of medications have been associated with gynecomastia and include:
- There are some drugs used to treat prostate cancer and these are
anti androgenic medications. By blocking the male hormones, these
drugs stimulate the actions of female sex hormones. The most commonly
used anti androgenic medications are flutamide and Finasteride.
- There are some medications used to treat AIDS that can also cause
gynecomastia. These medications are efavirenz or didanosine.
Unfortunately, these medications are life saving and the individual
just can’t stop them. There are some alternative HIV medications
available which do not cause gynecomastia.
- Anti-anxiety medications such as diazepam (Valium) also been linked
to gynecomastia. However, this is not a reproducible finding in all
patients who take valium.
- Tricyclic antidepressants have also been associated with gynecomastia.
- The most common medication known to cause gynecomastia is cimetidine.
However, this is not seen in all patients. There are other anti ulcer
medications which have been reported to cause gynecomastia. However,
this is not a universal finding.
- Cancer drugs are also known to cause gynecomastia.
- Heart medications such as digitalis and spironolactone are also
known to cause gynecomastia.
Illicit drugs and alcohol
Illicit drug use and alcohol appears to be a common cause of gynecomastia among adolescents and older individuals. The majority of these individuals develop gynecomastia after prolonged use of these agents. Other illicit drugs that have also been known to cause this disorder are heroin and use of anabolic steroids.
Alcohol is postulated to cause gynecomastia after the liver is destroyed. A cirrhotic liver is no longer able to breakdown the normal circulating female sex hormone- and this eventually accumulates and causes gynecomastia. Steroids and other excess androgens are sometimes converted by the body into estrogens and consequently cause gynecomastia.
A number of medications have been associated with gynecomastia and include:
- There are some drugs used to treat prostate cancer and these are
anti androgenic medications. By blocking the male hormones, these
drugs stimulate the actions of female sex hormones. The most commonly
used anti androgenic medications are flutamide and Finasteride.
- There are some medications used to treat AIDS that can also cause
gynecomastia. These medications are efavirenz or didanosine.
Unfortunately, these medications are life saving and the individual
just can’t stop them. There are some alternative HIV medications
available which do not cause gynecomastia.
- Anti-anxiety medications such as diazepam (Valium) also been linked
to gynecomastia. However, this is not a reproducible finding in all
patients who take valium.
- Tricyclic antidepressants have also been associated with gynecomastia.
- The most common medication known to cause gynecomastia is cimetidine.
However, this is not seen in all patients. There are other anti ulcer
medications which have been reported to cause gynecomastia. However,
this is not a universal finding.
- Cancer drugs are also known to cause gynecomastia.
- Heart medications such as digitalis and spironolactone are also
known to cause gynecomastia.
Illicit drugs and alcohol
Illicit drug use and alcohol appears to be a common cause of gynecomastia among adolescents and older individuals. The majority of these individuals develop gynecomastia after prolonged use of these agents. Other illicit drugs that have also been known to cause this disorder are heroin and use of anabolic steroids.
Alcohol is postulated to cause gynecomastia after the liver is destroyed. A cirrhotic liver is no longer able to breakdown the normal circulating female sex hormone- and this eventually accumulates and causes gynecomastia. Steroids and other excess androgens are sometimes converted by the body into estrogens and consequently cause gynecomastia.
Male Boobs: Embarrassing but harmless Part 3
Causes of Gynecomastia
There are many causes of bilateral breast enlargement. In most cases it is due to an abnormal or altered ratio between the male and female sex hormones. In simple, any one of the following changes in sex hormones can cause Gynecomastia:
- Decrease in production of male sex hormone androgen
- Increase in estrogen formation
- Decrease in sensitivity of breast tissue to androgens
Gynecomastia in infants
More than 60% of infant males have Gynecomastia at birth. This physiological condition is due to the female sex hormone which has crossed from the placenta. The condition is short lived and almost all cases resolve within a few weeks.
Gynecomastia during puberty
Gynecomastia that occurs around the time of puberty is very common. The exact numbers are unknown as many young males are too shy to tell anyone about their condition. However, hospital data reveal that at least 40-60% of males may develop some form of Gynecomastia at around puberty. The cause of this gynecomastia is due an excess of sex hormones. The condition is also more common in tall or overweight males. The condition is completely benign and resolves in 2-3 years.
There are many causes of bilateral breast enlargement. In most cases it is due to an abnormal or altered ratio between the male and female sex hormones. In simple, any one of the following changes in sex hormones can cause Gynecomastia:
- Decrease in production of male sex hormone androgen
- Increase in estrogen formation
- Decrease in sensitivity of breast tissue to androgens
Gynecomastia in infants
More than 60% of infant males have Gynecomastia at birth. This physiological condition is due to the female sex hormone which has crossed from the placenta. The condition is short lived and almost all cases resolve within a few weeks.
Gynecomastia during puberty
Gynecomastia that occurs around the time of puberty is very common. The exact numbers are unknown as many young males are too shy to tell anyone about their condition. However, hospital data reveal that at least 40-60% of males may develop some form of Gynecomastia at around puberty. The cause of this gynecomastia is due an excess of sex hormones. The condition is also more common in tall or overweight males. The condition is completely benign and resolves in 2-3 years.
Male Boobs: Embarrassing but harmless Part 2
Frequency
Breast growth in males is more common than what one is led to believe. Many male children develop breast enlargement during puberty. From available data, this phenomenon is seen in about 35-60% of males and is considered physiological. The exact numbers remain unknown because not many males brag about the disorder. The condition is most commonly seen in males between the ages of 12-16.
The prevalence increases again in males in the 6-7th decade of life. The condition is typically identified by the individual himself. In the majority of cases, there is no milk production from the breast and unlike the female; breast enlargement in males is not deemed erotic or sexy.
Breast enlargement in the younger age group of males is almost always physiological and generally resolves with time. In males who are older, the cause may be linked to various factors (see below) and may not always resolve.
Pseudo-gynecomastia is a condition which looks very similar in size and shape to Gynecomastia. However, unlike glandular tissue which is found in Gynecomastia, only fat is found in pseudo-gynecomastia. The condition is more common in obese males.
Breast growth in males is more common than what one is led to believe. Many male children develop breast enlargement during puberty. From available data, this phenomenon is seen in about 35-60% of males and is considered physiological. The exact numbers remain unknown because not many males brag about the disorder. The condition is most commonly seen in males between the ages of 12-16.
The prevalence increases again in males in the 6-7th decade of life. The condition is typically identified by the individual himself. In the majority of cases, there is no milk production from the breast and unlike the female; breast enlargement in males is not deemed erotic or sexy.
Breast enlargement in the younger age group of males is almost always physiological and generally resolves with time. In males who are older, the cause may be linked to various factors (see below) and may not always resolve.
Pseudo-gynecomastia is a condition which looks very similar in size and shape to Gynecomastia. However, unlike glandular tissue which is found in Gynecomastia, only fat is found in pseudo-gynecomastia. The condition is more common in obese males.
Male Boobs: Embarrassing but harmless
Gynecomastia (male boobs) is defined as the growth of breast glandular tissue in males. The term gynecomastia is derived from the Greek terminology meaning female like breast. The disorder is completely benign and is frequently seen in prepubertal children and young teenagers. Another very similar condition to Gynecomastia is pseudo-gynecomastia- which looks and resembles Gynecomastia but the breast tissue is composed of fat only.
