Men's Health

Question 1

What management strategies can be tried in a man suffering from premature ejaculation?

Answer 1

SSRI - helps to delay ejaculation and also helps to counter some of the associated anxiety - does not necessarily have to be taken regularly, can be taken PRN.

Condom use to reduce penile sensation

More frequent intercourse / masturbation

Psychosexual counselling

Question 1

For men undergoing androgen deprivation therapy for prostate cancer, what is the first line treatment for any hot flushes they may develop?

Answer 1

Medroxyprogesterone

Question 2

What is the most common cause of haematospermia in men under 40?

Answer 2

Infection
Normally either UTI or STI

(In men over 40, there is a higher likilood of haematospermia being secondary to malignancy such as prostate, bladder or testicular)

Question 3

What baseline investigations should be done in men presenting with haematospermia?

Answer 3

Urine MSU in ALL presenting with haematospermia

PSA in men presenting> 40 (+/- DRE)

Question 4

When should you refer a man with haematospermia to a urologist?

Answer 4

*If recurrent unexplained presentations (if single unexplained presentation in man < 40 then fine to reassure and explain likely benign and self-limiting)
* If unexplained haematospermia in man > 40
* If suspicion of prostate / testicular cancer
* If investigations in primary care suggest cysts or calculi of the prostate or seminal vesicles