Male Reproductive Health Problems - Research Paper Example

Problems of Male Reproductive Health: State of Knowledge and Research Abstract Male reproductive health is an important health problem although it does not receive as much attention compared to the other health problems from the United States Centers for Disease Control and Prevention. Nevertheless, thousand of studies have been made on the subject. This work reviews 16 of the latest studies on benign prostatic hyperplasia, prostrate cancer, prostatitis, and erectile dysfunction. Overall, there is an optimistic note: there is prospect for developing a vaccine on prostrate cancer, the stigma associated with prostatitis will probably be completely eliminated, and management of erectile dysfunction will likely significantly improve. However, the prospects are not clear for benign prostatic hyperplasia. Problems of Male Reproductive Health: State of Knowledge and Research I. Introduction Male reproductive health is an important but inadequately attended health problem in the United States. While the official website of the United States Center for Disease Control and Prevention (CDCP) devotes significant attention to male infertility, attention has been inadequate on benign prostatic hyperplasia, prostate cancer, prostatitis, and erectile dysfunction. In contrast, the CDCP has been enough on “global reproductive health,” infertility, maternal and child health, pregnancy risks, refugee reproductive health, teen pregnancy, unintended pregnancy, and women’s reproductive health. What is the current state of knowledge of medical science on male reproductive health? What are some of the findings of current research? This is the scope of inquiry of this paper. The goal is to define what the future will be like in managing male reproductive health problems. We focus on benign prostatic hyperplasia, prostate cancer, prostatitis, and erectile dysfunction. The ailment benign prostatic hyperplasia is characterized by moderate-to-severe lower urinary tract infection and the pathogenesis takes place in comorbidity (McVary, 2006, p. S122). Treatments may include surgery but non-surgical therapy methods are available using α1-AR antagonist medical therapy (McVary, 2006, p. S124). Diagnosis for benign prostatic hyperplasia includes checking for lower urinary tract symptoms (McVary, 2006, p. 124): urgency, frequency nocturia, incomplete bladder emptying, and weak urine stream. Mortality from prostate cancer has been increasing since 1985 (Heidenriech, 2006, p. 6). Prostate cancer is the most common malignancy among males (Heidenriech, 2006, p. 6). Prostate cancer is usually in the peripheral zone of the prostate and may be detected by digital rectal examination (DRE) when the volume is about 0.2ml or even larger (Heidenriech, 2006, p. 6). There is a table for prostate specific antigen level (PSA) and risk for prostate cancer in Heidenriech (2006, p. 11). For example, in the said table, a PSA level of 4-10 ng/mL indicate a positive predictive risk value of 41%. Further, the predictive value of diagnostic procedures currently in use for screening population ranges from 20 to 80% (2006, p. 12). According to Wagenlehner et al. (2009, p. 175), prostatis is a “multifactorial condition of unknown etiology” affecting 10% of men. The origin of the disease can be bacterial or non-bacterial but the latter is only 7% of the cases (Wagenlehner et al., 2009, p. 175). The symptoms of prostates include inflammatory as well as non-inflamatory pelvic pain. Other symptoms are present, depending on the specific type of prostatitis (Wagenlehner, 2009, p. 176-182). Erectile dysfunction is one of the two most prevalent complaints in male sexual medicine (Hatzimouratidis, 2010, p. 1). Around 5-20% of the men have moderate to severe erectile dysfunction (Hatzimouratidis, 2010, p. 1). Diagnosis use of questionnaires and assessment of “intravaginal latency time” (Hatzimouratidis, 2010, p. 1). II. Current research As of 14 October 2010, in the official website of the US National Library of Medicine, National Institute of Health, there are 18,882 articles or reviews related to benign prostatic hyperplasia, 89,303 for prostate cancer, 5,161 for prostatitis, and 15,981 for erectile dysfunction. These figures indicate that scientific community has considered the ailments very important enough despite the lackluster attention that the CDCP has been giving into male reproductive health ailments. The following is a sample of a few of the latest research. Benign prostatic hyperplasia. Park et al. (2010, p. 691) found that holmium laser enucleation of the prostate (HoLEP) therapy is effective and safe regardless of the size of the prostate. In their experiment, the mean age