Gynecomastia is a disorder which occurs in both breasts, only rarely is it seen in only one breast. Unlike Pamela Anderson you will never grow 44 cup size breasts: the breast enlargement is more similar to breast growth seen in pubertal and young teenage females. In almost all cases, the breast growth is symmetrical and painless. The majority of the cases of breast enlargement subside on their own which may take about 1-2 years to completely disappear.
Gynecomastia by definition is enlargement of both breasts in a male. The condition is almost always bilateral but in some cases may be one sided. The condition most commonly is seen at puberty and in older age males. The majority of individuals have no symptoms, except for the obvious enlargement.
The condition is linked to an imbalance between the male and female sex hormones. In other cases, gynecomastia may be caused by certain medications, alcohol, marijuana and liver failure. Surgery is only done for cosmetic reasons and only after some time period has elapsed since the condition started.
Gynecomastia is a disorder which occurs in both breasts, only rarely is it seen in only one breast. Unlike Pamela Anderson you will never grow 44 cup size breasts: the breast enlargement is more similar to breast growth seen in pubertal and young teenage females. In almost all cases, the breast growth is symmetrical and painless. The majority of the cases of breast enlargement subside on their own which may take about 1-2 years to completely disappear.
Gynecomastia by definition is enlargement of both breasts in a male. The condition is almost always bilateral but in some cases may be one sided. The condition most commonly is seen at puberty and in older age males. The majority of individuals have no symptoms, except for the obvious enlargement.
The condition is linked to an imbalance between the male and female sex hormones. In other cases, gynecomastia may be caused by certain medications, alcohol, marijuana and liver failure. Surgery is only done for cosmetic reasons and only after some time period has elapsed since the condition started.
Acne Part 12
Patient Education
To avoid the disfiguring effects of acne, it is essential to educate the patient about acne. Patients need to know the facts and dispel the myths about the disorder. The acne is not related to hygiene and extensive scrubbing and use of strong alcohol based acids only worsen the disorder.
Patients should know that simple washing with warm water and soap is sufficient. Individuals with acne have to know that acne is not caused by stress but in fact acne can worsen the stress. The role of cosmetic products in the etiology of acne is overstated. Cosmetics do not cause acne but may worsen the redness and skin irritation. Oil based cosmetics generally worsen the acne.
Prognosis
Most teenagers and young adults with acne grow out of this stage by the mid to late 20s. The best treatment for acne is the combination of drugs in which a retinoid is a part of the treatment regimen.
Depending on the physician and his/her experience, the combination therapy may be variable. One needs to go to a dermatologist who has experience in treating acne. All patients with acne should be given realistic expectations about their treatment plan, along with good follow-up. These measures can contribute to the ultimate success of treatment.
The majority of individuals who get treated early for acne have excellent results. For those who have delayed their treatment, some scarring and facial disfiguring may be evident. In such cases, a visit to a cosmetic or plastic surgeon may be necessary. Today, advances in lasers can help smooth the skin and remove the facial scars. Before going to any plastic surgeon for scar removal, be informed about the various skin peeling procedures. They are not only expensive and the results are not always guaranteed.
To avoid the disfiguring effects of acne, it is essential to educate the patient about acne. Patients need to know the facts and dispel the myths about the disorder. The acne is not related to hygiene and extensive scrubbing and use of strong alcohol based acids only worsen the disorder.
Patients should know that simple washing with warm water and soap is sufficient. Individuals with acne have to know that acne is not caused by stress but in fact acne can worsen the stress. The role of cosmetic products in the etiology of acne is overstated. Cosmetics do not cause acne but may worsen the redness and skin irritation. Oil based cosmetics generally worsen the acne.
Prognosis
Most teenagers and young adults with acne grow out of this stage by the mid to late 20s. The best treatment for acne is the combination of drugs in which a retinoid is a part of the treatment regimen.
Depending on the physician and his/her experience, the combination therapy may be variable. One needs to go to a dermatologist who has experience in treating acne. All patients with acne should be given realistic expectations about their treatment plan, along with good follow-up. These measures can contribute to the ultimate success of treatment.
The majority of individuals who get treated early for acne have excellent results. For those who have delayed their treatment, some scarring and facial disfiguring may be evident. In such cases, a visit to a cosmetic or plastic surgeon may be necessary. Today, advances in lasers can help smooth the skin and remove the facial scars. Before going to any plastic surgeon for scar removal, be informed about the various skin peeling procedures. They are not only expensive and the results are not always guaranteed.
Acne Part 11
Miscellaneous medications
With a large lucrative market and millions of individuals seeking to look younger and more beautiful, there are daily reports of newer products, herbs, spices, mineral and nutrients claiming to cure acne. The majority of these substances are worthless.
A few chemicals that may have the potential to treat acne include zinc and use of lasers. However, there are no scientific data to back the claims made by these individuals who sell or offer these products.
Surgery
Surgery for acne is a last resort treatment. When all therapies have failed and the comedomes are large, surgery may be of some benefit. The surgery is a very minor procedure and involves extraction of the blackheads with a special instrument (comedo extractor). In rare cases, corticosteroids may be injected into the lesion to help reduce the redness and soften up the comedone. Steroids may also help to reduce the scarring.
Surgery may cause skin scarring and dermabrasion may be required in future. Be careful about whom you choose as your surgeon. Results after acne treatment are not always great and in cosmetic surgery, there are no refunds.
With a large lucrative market and millions of individuals seeking to look younger and more beautiful, there are daily reports of newer products, herbs, spices, mineral and nutrients claiming to cure acne. The majority of these substances are worthless.
A few chemicals that may have the potential to treat acne include zinc and use of lasers. However, there are no scientific data to back the claims made by these individuals who sell or offer these products.
Surgery
Surgery for acne is a last resort treatment. When all therapies have failed and the comedomes are large, surgery may be of some benefit. The surgery is a very minor procedure and involves extraction of the blackheads with a special instrument (comedo extractor). In rare cases, corticosteroids may be injected into the lesion to help reduce the redness and soften up the comedone. Steroids may also help to reduce the scarring.
Surgery may cause skin scarring and dermabrasion may be required in future. Be careful about whom you choose as your surgeon. Results after acne treatment are not always great and in cosmetic surgery, there are no refunds.
Acne Part 10
Retinoids
Retinoids, which are derivatives of vitamin A, act by decreasing comedomes and decreasing oil production. Retinoids are the most effective agents for acne. They have been a mainstay of acne treatment for the past 25 years.
Until recently, tretinoin was the only available topical retinoid. This agent is used as a single agent and quite effective for mild to moderate acne. Tretinoin is available as a cream, gel or liquid. The cream has the lowest potency, and the liquid has the highest potency. All tretinoin formulations can cause some skin irritation and this is related to the strength of the formulation.
Tretinoin is applied to clean dry skin. Because the drug can cause light sensitivity, sun exposure should be avoided when applying the treatment. Or the treatment can be applied at night time. To minimize irritation, tretinoin should be started at a low concentration, which can then be gradually increased as needed. Skin irritation usually decreases with continued therapy.
