Men’s Health

On average, men die earlier than women, live unhealthier lives, and see doctors less often. One in two men dies from cardiovascular disease, and the incidence of cancer is higher in men than in women. Most of what men know about health they learned through their partners. Many men keep quiet about their ailments. Often the fear of a bad diagnosis at the doctor is even so great that “man” prefers not to go at all. In the following, diseases are described under “male genital system”, which are assigned to this category according to ICD-10 (N40-N51, N62). The ICD-10 is used for the International Statistical Classification of Diseases and Related Health Problems and is recognized worldwide.

Male genital system

The male genital organs (organa genitalia masculina) are divided into primary and secondary sexual characteristics. The primary sexual characteristics are used for reproduction. The secondary sexual characteristics develop during puberty. They signal sexual maturity. For the sake of completeness, the secondary sexual characteristics are also listed below, but are not discussed in further detail here. Primary sexual characteristics of the male

External sexual organs

  • Penis
  • Scrotum

Internal sex organs

  • Testis
  • Epididymis (epididymis)
  • Vas deferens (ductus referens)
  • Sex glands
    • Seminal vesicle (vesicula seminalis)
    • Prostate (prostate gland)
    • Cowper glands

Secondary sexual characteristics of the male

  • Male body appearance – broad shoulders, narrow hips.
  • Vocal change
  • Increased body hair – chest, abdomen, back, armpits, pubic area, beard growth.
  • Increased buildup of muscles

Anatomy

PenisIt is a corpus cavernosum that fills with blood and becomes erect (stiff) when excited. It can be divided into the root of the penis (radix penis), the body of the penis (corpus penis) and the glans penis (glans penis). TestisThe testes (testis) are located in the scrotum, the scrotum. They are arranged in pairs and are ovoid in appearance. One testis is about 4 to 5 cm long and 3 cm thick. The left testicle is often slightly larger and lies deeper in the scrotum. EpididymisThe epididymis is attached to the testicles. In an adult, they are each 5 to 6 cm long. Vas deferensEach epididymis has a vas deferens (duct). It is the continuation of the epididymal duct (ductus epididymidis). The vas deferens unites with the excretory duct of the seminal vesicle to form the spurting duct and opens into the urethra. Sex glands

  • Seminal vesicle: it is paired, about 5 cm long and located between the urinary bladder and rectum.
  • Prostate: the prostate is located just below the urinary bladder, in front of the rectum, and surrounds the urethra (urethra). It is about the size of a chestnut and consists of about 30-40 individual glands. The excretory ducts of these glands open into the urethra.
  • Cowper glands: they are also paired, but only pea-sized. They are located below the prostate gland.

Physiology

PenisThe urine is excreted through the urethra that runs in the penis. In the event of sexual intercourse, the penis serves to transfer sperm to the internal sex organs of the female. TestesThe testes are the male gonads. Sperm are produced in the testes and pass from there to the epididymis.The male sex hormone testosterone is also synthesized (formed) in the testes. EpididymisThe sperm cells mature into sperm in the epididymis and are stored there until the next ejaculation. Vas deferensDuring orgasm, sperm are released from the epididymis through the vas deferens into the urethra. Through peristaltic (wave-like) movements, the vas deferens direct sperm from the ductus epididymidis (epididymal duct) into the ductus ejaculatorius (spurting duct). Sex glands

  • Seminal vesicle: they secrete a slightly alkaline (basic) secretion into the vas deferens. This neutralizes the acidic environment of the urethra and female abdomen.Other components of the secretion such as fructose (fruit sugar) and prostaglandins (hormones) keep the sperm mobile and ensure that the sperm have enough energy to travel the distance to the egg.
  • Prostate: as an exocrine gland, the prostate produces a slightly acidic secretion (prostatic secretion) that protects the sperm and gives the ejaculate a fluid consistency. If orgasm occurs, the sperm and the secretion mix in the prostate. By contraction (contraction) of the prostate, the ejaculate (ejaculation) is pressed out through the urethra.
  • Cowper glands: during sexual arousal, they release the so-called “pleasure drop”, an alkaline (basic) secretion, into the urethra. This neutralizes urine residues in the urethra. In addition, the secretion makes the urethra and the end of the penis more slippery.

Common diseases of the male genital system

  • Balanitis (inflammation of the glans).
  • Benign prostatic hyperplasia (benign enlargement of the prostate).
  • Epididymitis (inflammation of the epididymis)
  • Erectile dysfunction (erectile dysfunction).
  • Testicular malignancies (testicular tumors)
  • Testicular pain
  • Hydrocele (water hernia)
  • Impotence
  • Infectious diseases – gonorrhea (gonorrhea), syphilis.
  • Maldescensus testis (undescended testis)
  • Orchitis (inflammation of the testicles)
  • Phimosis (narrowing of the foreskin)
  • Prostate carcinoma (prostate cancer)
  • Prostatitis (inflammation of the prostate)
  • Male sterility

The main risk factors for diseases of the male genital system

Behavioral causes

  • Diet
    • Micronutrient deficiency
  • Consumption of stimulants
    • Alcohol consumption
    • Tobacco consumption
  • Physical inactivity
  • Psycho-social situation
    • Stress
  • Overweight
  • Increased waist circumference (abdominal girth; apple type).
  • Mechanical/chemical irritation
  • Excessive hygiene (“overtreatment”), as well as lack of hygiene.

Disease-related causes

Medication

X-rays

  • Radiatio (radiotherapy)

Environmental pollution – intoxications (poisonings).

  • Overheating of the testicles
  • Environmental toxins (occupational substances, environmental chemicals) such as solvents, organochlorines, pesticides, herbicides.

Please note that the enumeration is only an extract of the possible risk factors. Other causes can be found under the respective disease.

The main diagnostic measures for diseases of the male genital system

Laboratory Diagnostics

  • Urine culture (pathogen detection and resistogram, i.e., testing of appropriate antibiotics for sensitivity/resistance).
  • Urine status (rapid test for: pH, leukocytes, nitrite, protein, glucose, ketone, urobilinogen, bilirubin, blood), sediment.
  • Inflammatory parameters – CRP (C-reactive protein).
  • Spermiogram (sperm cell examination)
  • PSA (prostate specific antigen)
  • Prostate biopsy (tissue sample from the prostate) by sonographically guided prostate biopsy (ultrasound-guided prostate puncture).

Medical device diagnostics

  • Scrotal sonography (ultrasound examination of the scrotal organs/testis and epididymis and their vasculature).
  • Transrectal prostate sonography – imaging of the prostate through the rectum, i.e. the ultrasound probe is inserted through the anus (anus) into the rectum (rectum)
  • I. v. pyelogram (synonyms: IVP; i. v. urogram; urogram; i. v. urography; excretory urography; excretory pyelogram; intravenous excretory urogram; radiographic imaging of the urinary organs or urinary tract system).
  • Diaphanoscopy (fluoroscopy of body parts through an attached light source; here: Scrotum (scrotum)) – to distinguish scrotal hernia (testicular hernia) and hydrocele (hydrocele).
  • Computed tomography (CT) of the abdomen (abdominal CT).
  • Magnetic resonance imaging of the pelvis (pelvic MRI).
  • Scintigraphy (imaging nuclear medicine procedure) – to assess testicular perfusion (testicular blood flow).
  • Urethrocystoscopy (urethral and bladder endoscopy).

Which doctor will help you?

For diseases of the male genital system should usually consult a urologist.