subjected to the therapy was 69 years old and operation time was from 20 to 208 minutes (Park et al., 2010, p. 691). Choi et al. (2010, p. 557) investigated the effects of transurethral resection (TURP) on erectile dysfunction for patients with benign prostatic hyperplasia and found that there is significant decrease in erectile dysfunction three months after the TURP. At the same time, however, they found that there is no significant change in erectile dysfunction six months after TURP (Choi et al., 2010, p. 557). McVary (2006, p. S122) reported that published data pointed out that affects about one-third of males in their 60s and one half of males 80 years old and above.. McVary revealed (2006, p. S122) that although benign prostatic hyperplasia can be treated effectively, the ailment often occurs in comorbidities with cardiovascular diseases, hypertension, and erectile dysfunction. McVary also revealed (2006, p. S122) that although treatments have been beneficial in addressing benign prostatic hyperplasia, they have side-effects. Norman (2006, p. 66) reported that alpha-blockers and 5-alpha reductase inhibitors are the two types of drugs commonly use for benign prostatic hyperplasia. Prostate cancer. Brawley et al. (2009, p. 264) reported that methods are now available to assess a man’s risk for prostate cancer and there are tools that “integrate multiple risk factors”. One man out six will be affected by prostate cancer in his lifetime in the United States (Brawley et al., 2009, p. 264). Brawley et al. (2009, p. 265) that the incidence of prostate cancer among blacks in the United States is consistently higher from 1975 to 2005. Leibowitz et al. (2009, p. 1) assess the effect of using high-dose testosterone-replacement therapy for the treatment of prostate cancer and found the treatment typically decreased prostate-specific antigen (PSA) progression among survivors. They found that patients are able to remain on the therapy for several years without the worsening the disease (p. 1). In approximately 40% of the survivors who had used the therapy, the level of prostate-specific antigen did not increase (Leibotwitz et al., 2009, p. 3). Taira et al. (2010, p. 71) assessed the performance of transperineal template-guided mapping biopsy in detecting prostate cancer and found that it has a high detection rate of 75.9% on initial biopsy. In contrast, tranrectal ultra (TRUS) biopsy is unable to detect about 20-30% of clinically significant cancers. Prostatitis. Kim et al. (2010, p. 426) assessed the risk factors for acute prostatitis after transrectal biopsy of the prostate and found that the incidence for acute prostatitis after the biopsy is only 2.0% and in almost all cases were probably caused by fluoroquionolone-resistant E. coli. The authors stressed the importance of cleansing before biopsy. Pioversan et al. (2009, p. 1049) investigated the correlation between asymptomatic prostatitis and prostate specific antigen (PSA) density and found that abnormal PSA density need not be attributed to prostatitis. Wagenlehner et al. (2009, p. 175) reviewed the literature and concluded that prostatitis has a tendency to become chronic and emphasized the need for patients to be informed on this risk. Cheng et al. (2010, p. 1) asserted based on their empirical study that the correlation between prostatitis and sexually transmitted disease is inconclusive, contradicting earlier studies. Erectile dysfunction. Washington & Shindel (2010, p. 169) studied the use of once-daily dose of tadalafil for erectile dysfunction and concluded that even if the treatment is not optimal for every patient, tadalafil is the first treatment for erectile dysfunction approved for daily use. Tadalafil is good because it expanded “our capacity to care for men with ED in a novel and unprecedented direction” (Washington & Shindel, 2010, p. 169). Emarah et al. (2010, p. 1047) confirmed that we can predict penile arterial vascular status among those with erectile dysfunction. III. Ongoing research Research continues on male reproductive health. We cover those which are among the most significant. Benign prostatic hyperplasia. Based on the official website of the US National Library of Medicine’s National Institutes of Health, some of the ongoing studies on benign prostatic hyperplasia pertain to the use of surgical techniques in laparoscopic extraperitoneal adenomectomy. In August 2010, the official website of the John Hopkins Medicine has offered awards of up to US$50,000 for research related to benign prostatic hyperplasia and it is expected that results will be available from research funded by the John Hopkins grants after a few years. The latest from the official website of Frost & Sullivan, a non-profit research