All users of tretinoin should be aware that when initially using the agent, a flare up may occur. This is common during induction therapy and not a sign of an adverse reaction. The skin flares up declines over the next few days.
Caution with Retinoids
Because of the known teratogenic (birth defects) effects of oral vitamin A products, the use of tretinoin in pregnancy is a major concern. When a female of child bearing age is prescribed tretinoin, the adverse effect on this drug on the fetus must always be explained to the individual. Numerous litigation cases have occurred with the use of these drugs in young females. A signed consent from the individual acknowledging the use of this drug must be placed in the chart.
Occasionally the retinoids may also cause an increase in the blood levels of fatty acids. Still in other individuals, the drugs have been associated with depression and suicidal thoughts.
Sun sensitivity may occur in some individuals who do take retinoids. Therefore it is recommended that the individual wear a sun screen or cover the skin while taking this medication
Topical Vitamin A products
Adapalene (Differin) and Tazarotene are two topical retinoids that have been approved for the use of Acne. These topical medications are applied once a day and are less irritating then benzyl peroxide and other antibiotics. Like the oral retinoids, the use of these drugs in pregnant females should be used with caution.
These vitamin A related products can treat several types of acne lesions. The retinoids may be applied topically or even be taken orally as a pill. When applied topically, they help to cleanse the pores and remove the skin oils. The oral retinoids are excellent for severe acne and lead to rapid clearance of the condition. They have a peeling action on the skin. Within a few weeks, the majority of individuals show a response and the drug also leads to a reduction in wrinkles on the face.
Retinoids, which are derivatives of vitamin A, act by decreasing comedomes and decreasing oil production. Retinoids are the most effective agents for acne. They have been a mainstay of acne treatment for the past 25 years.
Until recently, tretinoin was the only available topical retinoid. This agent is used as a single agent and quite effective for mild to moderate acne. Tretinoin is available as a cream, gel or liquid. The cream has the lowest potency, and the liquid has the highest potency. All tretinoin formulations can cause some skin irritation and this is related to the strength of the formulation.
Tretinoin is applied to clean dry skin. Because the drug can cause light sensitivity, sun exposure should be avoided when applying the treatment. Or the treatment can be applied at night time. To minimize irritation, tretinoin should be started at a low concentration, which can then be gradually increased as needed. Skin irritation usually decreases with continued therapy.
All users of tretinoin should be aware that when initially using the agent, a flare up may occur. This is common during induction therapy and not a sign of an adverse reaction. The skin flares up declines over the next few days.
Caution with Retinoids
Because of the known teratogenic (birth defects) effects of oral vitamin A products, the use of tretinoin in pregnancy is a major concern. When a female of child bearing age is prescribed tretinoin, the adverse effect on this drug on the fetus must always be explained to the individual. Numerous litigation cases have occurred with the use of these drugs in young females. A signed consent from the individual acknowledging the use of this drug must be placed in the chart.
Occasionally the retinoids may also cause an increase in the blood levels of fatty acids. Still in other individuals, the drugs have been associated with depression and suicidal thoughts.
Sun sensitivity may occur in some individuals who do take retinoids. Therefore it is recommended that the individual wear a sun screen or cover the skin while taking this medication
Topical Vitamin A products
Adapalene (Differin) and Tazarotene are two topical retinoids that have been approved for the use of Acne. These topical medications are applied once a day and are less irritating then benzyl peroxide and other antibiotics. Like the oral retinoids, the use of these drugs in pregnant females should be used with caution.
These vitamin A related products can treat several types of acne lesions. The retinoids may be applied topically or even be taken orally as a pill. When applied topically, they help to cleanse the pores and remove the skin oils. The oral retinoids are excellent for severe acne and lead to rapid clearance of the condition. They have a peeling action on the skin. Within a few weeks, the majority of individuals show a response and the drug also leads to a reduction in wrinkles on the face.
Acne Part 9
Oral Antibiotics
Tetracyclines are the most frequently prescribed oral antibiotics for the treatment of acne. These antibiotics are taken for short term duration only.
There are a number of tetracycline drugs (minocyline, doxycycline) which are used to treat acne. However, the majority of acne sufferers fail to respond to these drugs and the drugs also have a few side effects.
Most users of tetracycline type drugs for acne reveal a great disappointment with this therapy.
Tetracyclines are the most frequently prescribed oral antibiotics for the treatment of acne. These antibiotics are taken for short term duration only.
There are a number of tetracycline drugs (minocyline, doxycycline) which are used to treat acne. However, the majority of acne sufferers fail to respond to these drugs and the drugs also have a few side effects.
Most users of tetracycline type drugs for acne reveal a great disappointment with this therapy.
Acne Part 8
Prescription medications
Various prescription medications are available for the treatment of acne. These include the antibiotics and retinoids. These prescribed medications are generally administered for moderate to severe long standing acne which has failed to respond to all other measures.
Antibiotics have been used for a long time in the treatment of acne. They are most effective in the treatment of acne which is red and tender. The antibiotics kill the bacteria and cause decrease in redness and swelling. However, these antibiotics do not work in all individuals and the results are not always predictable. The antibiotics can be applied topically or be taken as a pill.
In general, most individuals show a poor response to antibiotic. Judging from the number of antibiotics prescribed to treat acne, should indicate that one antibiotic alone does not always work for all individuals.
Topical antibiotics
Topical antibiotics can help reduce acne. Types of topical antibiotics include erythromycin, clindamycin, and sulfa drugs. The topical approach is sometimes effective because the medication is applied directly to the skin lesions. In addition, because the drug is not swallowed, there are fewer side effects.
A disadvantage of all antibiotic treatment is that bacteria often develop tolerance and resistance to the medication over time, and thus become difficult to eradicate. Almost all topical antibiotics are associated with some minor skin irritation which may be due to the solution in which the antibiotic is dissolved.
Various prescription medications are available for the treatment of acne. These include the antibiotics and retinoids. These prescribed medications are generally administered for moderate to severe long standing acne which has failed to respond to all other measures.
Antibiotics have been used for a long time in the treatment of acne. They are most effective in the treatment of acne which is red and tender. The antibiotics kill the bacteria and cause decrease in redness and swelling. However, these antibiotics do not work in all individuals and the results are not always predictable. The antibiotics can be applied topically or be taken as a pill.
In general, most individuals show a poor response to antibiotic. Judging from the number of antibiotics prescribed to treat acne, should indicate that one antibiotic alone does not always work for all individuals.
Topical antibiotics
Topical antibiotics can help reduce acne. Types of topical antibiotics include erythromycin, clindamycin, and sulfa drugs. The topical approach is sometimes effective because the medication is applied directly to the skin lesions. In addition, because the drug is not swallowed, there are fewer side effects.
A disadvantage of all antibiotic treatment is that bacteria often develop tolerance and resistance to the medication over time, and thus become difficult to eradicate. Almost all topical antibiotics are associated with some minor skin irritation which may be due to the solution in which the antibiotic is dissolved.
Acne Part 7
Acidic solutions
Mild acidic solutions are available in most pharmacies and health care stores. Theses acidic solutions like salicylic and glycolic acids can be effective in some cases. The mild acids peel of the old skin and open up the pores, thus removing the accumulated oil inside the skin pores. However, the effectiveness of these acids is variable and they do not work for the moderate to severe cases of acne. Drying up of the skin is a common problem with these peeling acids.
