MANday: Why a Urological Wellness Exam Is Important For Young Men

Men, aged 25-35 years and in the prime of life, are commonly considered immune from most health risk factors (i.e. prostate) that impact older men. Therefore, a general medical exam, barring occupational or insurance reasons, would likely be deferred until much later. This immunity is a common misconception, especially with urological conditions. Young men can often have undiagnosed conditions that may cause infertility or an early death.

This group has a higher risk for testicular cancer. Out of 8000 new testicular cancers diagnosed in 2013, ~12% presented with advanced metastatic disease. Delays in diagnosis can lower 5-year survival rates from 99% for cancer inside the testis to 74% for metastatic disease. Regular Testicular Self-examination (TSE), as recommended for early detection of testicular cancer (TC) by the American Cancer Society, can be correctly and safely taught at the wellness exam.

TSE can also detect scrotal varicoceles that can disrupt young men’s fertility and Testosterone. Varicoceles, present in 15% of men since puberty, are dilated veins that abnormally heat the testicles. Prolonged raised testicular temperature kills germ cells that produce sperm, reduces testicular size, damages sperm DNA, and decreases Testosterone production. Diagnosis is made by physical exam and confirmed by ultrasound.  

Finally, common sexually transmitted infections (STI’s), such as Genital Herpes and genital warts, are often overlooked and may lie concealed until a physical wellness check. Herpes is often asymptomatic or may present initially as a rash or jock itch. Genital warts, caused by the Human Papilloma Virus (HPV), are often overlooked as harmless bumps or skin tags, but they pose a serious risk of causing penile cancer in men and cervical cancer in women. An evaluation of risk factors during the wellness exam will also guide further testing for other asymptomatic STI’s, such as Chlamydia and HIV, that can impact the fertility and lifespan of young men. 

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Clavijo, R. I., Carrasquillo, R., & Ramasamy, R. (2017). Varicoceles: prevalence and pathogenesis in adult men. Fertility & Sterility, 108(3), 364–369. https://doi-org.ezp.twu.edu/10.1016/j.fertnstert.2017.06.036

Fadich, A., Giorgianni, S. J., Rovito, M. J., Pecchia, G. A., Bonhomme, J. J., Adams, W. B., Stephenson, C. L., Mesa-Morales, F. E., & Sparkes, J. S. (2018). USPSTF Testicular Examination Nomination-Self-Examinations and Examinations in a Clinical Setting. American journal of men’s health12(5), 1510–1516. https://doi.org/10.1177/1557988318768597

Huang, I.-S., Wren, J., Bennett, N. E., & Brannigan, R. E. (2018). Clinical Consultation Guide on Imaging in Male Infertility and Sexual dysfunction. European Urology Focus, 4(3), 338–347. https://doi.org/10.1016/j.euf.2018.09.018

Rovito, M. J., Manjelievskaia, J., Leone, J. E., Lutz, M., Cavayero, C. T., & Perlman, D. (2018). Recommendations for Treating Males: An Ethical Rationale for the Inclusion of Testicular Self-Examination (TSE) in a Standard of Care. American journal of men’s health12(3), 539–545. https://doi.org/10.1177/1557988315620468

Andre Piliszek is a certified Family Nurse Practitioner (FNP-C) and brings to The Y Factor over 25 years of outpatient clinical experience as a certified DOT medical examiner, Nurse, Medical Assistant, and Radiographer.

In 1992, Andre graduated from Houston Baptist University earning a Bachelor of Science degree with a double major in Chemistry and Biology. He then graduated with honors from Texas Chiropractic earning a Doctorate of Chiropractic (DC) degree in 2007. During this time, he was also inducted into the Omega Psi Honor Society. In 2011, Andre also graduated with honors from Hardin Simmons University earning an additional Bachelor of Science degree with a major in Nursing (BSN). In 2020, he then graduated from Texas Woman’s University earning a Master of Science degree (MSN) with a specialization in the Family Nurse Practitioner tract. He was also recently inducted into the Society for Collegiate Leadership & Achievement honor society.

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