Circumcision Healing

Circumcision Healing

“I have been performing circumcision for men for many years now,” says Dr Taufiq, resident doctor, DTAP (Dr. Tan & Partners) clinic.

One of the common fears that is stopping or holding them back from going through the procedure is the fear of pain or complications during the recovery process. Let me reassure you with our current method, having complications or pain is much less than before. However, I have compiled a list of tips to help you to optimize your recovery based on my experience and my patients’ feedback.

Also read: HOW DOES SUTURELESS CIRCUMCISION​ TECHNIQUE (SHANG RING) WORK?


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1. Have adequate rest

Especially during the first few days up to a week after the procedure, it is best to have adequate rest to allow your body to focus on healing. I will usually provide medical leave for up to a week to ensure that you have adequate rest at home.

2. Avoid strenuous activities

I know some men may get restless or feel uncomfortable with lack of physical activity especially when they are used to exercising regularly. However, this is important as well to help with recovery and avoid complications like bleeding or swelling. I had a few patients who started brisk walking within a few days of procedure and ended up with swelling around the wound area. It is advised to avoid strenuous activity for 4 weeks. Normal day to day walking is allowed so don’t have to worry about this procedure affecting your daily activities. 

3. Keep it clean

After the procedure, with the ring still intact, you are allowed to shower as per normal. To keep the wound area clean, you just need to let the soap and water from your body to run down to the area. No need to specifically rub, apply soap and it. If there is an obvious liquid or residue on it you can wash it off with water. By keeping the area clean it helps to allow the wound to heal faster.

4. Keep it dry

After cleaning, the ring tends to retain water or moisture. It is advised to dry it properly before putting on your clothes. You can use a soft towel to dab dry or a hairdryer using normal temperature to dry the area. If the wound stays we may promote infection or increase serous discharge production. So make sure it is dry before you put on your pants.

5. Antibiotic powder

After the procedure, you will be prescribed antibiotic powder. This is very helpful to keep the wound dry and also prevent infection. Apply at least once to twice a day.

6. Sleep on your side

One of the common causes of discomfort after circumcision is erection. For men, erections occur naturally at night or early morning. So this sometimes causes discomfort. Sleeping on your side may help to reduce the frequency of erections at night while you’re sleeping thus minimizing discomfort.

7. Ice pack

Another effective way to minimize erections is by applying ice pack. You can standby an ice pack or a pack of frozen peas by your bedside. If in the case of an erection that is causing pain, you can apply the ice pack on your scrotum. The cold will help to reduce your erection. 

Take as soon as you start to feel discomfort.

Next read: WHAT ARE THE TOP 7 REASON MEN UNDERGO CIRCUMCISION

Next read: CIRCUMCISION REDUCES BACTERIA AND RISK OF STDS

For more information: HOW IS THE ADULT CIRCUMCISION (FORESKIN REMOVAL) PROCEDURE DONE?

Speak to your doctor if you have any questions regarding circumcision.


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Movember: Testicular Cancer

Testicular Cancer & Self-Examination

It is November this month, which is also the month of Movember! Movember is an annual event which to most people, involves the growing of moustaches and beards. But the true meaning behind Movember is to raise awareness of men’s health issues, such as prostate cancer, testicular cancer, and men’s suicide. 

In the same vein, today we will be talking more about testicular cancer and self-examination. Testicular cancer is the most common cancer in men aged 15 to 34 years.

The testicles are the sex organs located inside the scrotum. They produce the male sex hormones and sperm for reproduction. Testicular cancer is a cancer that arises from the cells that make up the testicle. Testicular cancer is comparatively rare when put side by side with other cancers, but testicular cancer is the most common cancer in males between the ages of 15 and 35.

Signs & Symptoms Of Testicular Cancer

  • A lump or enlargement of the testicle (cancer usually affects one testicle in most cases)
  • A feeling of discomfort, pain or heaviness in the testicle or scrotum
  • A dull ache in the lower abdomen or groin
  • Fluid in the scrotum
  • Groin lymph node swellings 
  • Breast swelling or tenderness

Know Your Risk!

Are you between 15-35 years old, of certain ethnicity, have an undescended testicle or a personal or family history of testicular cancer? Consider a testicular cancer screening.

The chances of a cure and full recovery increases when the cancer is detected EARLY.


The vast majority of testicular cancers are from germ cells (the cells that produce immature sperm). They can be either a seminoma or nonseminoma tumour. What causes germ cells to become abnormal and develop into cancer isn’t known, but factors that may increase your risk of testicular cancer include:

  • An undescended testicle
  • Personal history of testicular cancer (e.g. in other testicle)
  • Abnormal testicle development
  • Syndromes such as Klinefelter syndrome
  • Family history of testicular cancer
  • Being ages 15-35, however, testicular cancer can occur at any age too

However, many men with testicular cancer have no known risk factors

Cancer can also arise from the stromal (connective) tissues. These are often benign but sometimes can be malignant. These grow in the tissues that produce hormones inside the testicles. Testicular cancers can also be secondary (spread to the testicles from other organs), or lymphomas. 