Salicylic Acid
Salicylic acid is a chemical available in various concentrations as an over the counter medication. This agent inhibits the formation of black heads by acting as peeling agent. It has been shown to be as effective as benzyl peroxide in the treatment of acne. Salicylic acid is well tolerated and should be applied once or twice daily.
Sulfur Preparations
Sulfur preparations have been used to treat acne for centuries. Sulfur is combined with other over the counter acne medications. This agent has been shown to be effective in the treatment of acute acne lesions and acts as a keratolytic agent. It has a few unpleasant side effects including an unpleasant odor and skin discoloration. Today, sulfur medications are rarely used in the treatment of acne because of the availability of better and effective agents.
Azelaic Acid
Azelaic acid is a decarboxylic acid is sometimes used to treat mild acne. How it works remains unknown but it appears to be as effective as salicylic acid and tretinoin in the treatment of mild to moderate acne.
Azelaic acid is a cream which is applied twice a day. Most individuals have no complaints but some may develop skin irritation and redness at the site of application. Because the agent also has the ability to decrease skin pigmentation, it should be used with caution in dark skinned individuals.
For the most part, all the above treatments are third rate and only help mild acne.
Mild acidic solutions are available in most pharmacies and health care stores. Theses acidic solutions like salicylic and glycolic acids can be effective in some cases. The mild acids peel of the old skin and open up the pores, thus removing the accumulated oil inside the skin pores. However, the effectiveness of these acids is variable and they do not work for the moderate to severe cases of acne. Drying up of the skin is a common problem with these peeling acids.
Salicylic Acid
Salicylic acid is a chemical available in various concentrations as an over the counter medication. This agent inhibits the formation of black heads by acting as peeling agent. It has been shown to be as effective as benzyl peroxide in the treatment of acne. Salicylic acid is well tolerated and should be applied once or twice daily.
Sulfur Preparations
Sulfur preparations have been used to treat acne for centuries. Sulfur is combined with other over the counter acne medications. This agent has been shown to be effective in the treatment of acute acne lesions and acts as a keratolytic agent. It has a few unpleasant side effects including an unpleasant odor and skin discoloration. Today, sulfur medications are rarely used in the treatment of acne because of the availability of better and effective agents.
Azelaic Acid
Azelaic acid is a decarboxylic acid is sometimes used to treat mild acne. How it works remains unknown but it appears to be as effective as salicylic acid and tretinoin in the treatment of mild to moderate acne.
Azelaic acid is a cream which is applied twice a day. Most individuals have no complaints but some may develop skin irritation and redness at the site of application. Because the agent also has the ability to decrease skin pigmentation, it should be used with caution in dark skinned individuals.
For the most part, all the above treatments are third rate and only help mild acne.
Acne Part 6
Benzyl peroxide
Benzyl peroxide is available over the counter and has been used to treat acne for at least 50 years. This agent can kill the bacteria and also acts as an abrasive agent. It is the only topical agent that is most effective against the bacteria which is commonly found in acne pustules.
Benzyl peroxide is available in various concentrations (2.5 to 10 percent), although there is no evidence that using higher concentrations result in better treatment. The water-based formulations cause less drying of the skin than the alcohol-based preparations. Benzyl peroxide gels are applied once or twice daily.
The most common side effect of the agent is skin irritation. This effect occurs more often at higher concentrations and tends to decrease with continued use. Some individuals develop contact allergy. All patients using benzyl peroxide formulations should test the skin to make sure they do not have contact allergy. The drug is a strong oxidizing agent and can irreversibly stain clothing and linen. The drug is best applied in the morning so it will be dry by night time and so the risk of staining is avoided.
The big question is does this chemical work? and the answer is a NO, it is close to crap. The majority of individuals who have acne remain dis-satisfied with benzyl peroxide.
Benzyl peroxide is available over the counter and has been used to treat acne for at least 50 years. This agent can kill the bacteria and also acts as an abrasive agent. It is the only topical agent that is most effective against the bacteria which is commonly found in acne pustules.
Benzyl peroxide is available in various concentrations (2.5 to 10 percent), although there is no evidence that using higher concentrations result in better treatment. The water-based formulations cause less drying of the skin than the alcohol-based preparations. Benzyl peroxide gels are applied once or twice daily.
The most common side effect of the agent is skin irritation. This effect occurs more often at higher concentrations and tends to decrease with continued use. Some individuals develop contact allergy. All patients using benzyl peroxide formulations should test the skin to make sure they do not have contact allergy. The drug is a strong oxidizing agent and can irreversibly stain clothing and linen. The drug is best applied in the morning so it will be dry by night time and so the risk of staining is avoided.
The big question is does this chemical work? and the answer is a NO, it is close to crap. The majority of individuals who have acne remain dis-satisfied with benzyl peroxide.
Acne Part 5
TREATMENT
Basic Skin care at home
All individuals with acne should consider performing some basic skin hygiene at home. The major goal of all acne treatment is to prevent scarring and disfiguring of the face. When acne is left treated, severe scarring can result.
It is recommended that one wash the face at least 2-3 times a day to remove the excess oil from the skin. There are numerous acne cleansing products available but a simple bland soap will do just as well. One should not scrub the skin too hard as this may lead to further irritation. One should avoid all fragrances and perfumes on the face to limit the extent of skin irritation.
Medical Treatment
The major treatment of acne is medications. There are 100s of medications available for the treatment of acne- this fact alone should immediately lead one to suspect that no one really knows what the best medication is. Every single day, there is a new agent advertised which is claimed to be the best drug for acne. There are many herbs, oils, soaps, and nutrients which are supposed to treat acne, but they all lack any scientific data or clinical proof of their efficacy. The majority of these agents are a waste of money and do not cure acne (except empty your pockets).
Despite these numerous options available, only a few drugs are actually helpful in the treatment of acne. There are both over the counter and prescription drugs available in the treatment of acne.
Selecting a Treatment Regimen
The physician treating acne should consider some skin factors when managing acne. Patients with dry skin benefit best most from creams, whereas patients with oily skin do best with solutions which may contain an alcohol. Using the appropriate vehicle can lead to better compliance by limiting side effects.
Over the counter medications
There are numerous over the counter medications available to treat acne. These non prescription chemicals include everything from baby oil, shampoos, soaps, creams, ointments, herbs, minerals, emollients etc. No one knows if these work and judging from the number of chemicals available, it is a sure bet that the majority do not work.
Basic Skin care at home
All individuals with acne should consider performing some basic skin hygiene at home. The major goal of all acne treatment is to prevent scarring and disfiguring of the face. When acne is left treated, severe scarring can result.
It is recommended that one wash the face at least 2-3 times a day to remove the excess oil from the skin. There are numerous acne cleansing products available but a simple bland soap will do just as well. One should not scrub the skin too hard as this may lead to further irritation. One should avoid all fragrances and perfumes on the face to limit the extent of skin irritation.
