Knowledge, Attitude and Practices Regarding Benign Testicular Disorders in the Educated Young Men of Pakistan

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Abstract

Background

It has been seen that despite the increasing incidence of benign testicular disorders (BTDs), little work has been done towards its awareness among the male populace. Also, the trend of not seeking help in this regard is concerning. In this study, we aim to better perceive the level of understanding and common practices regarding BTDs among educated young men.

Methods

A cross-sectional study was carried out among two groups of ages 14-20 and 21-28 years. The inclusion criterion was that of educated males in an urban setting. Data were collected through a standardized questionnaire using cluster sampling by independent interviewers. The questionnaire consisted of four parts dealing with demographics, knowledge, attitudes and practices. Chi-square and Mann-Whitney U test were used as the primary statistical tests.

Results

The sample population consisted of an equal number of participants between the ages of 14 and 20, and between 21 and 28 years (n = 200, 50%). About half the participants (n = 215, 53.8%) were not familiar with the term BTDs. The majority (n = 324, 78.8%) of participants were not aware of symptoms of BTDs. Three-fourth of the participants believed that the subject is considered taboo in Pakistan (n = 307, 73.6%) while a majority of participants (n = 340, 85%) believed media coverage can help spread awareness of BTDs. A huge number (n = 268, 67%) thought that BTDs can cause fertility problems while one-third of them would not perform testicular self-examination (TSE) in case of pain or swelling in the scrotal region (n = 119, 29.8). The level of education and age were significantly associated with the knowledge regarding symptoms and types of BTDs.

Conclusion

Knowledge of BTDs and practices of TSE in the young educated men of Karachi are alarmingly poor. Therefore, there is an urgent need to create awareness at all levels using different strategies and platforms.

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Most cited references 25

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Increasing incidence of testicular cancer worldwide: a review.

Eric Huyghe, Tomohiro Matsuda, Patrick F Thonneau (2003)

Testicular cancer (TC) is the most common malignancy in 20 to 34-year-old men. Numerous publications have shown an increase in the incidence of testis cancer in the last 40 years with substantial differences among countries. We evaluated worldwide variations in testicular cancer incidence and compared trends in different regions in the world. We reviewed 441 studies provided by a MEDLINE search using the key words testis/testicular, cancer/tumor and incidence that were published between 1980 and 2002. From these articles we selected only those devoted to testis cancer incidence and of them only the most recent studies from each country or region. Nevertheless, articles using the same data base but providing new and additional information, for example differences among ethnic groups or controversial explanations for trends, were also retained. We selected 30 articles and analyzed their methodological approach and main results. Worldwide we observed a clear trend toward an increased TC incidence in the last 30 years in the majority of industrialized countries in North America, Europe and Oceania. Nevertheless, surprising differences in incidence rates were seen between neighboring countries (Finland 2.5/100,000 cases versus Denmark 9.2/100,000) as well as among regions of the same country (2.8 to 7.9/100,000 according to various regional French registers). In addition, substantial differences in the TC incidence and trends were observed among ethnic groups. The increase in the TC incidence was significantly associated with a birth cohort effect in the United States and in European countries. To date except for cryptorchidism no evident TC risk factor has been clearly demonstrated, although the environmental hypothesis with a key role of endocrine disrupters has been put forward by several groups. Such a recent increase in the TC rate in most industrialized countries should lead urologists and andrologists to give more attention to testicular cancer symptoms in adolescents and young adults. In a public health perspective further research using cases collected through national and regional population based registers and case-control studies must be strongly encouraged if we wish to be able to assess future trends in TC incidence rates and also identify risk factors.

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Reduced fertility among overweight and obese men.

Donna Baird, Dale Sandler, Aaron Blair … (2006)

Overweight and obese men have been reported to have lower sperm counts and hormonal changes, but data are lacking regarding effects on couple fertility. We examined the relationship between male body mass index (BMI) and infertility in couples enrolled in the Agricultural Health Study in the United States. The analysis sample was limited to couples (wife <40 years old) with an attempt at pregnancy in the last 4 years based on pregnancy and fertility data provided by wives. Infertility was defined as not conceiving a pregnancy after at least 12 months of unprotected intercourse regardless of whether or not a pregnancy ultimately occurred. Self-reported weight and height were used to calculate BMI (kg/m). Adjusted odds ratios (aORs) for infertility associated with increases in male BMI were calculated with logistic regression. Adjusting for potential confounders, a 3-unit increase in male BMI was associated with infertility (aOR = 1.12; 95% confidence interval = 1.01-1.25; n = 1329). There was a dose-response relationship, and the BMI effect was stronger when the data were limited to couples with the highest-quality infertility data. The association between BMI and infertility was similar for older and younger men, suggesting that erectile dysfunction in older men does not explain the association. This report of lower fertility in overweight and obese men needs replication. If the findings are robust, programs to prevent obesity may improve men's reproductive health and save medical costs for infertility treatment.

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Mechanisms linking obesity to male infertility

Atif Katib (2015)

Introduction Obesity in men is associated with infertility in numerous studies. The current trend for decline in semen parameters parallels the increasing prevalence of obesity worldwide. In addition to impaired semen quality, fertility among obese men may be affected by sexual dysfunction, endocrinopathy, aromatization activity, psychological and thermal effects, sleep apnea, leptin and minor toxins, and possibly the inflammatory and obstructive elements of epididymitis pathology. The variable degrees of certainty associated with these causes parallel the levels of supporting evidence. This search aims to shed lights on different conditions that obese men suffer from; as that makes the treatment of infertility more categorized. Material and methods A PubMed search was conducted to identify clinical and pathological mechanisms linking obesity to male infertility. Results Among the myriad of publications reviewed in this paper, impaired spermatogenesis and sexual dysfunction have been shown to drive other variables towards poor fertility potentials. The paper presented a new, detailed flow chart showing more factors and further interactions among conditions leading to infertility. Conclusions The prime hormonal defect in obese men is hypotestosteronaemia, which results in impaired spermatogenesis leading to poor fecundability. Studies have shown that most mechanisms accounting for reduced fertility potentials in overweight men are reversible.

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Journal

Journal ID (nlm-ta): Cureus

Journal ID (iso-abbrev): Cureus

Journal ID (issn): 2168-8184

Title: Cureus

Publisher: Cureus (Palo Alto (CA) )

ISSN (Electronic): 2168-8184

Publication date (Electronic, pub): 13 August 2017

Publication date (Electronic, collection): August 2017

Volume: 9

Issue: 8

Electronic Location Identifier: e1563

Affiliations

[1 ] Dow Medical College, Dow University of Health Sciences (DUHS), Karachi, Pakistan

[2 ] DIMC

[3 ] Department of Internal Medicine, Dow University of Health Sciences (DUHS), Karachi, Pakistan

Author notes

Syed Saadan Ahmed saadan-ahmed@ 123456live.com

Article

DOI: 10.7759/cureus.1563

PMC ID: 5640388

SO-VID: 161d9095-c96d-4df3-9e31-50e4bd731e2b

License:

This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Knowledge, Attitude and Practices Regarding Benign Testicular Disorders in the Educated Young Men of Pakistan

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Most cited references 25

Increasing incidence of testicular cancer worldwide: a review.

Reduced fertility among overweight and obese men.

Mechanisms linking obesity to male infertility

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