Phimosis (Foreskin Problems)

When boys are first born, their foreskin is tight. Over time it gradually loosens until it can be easily pulled back over the penis head (glans). Phimosis occurs when the foreskin remains unusually tight and cannot be drawn back. Some men can have phimosis throughout their life and are still able to have intercourse, although most would probably find it more comfortable without this condition.

Not being able to pull back the foreskin also means that it is difficult to clean the penis. This increases the chance of infection. Phimosis may also develop later in life, after puberty. It can be caused by thrush infections, which lead to scarring of the penis, or another condition (balanitis xerotica obliterans) that makes the foreskin stick to the penis.

Testicular Cancer

Testicular cancer is cancer that develops in the testicles, which are part of a man's reproductive system.

Although rare, this is the most common cancer in young men, affecting one in 199 men overall. As with any cancer, the cause is unknown, though it is more common in white men aged between 15 – 49 years of age. Almost half of those who get it are under 35.

Testicular cancer is one of the most beatable cancers when detected early. Nearly all men are cured.

Cancer of the Penis (Penile Cancer)

Cancer of the penis, or penile cancer, rarely affects men under 40, and only 1 in 100,000 men overall. It is a potentially fatal condition.

With penile cancer, tumours usually appear on the end of the penis or on the foreskin. Where circumcision is routinely performed, penile cancer is rare. Bacterial production of smegma (a cheese-like substance that can form under the foreskin of the penis) may be a risk factor. Unprotected sexual relations with multiple partners and cigarette smoking are also risk factors.

As with all cancers, penile tumours occur when cells abnormally divide and grow forming a lump. Tumours can be either benign or malignant. Benign tumours do not spread to other parts of the body, although they can press on surrounding organs, affecting their function. Malignant tumours are able to spread beyond their original site. Sometimes cells break off and travel in the bloodstream or lymphatic system to other organs in the body, growing new tumours there.

Testicular Torsion

Testicular torsion is something that 1 in 4000 men under the age of 25 experience every year. It occurs due to the rotation and twisting of the testicle. This causes swelling and eventually cuts off the blood supply to the testicle.

Testicular torsion is an emergency condition and can threaten the life of the organ. 

Male Infertility

Infertility is the inability to produce children after at least one year of unprotected intercourse. About one in seven couples have difficulty getting pregnant, and male infertility is the cause in a quarter of cases.

That means that around one man in twelve has some kind of fertility problem. The main reason for male infertility is not producing enough healthy sperm.

On average, about 50-500 million sperm are ejaculated during orgasm. However, only a few hundred make it as far as the egg. Therefore, if the number of sperm is too little, or if they are defective, the chances of a healthy sperm fertilising the egg are much slimmer.

Erectile Dysfunction

Erectile dysfunction (ED) is the persistent or recurrent inability to achieve or maintain an erection sufficient for sexual activity. It is sometimes known as 'impotence'.

It's a very common problem, particularly affecting men past the age of 40, and around 1 in 10 men overall.

ED can be triggered by psychological issues such as depression, stress or relationship difficulties. However, in about 75% of cases of ED, the cause is physical. Most men with ED have a combination of physical and psychological causes.

Priapism

Priapism is the medical term for a persistent erection that lasts at least 4 hours. It is usually painful, and may not be related to sexual stimulation or activity. Left untreated, it can cause lasting damage to the penis.

During a normal erection, blood flows into the penis and is kept there because the veins become compressed by the swollen muscles.

After ejaculation, hormones make the arteries get narrower, which releases the pressure on the veins, so that the blood can drain out again. With priapism, this doesn't always happen.

Peyronie's Disease

Peyronie's disease causes scar tissue, or a hard lump, to form inside the penis. The cause is not really known, though trauma (such as hitting or bending) of the penis may be involved.

In most cases, the hardened scar tissue can make the penis less flexible, cause pain and force the penis to bend or arc during erection. In severe cases, this pain, bending and associated emotional distress can cause impotence and make sexual intercourse difficult or even impossible.

Peyronie's disease occurs in about 1% of men, and is most common in middle-age, although it can also affect young and elderly men. Some men with the disease develop scar tissue and hardened cells in other elastic tissues of the body, such as the hand or the foot.

Varicoceles

A varicocele is a varicose vein above the testicles. All veins have valves inside them that keep the blood moving in one direction. With varicose veins, these valves have failed and blood can pool, eventually making the veins bulge.

Blood in the body is cooled as it moves through the veins back to the heart. If it sits in one place, the temperature of the blood increases. Therefore, in the testes, if the temperature of the blood increases because of varicoceles, male fertility can be reduced.

Sperm are sensitive to heat, and high temperatures can interfere with the production of sperm. Not all men with varicoceles are infertile. Approximately 10-15% of men develop a varicocele during their lifetime.

Blood in Semen

Haematospermia is a condition that refers to the presence of visible blood in ejaculate (semen); it can range from completely red to blood-tinged. This is different from blood seen when passing urine (referred to as haematuria).