Medical Treatment
The major treatment of acne is medications. There are 100s of medications available for the treatment of acne- this fact alone should immediately lead one to suspect that no one really knows what the best medication is. Every single day, there is a new agent advertised which is claimed to be the best drug for acne. There are many herbs, oils, soaps, and nutrients which are supposed to treat acne, but they all lack any scientific data or clinical proof of their efficacy. The majority of these agents are a waste of money and do not cure acne (except empty your pockets).
Despite these numerous options available, only a few drugs are actually helpful in the treatment of acne. There are both over the counter and prescription drugs available in the treatment of acne.
Selecting a Treatment Regimen
The physician treating acne should consider some skin factors when managing acne. Patients with dry skin benefit best most from creams, whereas patients with oily skin do best with solutions which may contain an alcohol. Using the appropriate vehicle can lead to better compliance by limiting side effects.
Over the counter medications
There are numerous over the counter medications available to treat acne. These non prescription chemicals include everything from baby oil, shampoos, soaps, creams, ointments, herbs, minerals, emollients etc. No one knows if these work and judging from the number of chemicals available, it is a sure bet that the majority do not work.
Acne Part 4
Causes and Risk Factors
There is a genetic predisposition for acne but the actual gene responsible has not been identified. Acne is often worsened by periods of stress and diet. Foods high in chocolate content, certain spices and hot foods are known to affect and worsen acne.
Propionibacteria acnes is the common bacterial cause of skin infection that accompanies acne. These bacteria are always present on the skin and play a major role in the causation of pustules.
Signs and Symptoms
Acne usually presents as small pimples (comedones). These can appear anywhere on the body but are commonly seen on the face, chest, back, and shoulders. Bacteria thrive in conditions where there is warmth, moisture and oil. When the bacteria grow into the comedone, the pimple and surrounding skin becomes red and swells up.
Frequently the comedone ruptures and pus can be extruded from it. After rupture of the comedone, it leaves a skin depression (pit) or a scar.
Who should seek medical help for Acne
In some individual the acne just does not go away, keeps on recurring and is severe. In some individuals the pustules are large and are a major cosmetic problem. In others the acne has failed to respond to over the counter medications. Anyone who has acne which is moderate to severe and is of a cosmetic concern should see a doctor because there are medications to treat this condition.
Diagnosis
The diagnosis of acne is straightforward. No x rays or blood work is required. The diagnosis is easily made by inspecting the skin.
There is a genetic predisposition for acne but the actual gene responsible has not been identified. Acne is often worsened by periods of stress and diet. Foods high in chocolate content, certain spices and hot foods are known to affect and worsen acne.
Propionibacteria acnes is the common bacterial cause of skin infection that accompanies acne. These bacteria are always present on the skin and play a major role in the causation of pustules.
Signs and Symptoms
Acne usually presents as small pimples (comedones). These can appear anywhere on the body but are commonly seen on the face, chest, back, and shoulders. Bacteria thrive in conditions where there is warmth, moisture and oil. When the bacteria grow into the comedone, the pimple and surrounding skin becomes red and swells up.
Frequently the comedone ruptures and pus can be extruded from it. After rupture of the comedone, it leaves a skin depression (pit) or a scar.
Who should seek medical help for Acne
In some individual the acne just does not go away, keeps on recurring and is severe. In some individuals the pustules are large and are a major cosmetic problem. In others the acne has failed to respond to over the counter medications. Anyone who has acne which is moderate to severe and is of a cosmetic concern should see a doctor because there are medications to treat this condition.
Diagnosis
The diagnosis of acne is straightforward. No x rays or blood work is required. The diagnosis is easily made by inspecting the skin.
Acne Part 3
Pathology of acne
Hair follicles are present on all parts of the body, except for the soles and palms of the extremities. Inside the hair follicles are glands which also secrete sebum (oil). The sebum is secreted at a constant rate and lubricates the skin. These sebaceous gland are specially prevalent on the face, back, axilla and chest.
It is believed that in acne, there are a lot of dead cells and debris inside the hair follicle which plug the pores of the skin. The pores are unable to release their oily secretions and tend to enlarge. When these pimples grow to a certain size, they become conspicuous on the face and may even rupture.
Once the pores are plugged, the bacteria that normally live on the skin start to grow in the pores and are responsible for the acne. The bacteria cause the redness and skin irritation. When the bacteria mix with the oils from the hair follicles, it secretes substance which can cause skin irritation.
Acne is always worsened in the presence of the male hormones. These hormones are present in both males and females, but in a much higher concentration in males. These male hormones can cause enlargement of the sweat glands on the skin and cause these same glands to increase the production of oil. This increased oil secretion then causes the pores to plug up and lead to acne. In all males, there is a surge of the male hormones at puberty and this is the time when most males show the development of facial acne. In some men, the condition progresses leading to severe acne on the face and back.
Estrogen, the female sex hormone, on the other hand helps to improve the acne. This is the major reason why during the menstrual cycle the acne is variable. This is one of the reasons why most women who take the birth control pill, almost never develop acne. In fact, some dermatologist will even prescribe oral contraceptives for a short period for the treatment of acne.
Hair follicles are present on all parts of the body, except for the soles and palms of the extremities. Inside the hair follicles are glands which also secrete sebum (oil). The sebum is secreted at a constant rate and lubricates the skin. These sebaceous gland are specially prevalent on the face, back, axilla and chest.
It is believed that in acne, there are a lot of dead cells and debris inside the hair follicle which plug the pores of the skin. The pores are unable to release their oily secretions and tend to enlarge. When these pimples grow to a certain size, they become conspicuous on the face and may even rupture.
Once the pores are plugged, the bacteria that normally live on the skin start to grow in the pores and are responsible for the acne. The bacteria cause the redness and skin irritation. When the bacteria mix with the oils from the hair follicles, it secretes substance which can cause skin irritation.
Acne is always worsened in the presence of the male hormones. These hormones are present in both males and females, but in a much higher concentration in males. These male hormones can cause enlargement of the sweat glands on the skin and cause these same glands to increase the production of oil. This increased oil secretion then causes the pores to plug up and lead to acne. In all males, there is a surge of the male hormones at puberty and this is the time when most males show the development of facial acne. In some men, the condition progresses leading to severe acne on the face and back.
Estrogen, the female sex hormone, on the other hand helps to improve the acne. This is the major reason why during the menstrual cycle the acne is variable. This is one of the reasons why most women who take the birth control pill, almost never develop acne. In fact, some dermatologist will even prescribe oral contraceptives for a short period for the treatment of acne.
Acne Part 2
Modern day misconceptions about acne
there are a million theories about acne and why it occurs and so forth. Most of these theories are not simply rubbish. The most common false beliefs about acne are:
- The condition is due to poor hygiene of the face
- The condition is due to dirt in the environment
- Acne is not genetically acquired
- Foods do not affect acne
- Acne can be treated with herbs and nutrients
- Acne is caused by stress
- Buying more expensive soaps and creams leads to better treatment
there are a million theories about acne and why it occurs and so forth. Most of these theories are not simply rubbish. The most common false beliefs about acne are:
- The condition is due to poor hygiene of the face
- The condition is due to dirt in the environment
- Acne is not genetically acquired
- Foods do not affect acne
- Acne can be treated with herbs and nutrients
- Acne is caused by stress
- Buying more expensive soaps and creams leads to better treatment
Acne Part 1
Acne is a common skin condition which affects millions of teenagers and young men. It is a disorder of the skin that presents as an irritating red skin rash with one or more pustules (pimples) on the face. The disorder affects more than 80% of adolescents and young men.