institute believes that current research on benign prostatic hyperplasia has shifted its focus from symptom relief to disease management in treating benign prostatic hyperplasia. Prostate cancer. Meanwhile, in the case of prostate cancer, the official website of the US National Library of Medicine’s National Institutes of Health reported that many groups are doing research on the use of cancer vaccines to address prostate cancer. According to the official website of the US National Library of Medicine’s National Institutes of Health, the use of vaccines was raised as a result of developments in characterizing tumor-related antigens. According to the NIH, researchers see the use of vaccines highly possible given the “relative indolence” of prostate cancer. According to the NIH, the “relative indolence” of prostate cancer provides time for the body to generate immune response. According the NIH, the benefits and dangers of prostate-specific antigen screening for prostate cancer are continually being investigated. On the other hand, since 16 September 2010, through its official website (cancer.net), the American Society of Clinical Oncology identified the following to be the direction of their research on prostate cancer: 1) Correlation among nutrition, lifestyle, and prostate cancer; 2) Improving current tests for prostate cancer; 3) Developing better surgical techniques; 4) Developing shorter treatment schedule; 5) The use of high-intensity focused ultra-sound for the treatment of prostate cancer; 6) Improving tests that evaluate the success of treatment on prostate cancer; and 7) Therapy techniques for advanced prostate cancer. Prostatitis. The official website of the US National Library of Medicine’s National Institutes of Health reported that the Chinese scientists are studying nonobacteria as a possible etiology for type III prostatitis. The official website also reported that the etiology of the disease “remains poorly understood” even if the subject has been the focus of many studies. The official website of the Prostatitis Foundation (prostitis.org) indicates that among the most important of ongoing research in prostatitis are on the following: 1) a John Hopkins Foundation-funded research that indicates that about 95% of prostatitis are non-bacterial; and 2) Multidisciplinal or “broader” approaches to the study of prostatitis based on the initiative of the United States Institute of Diabetes and Digestive and Kidney Diseases of the National Institutes of Health. Erectile dysfunction. The official website of the US National Library of Medicine’s National Institutes of Health reported that a long-term ongoing research on erectile dysfunction is on the use of gene therapy for treating erectile dysfunction. According to the website, the study had already completed a phase 1 of the study as of November 2009. Meanwhile, Schoenstadt (2009) narrates that current research on erectile dysfunction focuses on causes, particularly on the role of diabetes and high blood pressure. Schoenstadt (2009) also pointed that gene therapy is now being tested in several centers. Meanwhile Manou et al. (2009, p. 132) found that Sildenafil is an effective treatment for erectile dysfunction resulting from spinal cord injury. IV. Conclusion: Impact on the future Thus, based on our current state of knowledge and ongoing research, it is not without basis that we can boldly assert the following. Firstly, a vaccine for that would either eliminate or reduce the risk for prostrate cancer can be found. Secondly, the stigma that may be associated with prostatitis will be likely eliminated. Finally and thirdly, dealing with erectile dysfunction will significantly improve in the coming years. References Brawley, O., Ankerst, D., and Thomson, I. (2009). Screening for prostate cancer. Cancer Journal for Clinicians, 59 (2), 264-273. Cheng, I., Witte, S., Jacobsen, S., Haque, R., Quinn, V., Quesenberry, C., Caan, B., & Eeden, S. (2010). Prostatis, sexually transmitted diseases, and prostrate cancer: The California men’s health study. Plos One, 5 (1), 1-9. Choi, S., Zhao, C., & Park, J. (2010). The effect of transurethral resection of the prostate on erectile dysfunction in patient with benign prostatic hyperplasia. Korean Journal of Urology, 51, 557-560. Heidenreich, A., Aus, G., Abbou, C., Bolla, M., Joniau, S., Matveev, V., Schid, H., & Zattoni, F. (2007). Update March.2007: Guidelines for Prostate Cancer. European Association of Urology. Emarah, A., El-Heggar, S., Osman, I., & Khafagy, A. (2010). Correlation between penile cavernosal artery blood flow and retinal vascular findings in arteriogenic erectile dysfunction. Clinical Ophthalmology, 2010:4, 1047-1051. 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