Controversies in male adolescent health: varicocele, circumcision, and testicular self-examination

Factors associated with testicular self-examination among unaffected men from multiple-case testicular cancer families

Background

The lifetime testicular cancer (TC) risk in the general population is relatively low (~1 in 250), but men with a family history of TC are at 4 to 9 times greater risk than those without. Some health and professional organizations recommend consideration of testicular self-examination (TSE) for certain high-risk groups (e.g. men with a family history of TC). Yet little is known about factors associated with TSE behaviors in this at-risk group.

Methods

We collected information on this subject during an on-going NCI multidisciplinary, etiologically-focused, cross-sectional Familial Testicular Cancer (FTC) study. We present the first report specifically targeting TSE behaviors among first- and second-degree relatives (n = 99) of affected men from families with ≥ 2 TC cases. Demographic, medical, knowledge, health belief, and psychological factors consistent with the Health Belief Model (HBM) were evaluated as variables related to TSE behavior, using chi-square tests of association for categorical variables, and t-tests for continuous variables.

Results

For men in our sample, 46% (n = 46) reported performing TSE regularly and 51% (n = 50) reported not regularly performing TSE. Factors associated (p < .05) with regularly performing TSE in multivariate analysis were physician recommendation and testicular cancer worry. This is the first study to examine TSE in unaffected men from FTC families.

Conclusion

The findings suggest that, even in this high-risk setting, TSE practices are sub-optimal. Our data provide a basis for further exploring psychosocial issues that are specific to men with a family history of TC, and formulating intervention strategies aimed at improving adherence to TSE guidelines.

Décalottage ou circoncision : quelle indication dans le phimosis ?

Phimosis remains a major question for mothers and induces a high number of consultations. However, large epidemiologic series have shown that congenital phimosis may disappear spontaneously in around 80% of cases with development and should'nt need any treatment before the age of five or six years old. Theses elements go against sociocultural habits which induce many circumcisions before the age of six. Corticoid treatment of phimosis seems to be very efficient to facilitate the disparition of phimosis. The aim of this literature review is to evaluate medical, socioeconomical and therapeutics aspects of phimosis. Based on these data, we recommend never to treat phimosis before the age of one year old, to wait as long as possible for spontaneous evolution of phimosis until the age of five years old, and, in case of non evolution of congenital phimosis or pathologic phimosis to use as first step treatment corticoid topics rather than surgical treatment.

Genitourinary issues in the male college student: a case-based approach

Five percent of all ambulatory visits by men 18 years of age or older include genitourinary symptoms as a reason for the visit. In this article, using typical, unusual, or otherwise instructive cases, the authors review a select group of genitourinary issues in the college-age male. Warts (human papilloma virus), is the most common sexually transmitted infection, and it may mimic other disease. Testicular cancer is one of the most serious diseases to confront health care providers. Varicoceles are the most common scrotal mass. Urethritis is a common presentation of sexually transmitted infection in the young adult male. Acute prostatitis is an unusual condition in the young adult, but it is easily treatable. Sexual dysfunction causes great distress in the young adult, but a systematic approach usually leads to a treatable psychological or environmental cause. With understanding of these medical conditions, the practitioner should feel comfortable addressing the most challenging genitourinary health needs of this population.