The decision to undergo screening is one that a man should make with his doctor following a careful discussion of the risks and benefits of screening. In men who wish to be screened, the American Urologic Association recommends getting a baseline PSA, along with a digital rectal exam at age 40.
2. Erectile Dysfunction
It is estimated that 20–30 million men in the United States suffer from erection problems, but only 5%–10% actually seek treatment. Men who should be screened are those over 40 years of age, those with a predisposing comorbidity, such as cardiovascular disease, diabetes, or depression.
3. Urinary Incontinence
Over half of the female population report urinary incontinence yet only half of these women report these symptoms to their health care provider. Treatment is highly successful and can dramatically improve a patient’s quality of life.
More than half of men in their 60s and up to 90% of men in their 70s and 80s have some symptoms of BPH. A urology referral is warranted if the patient has a history of urinary tract infections, does not achieve satisfactory results with medical therapy, desires more definitive surgical management or has an elevated serum creatinine and evidence of hydronephrosis.
5. Kidney Stones
Nephrolithiasis is a common disorder, with a lifetime prevalence of 10% in white men and 5% in white women. Left untreated, the lifetime recurrence rates are 60% – 80%. In pregnant women, obstructing stones may cause premature labor, intractable pain, or cause urosepsis.
6. Overactive Bladder
1 in 6 adults in the United States suffer form the symptoms of OAB. Nearly a quarter of these patients are too embarrassed to discuss it with their health care providers. The causes can be multifactorial possibly neurogenic, oncologic, hyperactivity and/or instability.
Vasectomy is perhaps the most effective form of birth control and should be considered for any patient who does not want to have any children.
8. Microscopic Hematuria
Microscopic hematuria can be a sign of a significant urologic problem. All patients with asymptomatic microscopic hematuria should undergo an appropriate urologic evaluation.
9. Chronic Uninary Tract Infection (UTI)
Bacterial persistence, inability to eradicate an infection despite appropriate therapy, repeat infections in a patient with a complicated urinary tract and isolation of Proteus SP should trigger a urologic evaluation.
In up to 50% of infertile couples there is thought to be some contributing male factor. Patients that have infertility as their presenting symptom can often have an underlying medical condition. All men who are experiencing fertility issues should undergo a urologic evaluation.