Acne can occur on the face, chest, arms and back but has a high propensity for occurring on the face. Acne while not life threatening, is the most dreadful skin disorder for a young teenager. While most men develop acne in their teenage years, some may develop it in the 3rd decade of life.
Even a single acne lesion can create a lot of social problems and for those with multiple lesions on the face, it is can cause potentially life long loss of self esteem, depression and social isolation.
For all men, there is absolutely nothing great about acne; it probably ranks as the worst skin disorder a men can have. Perhaps having a very small penis is more embarrassing that bad acne. When the condition is not treated, acne can lead to disfiguring of the face which is also associated with numerous residual scars.
Once acne scars occur, the condition is difficult to treat (despite what dermatologists and cosmetic surgeons claim). Unlike the 1980s when only topical preparations where available to treat acne; today, however, newer and more effective drugs are available.
Acne can occur on the face, chest, arms and back but has a high propensity for occurring on the face. Acne while not life threatening, is the most dreadful skin disorder for a young teenager. While most men develop acne in their teenage years, some may develop it in the 3rd decade of life.
Even a single acne lesion can create a lot of social problems and for those with multiple lesions on the face, it is can cause potentially life long loss of self esteem, depression and social isolation.
For all men, there is absolutely nothing great about acne; it probably ranks as the worst skin disorder a men can have. Perhaps having a very small penis is more embarrassing that bad acne. When the condition is not treated, acne can lead to disfiguring of the face which is also associated with numerous residual scars.
Once acne scars occur, the condition is difficult to treat (despite what dermatologists and cosmetic surgeons claim). Unlike the 1980s when only topical preparations where available to treat acne; today, however, newer and more effective drugs are available.
Thursday, March 12, 2009
Vasectomy- the ultimate male contraceptive Part 12
Which gender should undergo sterilization?
The choice between vasectomy and tubal ligated is often discussed with the doctor and ultimately it depends on the partners involved. Both procedures have low risks, are quite effective and both can be reversed in most cases. The majority of individuals who have had complications from either surgery have been related more to the anesthesia than the actual procedure itself. Ultimately, the choice between the two procedure and which couples undergoes it, is determined by the couple themselves.
Conclusion
Over the last decade, vasectomy has been shown to be an effective form of contraception. The chief advantage of vasectomy--its permanence--is also its main disadvantage. The procedure is simple, but reversing it is difficult, very expensive, and often unsuccessful. It is estimated that pregnancy does occur after about 1 in 2,000 vasectomies. Although there is a surgery to reverse vasectomy, the procedure fails in about 60% of cases.
Physicians are studying new methods of blocking the vas that may produce less tissue damage and scarring and might thus permit more successful reversal. But these methods are all experimental, and their effectiveness has not yet been confirmed. In the meantime, any man who chooses to have a vasectomy should consider it irreversible.
The choice between vasectomy and tubal ligated is often discussed with the doctor and ultimately it depends on the partners involved. Both procedures have low risks, are quite effective and both can be reversed in most cases. The majority of individuals who have had complications from either surgery have been related more to the anesthesia than the actual procedure itself. Ultimately, the choice between the two procedure and which couples undergoes it, is determined by the couple themselves.
Conclusion
Over the last decade, vasectomy has been shown to be an effective form of contraception. The chief advantage of vasectomy--its permanence--is also its main disadvantage. The procedure is simple, but reversing it is difficult, very expensive, and often unsuccessful. It is estimated that pregnancy does occur after about 1 in 2,000 vasectomies. Although there is a surgery to reverse vasectomy, the procedure fails in about 60% of cases.
Physicians are studying new methods of blocking the vas that may produce less tissue damage and scarring and might thus permit more successful reversal. But these methods are all experimental, and their effectiveness has not yet been confirmed. In the meantime, any man who chooses to have a vasectomy should consider it irreversible.
Vasectomy- the ultimate male contraceptive Part 11
Reversal of vasectomy
There are some surgeons who specialize in reversal of vasectomies. With some difficulty, it is possible to reconstruct the vas deferens and restore sperm flow. Several microscopic procedures have been developed. The success rate varies depending on whom one talks to. The surgeons (remember they get paid) all claim a high success in reversing the procedure. However, not all patients agree to what the doctors say. At best, only 30-50% of individuals are able to have their vasectomies reversed
For those desperate couples still desiring children, needle aspiration, is another technique of obtaining sperm after vasectomy. This is done usually when the surgical reconstruction of the vas deferens fails. Sperm which are collected in the testis are obtained via a needle. The procedure is done in the doctors’ office. The technique is still in its infancy and collection of viable sperm is difficult and time consuming. Repeated treatments are usually required. The collected sperm are then used with a variety of in vitro fertility techniques such as artificial insemination.
There are some surgeons who specialize in reversal of vasectomies. With some difficulty, it is possible to reconstruct the vas deferens and restore sperm flow. Several microscopic procedures have been developed. The success rate varies depending on whom one talks to. The surgeons (remember they get paid) all claim a high success in reversing the procedure. However, not all patients agree to what the doctors say. At best, only 30-50% of individuals are able to have their vasectomies reversed
For those desperate couples still desiring children, needle aspiration, is another technique of obtaining sperm after vasectomy. This is done usually when the surgical reconstruction of the vas deferens fails. Sperm which are collected in the testis are obtained via a needle. The procedure is done in the doctors’ office. The technique is still in its infancy and collection of viable sperm is difficult and time consuming. Repeated treatments are usually required. The collected sperm are then used with a variety of in vitro fertility techniques such as artificial insemination.
Vasectomy- the ultimate male contraceptive Part 10
Complications
Serious complications after vasectomy are rare. Pain, bleeding and some redness at the incision site may occur in a few individuals. Rarely, sperm remain in the vas may build up and may require removal. However, the majority of these collections disappear with time.
Vasectomy does not cause prostate cancer. Nevertheless, as a precaution, the American Urological Association (AUA) recommends that men over 40 who had a vasectomy for more than 20 years previously should have a yearly test for prostate cancer. Today, vasectomy is a safe procedure. Thousands of men have had this procedure and go on to lead healthy normal lives.
Will vasectomy affect my libido?
Vasectomy has no affect on the male hormones. There is no change in libido, desire or the ability to make love. Both erections and orgasms remain the same. In fact, most couples report more spontaneity in their love making and devoting less time to worrying about pregnancy.
Serious complications after vasectomy are rare. Pain, bleeding and some redness at the incision site may occur in a few individuals. Rarely, sperm remain in the vas may build up and may require removal. However, the majority of these collections disappear with time.
Vasectomy does not cause prostate cancer. Nevertheless, as a precaution, the American Urological Association (AUA) recommends that men over 40 who had a vasectomy for more than 20 years previously should have a yearly test for prostate cancer. Today, vasectomy is a safe procedure. Thousands of men have had this procedure and go on to lead healthy normal lives.
Will vasectomy affect my libido?
