When it comes to men’s health, the first thought very often goes to the prostate or to problems that appear in old age. This is because even today men tend to turn to doctors when there is something to treat rather than to prevent problems. “Something, however, is slowly changing”, comments Alberto Gheza, urologist and andrologist. Perhaps it is thanks to the gentle push of mothers and fathers, increasingly informed and sensitive, perhaps because of the introduction of vaccination against the main oncogenic strains of papillomavirus (HPV) for preadolescent boys too, or perhaps because of awareness initiatives such as Movember (a term coined from the fusion of moustache and November, used for the annual awareness campaign on prostate and testicular cancer), but the impression is that boys, even very young ones, are more attentive than previous generations both to their physical health and to their sexuality. “A fact that bodes well”, Gheza adds. “A check-up from age 16 onward, in fact, represents an important investment in future well-being, for a more aware and safer sex life and also to learn to preserve one’s fertility”.
When should the first andrological consultation take place?
It is never too early to think about the health of the male urogenital system. Once out of pediatric age, however, the check-up with the urologist/andrologist is today left to the initiative of young men. “There is no longer a moment of checking like the one represented by the medical examination for military service, suspended in the early 2000s”, Gheza recalls. “That is why we must try to build a new awareness”. Between ages 16 and 19, according to the physician, would be a good time to request a consultation with a urologist/andrologist.
Why have an andrological consultation
One of the purposes of the first meeting with the urologist/andrologist is to check the state of health of the urogenital system, to make sure there are no morphological and functional alterations that may have an impact on young people’s lives, including their sex lives. “A phimosis — that is, a narrowing of the opening of the foreskin — or a varicocele — that is, a dilation of some veins at the level of the testicle — can affect the sexual sphere right away and, if not treated, have repercussions that are harder to resolve over time”, Gheza explains. “A phimosis or a short frenulum could cause pain, with difficulty in achieving an erection and in having penetrative intercourse, on which psychological conditions can take hold. An untreated varicocele, on the other hand, increases the risk of male infertility. Fertility may not be an adolescent’s first thought, but treating a condition early, if necessary, could avoid bigger problems in the future, when perhaps one will try to start a family”. It should also be remembered that testicular cancer, although rare, is the most frequent neoplasm in young men.
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The andrological consultation as educational support
The andrological consultation is an educational tool. In all likelihood, moreover, at this age all boys have already begun, or are beginning, to approach sex: they are curious but inexperienced, they may have doubts and questions but be unable to talk about them openly with their parents. “So the physician, an outside and above all competent person, can also have an educational role, providing information both on the risks of sexually transmitted diseases and unwanted pregnancies and on prevention methods, and on good habits for staying healthy over time”. Sexually transmitted diseases too, in fact, can have significant repercussions on general health, on quality of life (sexual and otherwise) and on fertility.
Finally, the physician can explain the lifestyle-related risk factors that can compromise health and sexual performance, giving advice on good protective habits. First of all, avoiding smoking and alcohol, and preferring moderate-intensity aerobic training to high-intensity anaerobic training (such as weightlifting) that weighs on the pelvic floor, prostate and even the testicles.
After the first andrological consultation, are there follow-up checks?
If nothing abnormal emerges from the first consultation and there is no family history of disease, a boy who remains in good health can postpone the next check even by several years. If, on the other hand, there are conditions that require monitoring, for example a varicocele, the physician will recommend checks and instrumental tests (such as ultrasound) at intervals consistent with the clinical picture.
If, over the course of life, difficulties in conceiving should arise, an andrological consultation will make it possible, thanks also to tests such as the semen analysis, to verify the presence of related conditions and take action if necessary.
“We see each other again, finally, after age 50, when prostate changes are considered practically physiological”, Gheza concludes. “A service check, however, is a must”.