Although alarming, the most common causes are due to low-grade infection or inflammation. It is also commonly seen following urological procedures such as prostate biopsy, vasectomy and radiotherapy. A large proportion of patients will not have an obvious cause identified. Reassuringly, symptoms will frequently resolve on their own requiring no need for specific medical or surgical treatment.

Hydrocele

A hydrocele is a collection of fluid around the testicle beneath its outer covering. In adults, this occurs because the outer covering produces more fluid than it absorbs. Usually this isn’t caused by anything, but sometimes it is a response to something happening to the testicle itself, such as infection or injury.

Hydroceles can also occur in new born boys. When a child is developing in the womb, the testicles develop within the abdomen. The testis descend through the groin into the scrotum early in life. A hydrocele occurs when the passage from the abdomen to the scrotum does not close fully, allowing fluid from the abdomen to collect in the scrotum.

Cystitis

What is cystitis? 

Cystitis is another term for bladder inflammation. It’s often used when referring to a bladder infection, which happens when bacteria get into the bladder through the urethra, which is the opening where urine comes out. It’s more common in women, likely because the anus and female urethra are closer together.

But men can and do get cystitis occasionally. Read on to learn how to recognize the symptoms of cystitis and how this infection is treated.

What are the symptoms of cystitis in men? 

The symptoms of cystitis aren’t that different between the sexes.

You may notice:

• a frequent urge to urinate, even if you just did

• tingling or burning while urination

• frequent urination, with only small amounts coming out

• difficulty urinating

A more severe infection may also cause:

• bloody urine

• cloudy or smelly urine

• pelvic discomfort

• fever

• fatigue

See a doctor right away if you experience these symptoms of a more severe infection.

What causes cystitis in men? 

There are several types of cystitis, each with different causes:

• Bacterial cystitis. This is caused by a bacterial infection.

• Interstitial cystitis. Interstitial cystitis, sometimes called painful bladder syndrome, refers tolong-term inflammation of your bladder. It’s much more common in women, but it can affect men, too.

• Drug-induced cystitis. Your urinary system helps to flush out toxins and other unwanted substances. The filtered remains of some medications as they leave your body can inflame your bladder. This is particularly common with chemotherapy drugs, such as cyclophosphamide (Cytoxan) and ifosfamide (Ifex).

• Radiation cystitis. Radiation therapy in your pelvic region can also cause bladder inflammation.

• Foreign-body cystitis. Using a catheter in your urethra for a long period of time can introduce infectious bacteria into your urethra or damage urethral tissue. This makes you more prone to infection.

• Chemical cystitis. Exposure to certain chemicals in everyday products, such as heavily fragranced soaps or shampoos, can result in allergic reactions that cause inflammation.

Male genital skin conditions

Sexually Transmitted Diseases 

What are sexually transmitted diseases (STDs)?

Sexually transmitted diseases (STDs) are infections transmitted during sexual contact. STDs are often referred to as sexually transmitted infections (STIs). STDs can be transmitted during any type of sexual activity.

What are warning symptoms and signs of STDs in men?

In men, STDs can be grouped into three categories:

• STDs that predominantly cause genital lesions (sores or abnormalities on the genital organs)

• STDs that predominantly cause inflammation of the urethra (urethritis)

• STDs that cause symptoms and signs throughout the body (systemic STDs)

Some of the STDs that cause local lesions or urethritis, including gonorrhoea and syphilis, can also cause damage to other organs and spread within the body if not treated.

Depending upon the exact infection, STDs that cause genital lesions may cause:

• genital warts,

• painful blisters, or

• ulcers.

STDs that cause urethritis cause early signs and symptoms often associated with a urinary tract infection, including:

• painful or burning sensation during urination and

• discharge from the urethra.

The section below reviews the specific signs and symptoms of eight common STDs.

How do men get STDs?

• STDs can be caused by different kinds of microorganisms, including viruses, bacteria, and parasites.

• Sexually transmitted viral infections include human papillomavirus (HPV), human immunodeficiency virus (HIV), herpes simplex virus (HSV), hepatitis B and C, and human herpesvirus-8 (HHV-8).

• Sexually transmitted bacterial infections include syphilis, gonorrhea, and chlamydia.

• Trichomonas is an example of a sexually transmitted infection caused by a parasite. Infestations with parasitic bugs, such as lice or scabies, can also be transmitted by close contact and may be acquired during sexual activity.

• Humans contract the Zika virus through the bite of an infected vector mosquito, and the Zika virus can be transmitted to others through sexual contact.

Who is at risk for contracting an STD?

Anyone who engages in any kind of sexual activity is at risk for STDs. The only way to eliminate the risk of acquiring an STD is abstinence from sexual activity. The use of latex condoms during sexual contact can greatly reduce the chances of contracting many STDs, but no method is completely safe.