Vasectomy has no affect on the male hormones. There is no change in libido, desire or the ability to make love. Both erections and orgasms remain the same. In fact, most couples report more spontaneity in their love making and devoting less time to worrying about pregnancy.
Vasectomy- the ultimate male contraceptive Part 9
Post surgery
A few days rest is all that is required after surgery. A groin support should be worn until the healing is complete and strenuous exercise should be avoided for a few weeks. Pain is minimal and easily controlled with Tylenol or ice packs. Sexual intercourse is refrained for a week or so.
When does vasectomy work?
Vasectomy does produce sterility immediately after the procedure. There are always some viable sperm present in the vas deferens for at least 1-2 weeks and can be ejaculated. Thus, it is highly recommended that after a vasectomy one should have the ejaculate analyzed twice to ensure that no viable sperm are present. This ejaculate collection is generally done at 1 and 4 weeks after the procedure.
When no sperm are seen, the man is sterile. During this 4 week period, it is recommended that some other type of sexual protection be undertaken for birth control. The majority of failures of vasectomy as a birth control measure occur during this time period.
A few days rest is all that is required after surgery. A groin support should be worn until the healing is complete and strenuous exercise should be avoided for a few weeks. Pain is minimal and easily controlled with Tylenol or ice packs. Sexual intercourse is refrained for a week or so.
When does vasectomy work?
Vasectomy does produce sterility immediately after the procedure. There are always some viable sperm present in the vas deferens for at least 1-2 weeks and can be ejaculated. Thus, it is highly recommended that after a vasectomy one should have the ejaculate analyzed twice to ensure that no viable sperm are present. This ejaculate collection is generally done at 1 and 4 weeks after the procedure.
When no sperm are seen, the man is sterile. During this 4 week period, it is recommended that some other type of sexual protection be undertaken for birth control. The majority of failures of vasectomy as a birth control measure occur during this time period.
Vasectomy- the ultimate male contraceptive Part 8
Vasclip
Dividing the vas deferens always complicates the reversal if one is required. With advances in technology, microclips have been used to block sperm transfer across the vas deferens. Reversal from the Vasclip is much easier than if the vas deferens was divided. The Vasclip procedure may be done either with a no scalpel technique or via an incision.
Results reveal that when the vas is not divided, the time to recovery is short and there are fewer complications. Results of reversibility after Vasclip indicate that reversal is a lot easier than after surgical division of the vas. However, the procedure should be considered permanent.
Dividing the vas deferens always complicates the reversal if one is required. With advances in technology, microclips have been used to block sperm transfer across the vas deferens. Reversal from the Vasclip is much easier than if the vas deferens was divided. The Vasclip procedure may be done either with a no scalpel technique or via an incision.
Results reveal that when the vas is not divided, the time to recovery is short and there are fewer complications. Results of reversibility after Vasclip indicate that reversal is a lot easier than after surgical division of the vas. However, the procedure should be considered permanent.
Vasectomy- the ultimate male contraceptive Part 8
No-scalpel Vasectomy
Recently no scalpel vasectomy has come into vogue. It basically means no incision is made with a knife. In this procedure, the vas deferens is identified from a small puncture hole in the scrotum and the vas is identified and picked up with special instruments.
Through this small button hole, the vas deferens is divided (or cauterized) and placed back in the scrotum. The puncture wound in the scrotum does not require any sutures, except for a small dressing.
Some surgeons recommend the no-scalpel method because it is quicker and lessens discomfort after surgery. The procedure also decreases the risk for bleeding and infection. The procedure is fast catching on with many urologists.
Recently no scalpel vasectomy has come into vogue. It basically means no incision is made with a knife. In this procedure, the vas deferens is identified from a small puncture hole in the scrotum and the vas is identified and picked up with special instruments.
Through this small button hole, the vas deferens is divided (or cauterized) and placed back in the scrotum. The puncture wound in the scrotum does not require any sutures, except for a small dressing.
Some surgeons recommend the no-scalpel method because it is quicker and lessens discomfort after surgery. The procedure also decreases the risk for bleeding and infection. The procedure is fast catching on with many urologists.
Vasectomy- the ultimate male contraceptive Part 8
Surgery
The surgery is done on an outpatient basis whereby the patient goes home the same day. The procedure is performed by a urologist and done under local anesthesia with some intravenous sedation.
The procedure may be done in the doctor’s office or clinic. Prior to the procedure, the groin and scrotal area are cleansed with an antibiotic and sterile drapes are placed around the area.
A small amount of local anesthetic in injected and the vas deferens is identified after making a small 1 cm incision. The vas deferens is cut and clipped at both ends, and placed back in the scrotum. The incision is closed and the same procedure is done on the other side of the scrotum. Some surgeons may cauterize (heat) the ends of the vas deferens.
This heating of the vas deferens almost always makes reversible impossible in future. After surgery, the patient is discharged home with a scrotal support.
The surgery is done on an outpatient basis whereby the patient goes home the same day. The procedure is performed by a urologist and done under local anesthesia with some intravenous sedation.
The procedure may be done in the doctor’s office or clinic. Prior to the procedure, the groin and scrotal area are cleansed with an antibiotic and sterile drapes are placed around the area.
A small amount of local anesthetic in injected and the vas deferens is identified after making a small 1 cm incision. The vas deferens is cut and clipped at both ends, and placed back in the scrotum. The incision is closed and the same procedure is done on the other side of the scrotum. Some surgeons may cauterize (heat) the ends of the vas deferens.
This heating of the vas deferens almost always makes reversible impossible in future. After surgery, the patient is discharged home with a scrotal support.
Vasectomy- the ultimate male contraceptive Part 7
When should the decision about vasectomy be made?
For all of the foregoing reasons, doctors advise that vasectomy be undertaken only by men who are prepared to accept the fact that they will no longer be able to father a child.
The decision should be considered along with other contraceptive options and discussed with a professional counselor. Men who are married or in a serious relationship should also discuss the issue with their partners.
There are many a man who have had vasectomy prematurely and go on to regret it. The regret is never about its efficacy as a contraceptive, but that it is a permanent procedure, which is very difficult to reverse.
For all of the foregoing reasons, doctors advise that vasectomy be undertaken only by men who are prepared to accept the fact that they will no longer be able to father a child.
The decision should be considered along with other contraceptive options and discussed with a professional counselor. Men who are married or in a serious relationship should also discuss the issue with their partners.
There are many a man who have had vasectomy prematurely and go on to regret it. The regret is never about its efficacy as a contraceptive, but that it is a permanent procedure, which is very difficult to reverse.
