Andrological prevention

When we talk about andrological prevention, we are probably entering a field unknown to many; unlike what happens for the female counterpart. In fact, the average age of the first gynecological examination is 15 years, unlike what happens in males where, often, the first specialist andrological check-up occurs at an older age, at the onset of symptoms and/or during the fruitless search for pregnancy.

In reality, there is no age to start with the prevention of pathologies of andrological interest. It is absolutely essential to research, from birth, the predisposing conditions and/or pathological alterations that can affect the male reproductive function in the present and/or future: just think of cryptorchidism screening, i.e. the evaluation of the presence or absence of testicles in their anatomical location, the scrotal sac. This condition is quite frequent at birth and, among other things, can be spontaneously resolved within the first months of life. However, it must be identified because an undescended testicle leads to a greater risk of developing not only spermatogenesis dysfunctions, but also testicular tumors in adulthood. For this reason, the subject who is born cryptorchid must provide, through the pediatrician, a correction of the cryptoorchidism within the year of life, if this does not occur spontaneously in the first months of life. Then, again in the neonatal phase, the evaluation of the external genitalia is carried out, then, the search for more or less important alterations of the urethral meatus, i.e. the outlet of the urethra at the level of the most distal portion of the penis. All this is the subject of the paediatric examination.

Similarly, during adolescence it is important to assess the normal growth of the testicles, which generally occurs precisely at the time when stature growth also occurs. It is important for young people, in puberty, to contact their doctor in order to make an assessment, identifying early on any pathological conditions that could impact reproductive health in the future.

An example is the detection of varicocele, i.e. a dilation of the veins surrounding the testicle, which involves the reflux of blood at the scrotal level. In the past it was easily diagnosed during the medical examination for fitness for military service which also included the inspection of the genitals. The presence of varicocele is associated with a higher risk of infertility, because it is believed that the presence of blood reflux inside the scrotum can lead to alterations in spermatogenesis and, therefore, in sperm production. The earlier the detection of this alteration, the less damage the varicocele has to spermatogenesis. All this underlines even more the importance of early diagnosis and possible intervention. Obviously, there are various degrees of varicocele: not all of them need to be treated. It is, however, important to know of the existence of this condition and it is necessary to contact the general practitioner or andrologist if there is evidence of this pathology, so that all appropriate treatment measures can be taken in time. Finally, testicular self-examination is of great use in order to be able to identify any alterations that require specialist consultation at an early stage.