1. Chlamydia

Chlamydia is a bacterial infection that is common in young adults who are sexually active. It is caused by the bacterium Chlamydia trachomatis. Both men and women can be infected, and many of those infected do not have any signs or symptoms.

When it does cause symptoms in men, symptoms of urethritis are the most common. It can also cause infection of the epididymis and testes.

2. Gonorrhea

Like chlamydia, gonorrhoea is a bacterial infection that may not always cause signs and symptoms and can remain undiagnosed. Also similar to Chlamydia, gonorrhoea can cause urethritis in men, leading to burning or pain on urination and discharge from the urethra.

Gonorrhoea is caused by Neisseria gonorrhoeae bacteria, and when symptoms do occur, they develop about 4-8 days after contracting the infection. Gonorrhoea can also cause infection in the rectum and in the throat. Moreover, it is possible for gonorrhoea to spread within the body, causing symptoms like rash and joint pain.

3. Trichomoniasis

Trichomoniasis is a sexually transmitted infection caused by the Trichomonas vaginalis parasite. Most women and men who are infected do not have symptoms, and as with chlamydia and gonorrhoea, may not know they are infected. When the infection does cause symptoms, it typically results in urethritis, with itching or burning and discharge from the urethra.

4. HIV

The human immunodeficiency virus (HIV) is perhaps the most feared STD. Infection with the HIV virus can occur during sexual contact, by sharing needles, or from an infected pregnant woman to her baby. The virus ultimately causes dysfunction of the body's immune system at a later time point. The average time from infection to immune suppression is 10 years.

No specific symptoms signal HIV infection, but some people develop fever and a flu-like illness 2 to 4 weeks after they have contracted the virus. Once immune suppression is present, serious complications like unusual infections, certain cancers, and dementia may develop. Numerous medications are available to help affected people manage the infection and delay or prevent progression of the illness.

5. Genital herpes

The herpes simplex viruses (HSVs) cause painful blistering sores on sexually exposed areas of the body. They can be transmitted during any type of sexual contact. Typically, the HSV type 1 (HSV-1) causes cold sores around the mouth, while the HSV type 2 (HSV-2) causes genital herpes, but both types of HSV are capable of infecting the genital area. Like some other STDs, it is possible to become infected with HSV and have very mild symptoms or none at all. Even when symptoms have occurred in the past, it is possible to transmit the infection during any period in which symptoms are not present.

The lesions caused by HSV typically take the form of painful blisters that eventually open, forming ulcers, and then crust over. In men, the sores can be found on the penis, scrotum, buttocks, anus, inside the urethra, or on the skin of the thighs. The first outbreak of HSV infection may be more severe than subsequent outbreaks and can be accompanied by fever and swollen lymph nodes.

7. Hepatitis B and C

Hepatitis is inflammation of the liver. Hepatitis B and hepatitis C are two viral diseases that can be transmitted by sexual contact. Both the hepatitis B virus (HBV) and hepatitis C virus (HCV) are transmitted by contact with the blood of an infected individual or by sexual activity, similar to the HIV virus.

HBV may not cause symptoms, but it causes symptoms of acute hepatitis in about 50% of infections. The primary danger with HBV infection is that around 5% of those infected progress to have long-term liver damage, or chronic hepatitis B. People with chronic hepatitis B are at increased risk for the development of liver cancer. 

Unlike HBV, HCV is rarely transmitted by sexual contact and is usually spread by contact with the blood of an infected person. Still, it is possible to transmit this virus as a result of sexual contact. Most people infected with HCV have no symptoms, so a delayed or missed diagnosis is common. In contrast to hepatitis B, most people with HCV infection (75%-85% of people infected) develop chronic infection with the possibility of liver damage. 

6. Genital warts (HPV)

Human papillomavirus infection (HPV) is a very common STD. Different types of HPV exist and cause different conditions. Some HPVs cause common warts that are not STDs, and other types are spread during sexual activity and cause genital warts. Still other types are the cause of precancerous chances and cancers of the cervix in women.

Most people with HPV infection do not develop genital warts or cancers, and the body is often able to clear the infection on its own. It is currently believed that over 75% of sexually active people have been infected at some point in life. When HPV causes genital warts in men, the lesions appear as soft, fleshy, raised bumps on the penis or anal area. Sometimes they may be larger and take on a cauliflower-like appearance.

8. Syphilis

Syphilis is a bacterial infection caused by Treponema pallidum bacteria. If not treated, the disease progresses through three phases and can also persist in a latent state. The initial manifestation is a painless ulcer known as a chancre at the site of sexual contact. The chancre develops 10-90 days after infection and resolves after-to 6 weeks.

9. Zika virus

The Zika virus has been associated with birth defects in babies born to infected mothers. Transmission of Zika virus occurs among humans by the bite of an infected vector mosquito. However, sexual transmission of the Zika virus is also possible, and an infected individual may spread the virus to his or her sex partners.