Wednesday, March 11, 2009
Vasectomy- the ultimate male contraceptive Part 6
Vasectomy may not be an appropriate method for you for several reasons including:
- it is not a protection against sexually transmitted disease
including HIV. Asides from abstinence, condoms offer the best
protection against these sexually transmitted infections
- if you have other medical illness such as heart disease,
uncontrolled blood pressure or diabetes or if you have
any disorders of the groin, such as an inguinal hernia
or hydrocele (fluid in the scrotum). All these conditions
must be treated before undertaking vasectomy
- you are too young or single and have no children
- you feel that your partner, relative or physician is
pushing you
- your marriage is on the rocks
- you feel that vasectomy may be the solution to your
emotional, marital and sexual problems
- you are still undecided about children in future
- you think that in future vasectomy may be reversible
- you are in a temporary state of stress and unable to
make up your mind
- your partner is apprehensive or insecure about the
procedure
- it is not a protection against sexually transmitted disease
including HIV. Asides from abstinence, condoms offer the best
protection against these sexually transmitted infections
- if you have other medical illness such as heart disease,
uncontrolled blood pressure or diabetes or if you have
any disorders of the groin, such as an inguinal hernia
or hydrocele (fluid in the scrotum). All these conditions
must be treated before undertaking vasectomy
- you are too young or single and have no children
- you feel that your partner, relative or physician is
pushing you
- your marriage is on the rocks
- you feel that vasectomy may be the solution to your
emotional, marital and sexual problems
- you are still undecided about children in future
- you think that in future vasectomy may be reversible
- you are in a temporary state of stress and unable to
make up your mind
- your partner is apprehensive or insecure about the
procedure
Vasectomy- the ultimate male contraceptive Part 5
Vasectomy may be appropriate for you for the following reasons:
- if you and your partner already have all the children you will ever
want and have no further children planned
- that you and your partner do not want to have children and you
cannot or do not want to use temporary methods of contraception
- that you desire a more permanent form of contraception
- that you or your partner have a medical disorder that prevents
the use of other forms of contraception
- you want the independence to enjoy sex without the fear of
pregnancy.
- if you and your partner already have all the children you will ever
want and have no further children planned
- that you and your partner do not want to have children and you
cannot or do not want to use temporary methods of contraception
- that you desire a more permanent form of contraception
- that you or your partner have a medical disorder that prevents
the use of other forms of contraception
- you want the independence to enjoy sex without the fear of
pregnancy.
Vasectomy- the ultimate male contraceptive Part 4
Who is the best candidate for vasectomy?
Whenever elective surgery is involved, spontaneous one sided decisions should never be made without some thought and knowledge. Before undertaking vasectomy, numerous factors have to be taken into account.
As with any method of contraception, it is essential to speak to your spouse/mate/partner. Generally, vasectomy is procedure undertaken by the married men. Single men rarely choose this form of contraception and it is almost incumbent on the surgeon to decline this procedure in this group of men as the procedure is difficult to reverse.
The decision about vasectomy should be made with thought given to the fact the procedure is permanent and that having a family in future is remote or nil. It is important to seek the advice of your physician or health care provider about the advantages and disadvantages about the procedure before making a hasty decision.
Whenever elective surgery is involved, spontaneous one sided decisions should never be made without some thought and knowledge. Before undertaking vasectomy, numerous factors have to be taken into account.
As with any method of contraception, it is essential to speak to your spouse/mate/partner. Generally, vasectomy is procedure undertaken by the married men. Single men rarely choose this form of contraception and it is almost incumbent on the surgeon to decline this procedure in this group of men as the procedure is difficult to reverse.
The decision about vasectomy should be made with thought given to the fact the procedure is permanent and that having a family in future is remote or nil. It is important to seek the advice of your physician or health care provider about the advantages and disadvantages about the procedure before making a hasty decision.
Vasectomy- the ultimate male contraceptive Part 3
Male Reproductive System
To understand how a vasectomy is performed, it is first essential to understand the anatomy and function of the male reproductive system. The testicles, or testes, produce sperm and the male hormone -testosterone.
The testis are located in the scrotum at the base of the penis and easily palpable (one can feel them). The scrotum is basically a pocket which protects the testis and maintains a normal temperature.
Each testis contains a thin long channel, called the epididymis, where sperm can be stored for as long as 6 weeks while they mature. The epididymis are connected to the prostate gland by a pair of tubes called the vas deferens. The vas deferens is part of a complex collection of blood vessels, nerves, and lymphatic channels called the spermatic cord. During ejaculation, seminal fluid produced by the prostate gland, which mixes with sperm from the testes to form semen, which then is ejaculated from the penis.
To understand how a vasectomy is performed, it is first essential to understand the anatomy and function of the male reproductive system. The testicles, or testes, produce sperm and the male hormone -testosterone.
The testis are located in the scrotum at the base of the penis and easily palpable (one can feel them). The scrotum is basically a pocket which protects the testis and maintains a normal temperature.
Each testis contains a thin long channel, called the epididymis, where sperm can be stored for as long as 6 weeks while they mature. The epididymis are connected to the prostate gland by a pair of tubes called the vas deferens. The vas deferens is part of a complex collection of blood vessels, nerves, and lymphatic channels called the spermatic cord. During ejaculation, seminal fluid produced by the prostate gland, which mixes with sperm from the testes to form semen, which then is ejaculated from the penis.
Vasectomy- the ultimate male contraceptive Part 2
Vasectomy may also be a good alternative for a couple where the female may be unable to take the oral contraceptive pill. Before undertaking vasectomy, it is most important to discuss one complication: the failure rate of vasectomy as a contraceptive method.
Pregnancy occurs after a vasectomy in most cases because the couple had sexual intercourse before azoospermia (absent sperm) was documented by two separate semen samples. Despite the importance of verifying the lack of sperm in the semen after vasectomy, many patients do not comply with the instructions for semen analysis.
Also for patients who still desire children, vasectomy is not the choice of contraception. Unlike the past 50 years where only women took part in birth control, vasectomy is now being selected as more permanent form of birth control for many couples.
Pregnancy occurs after a vasectomy in most cases because the couple had sexual intercourse before azoospermia (absent sperm) was documented by two separate semen samples. Despite the importance of verifying the lack of sperm in the semen after vasectomy, many patients do not comply with the instructions for semen analysis.
Also for patients who still desire children, vasectomy is not the choice of contraception. Unlike the past 50 years where only women took part in birth control, vasectomy is now being selected as more permanent form of birth control for many couples.
Vasectomy- the ultimate male contraceptive Part 1
Vasectomy is among the most reliable and cost-effective methods of contraception. Today it is the third most common used method of contraception and used by more than 10% of couples. It is fast overtaking oral contraceptives as a method of birth control.
Vasectomy is a small surgical procedure that cuts off the tubes (vas deferens) that are vital in sperm delivery to the testes; it is generally performed as a form of male contraception. The procedure is commonly performed and may take anywhere from 20-60 minutes and has relatively few complications.
More important, the sexual function (erection, ejaculation) of the penis is not changed. Close to half a million vasectomies are performed annually in the United States.
A vasectomy is an option for males who want permanent sterility. It is more effective as a contraceptive than the birth control pill, condoms, IUDs and other creams. Women have tubal ligation as a comparable procedure.
Tubal ligation is easy to do but very difficult to reverse.
Vasectomy is a small surgical procedure that cuts off the tubes (vas deferens) that are vital in sperm delivery to the testes; it is generally performed as a form of male contraception. The procedure is commonly performed and may take anywhere from 20-60 minutes and has relatively few complications.
More important, the sexual function (erection, ejaculation) of the penis is not changed. Close to half a million vasectomies are performed annually in the United States.
A vasectomy is an option for males who want permanent sterility. It is more effective as a contraceptive than the birth control pill, condoms, IUDs and other creams. Women have tubal ligation as a comparable procedure.
Tubal ligation is easy to do but very difficult to reverse.
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