Treatment For Testicular Cancer

Testicular cancer is highly treatable as they are very sensitive to chemotherapy, even when the cancer has spread outside of the testicle. Cure rates can reach as high as 90%-95%. However, patients cured of testicular cancer have about a 2% risk of developing a cancer in the contralateral testicle. 

If testicular cancer is found early when it is small and has not spread, the chances of a cure is much higher. Early testicular cancers may cause symptoms listed above that lead men to seek medical attention. The most common presenting symptom is a lump on the testicle. Having said that, testicular cancers in other people may not cause symptoms until the later stages.

There are doctors that recommend all men examine their testicles monthly after puberty, but because testicular self-exams have not been studied enough to know if they reduce the death rates from testicular cancer, no clear guidelines exist on whether or not they should be recommended to everyone. Each man has to decide for himself if he wants to examine himself. This might be more important if you have any of the risk factors listed above. Seek medical attention immediately if you do find a lump. Your doctor will advise as appropriate.

Testicular Self-Exam (TSE)

The testicles are easiest to examine when the skin of the scrotum is relaxed. The skin is usually relaxed when you are relaxed, or after a warm shower or bath. You can examine yourself lying down or standing up. Most doctors will examine you standing up. 

  1. Hold your penis away.
  2. Hold your testicle one at a time between your thumb and fingers.
  3. Roll it gently between your fingers.
  4. Feel for any lumps, bumps or fluid.
  5. If you do examine your testicles regularly, you will eventually know what is normal for you and what is different. Feel for any change in the size, shape, or consistency of your testicles. Seek medical attention if you notice any difference.

What’s Normal?

  • One testes may be slightly larger than the other
  • One side may hang lower than the other
  • Part of the testicle is known as the epididymis where sperm is stored. This may be felt as a bump at the posterior upper or posterior middle aspect of the testicles
  • Above the testicles you may feel a cord like structure – this is the spermatic cord where sperm is carried.

What’s Abnormal?

  • An abnormally large testes compared to the other side
  • A hard lump
  • Fluid around the testicle 
  • Dilated veins above the testicles which may feel like worms 
  • Tender lumps

Not all the above abnormalities are related to cancer. But if you do find such abnormalities, please visit your doctor for a consultation. One of the easiest ways to characterize a lump is with an ultrasound, which is completely painless.

Happy Movember everyone!

Speak To Our Male Doctor Today!

If you are experiencing any symptoms, or have any concerns or questions about prostate cancer and prostate cancer screening, please make an appointment with our clinics today or visit any of our Men’s Health Clinics or drop us an email at hello@dtapclinic.com for an appointment.

Circumcision Reduces Bacteria And Risk Of STDs

What is Circumcision?

Circumcision is a procedure where the excess foreskin is removed. This ritual has been performed on boys for thousands of years. It is currently practised by many faiths and culture. In the states, it is usually done within the first few days of life. Among Muslims and Jews, it is highly encouraged for boys to be circumcised. In fact, it is highly encouraged because it promotes better hygiene among other benefits. 

Male circumcision reduces the abundance of bacteria living on the penis and might help explain why circumcision offers men some protection against HIV, according to a study led by the Translational Genomics Research Institute (TGen).

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Are circumcised men less likely to contract HIV?

One of the most interesting benefits of circumcision is the finding that circumcised men are less likely to contract HIV, the virus that causes AIDS. In 2005, a study of South African men found that circumcised men who had sex with an HIV-positive woman were 63 percent less likely than uncircumcised men to contract the virus. Other than HIV, Circumcision has also been shown to reduce the risk of contracting HPV, or human papillomavirus. 

HPV is a virus that can cause cervical cancer in women. Another sexually transmitted virus is the herpes simplex virus type 2, better known as genital herpes. The risk of transmission of genital herpes is also reduced in men who were circumcised.


Bacteria and Sexually Transmitted Diseases (STDs)

Other than viruses, bacteria also are responsible for some of the common Sexually Transmitted Diseases (STDs). Circumcision has been proven to reduce incidence of Chlamydia Trachomatis infection. Interestingly, circumcision doesn’t just protect the men, but also protects the women as well.

In a study published in 2005 in American Journal of Epidemiology, there’s an 82% reduction of Chlamydia infection among women whose partners were circumcised as compared to women whose partners were uncircumcised.

A study of women in Kenya and Uganda enrolled in an RCT and followed up for 3 years found circumcision of their male partners was associated with a 59% reduction in incident syphilis among the women. A prospective study in Kenya by the same authors found that those with circumcised male partners had a 58% lower risk of incident Trachomatis vaginalis than did women with uncircumcised partners.

One of the main possible reasons behind lower risk of infection is the recent finding where there is a significant shift in the bacterial flora of the penis after circumcision. This was according to a study published by the online journal mBio. This international collaboration focused on 156 men in Rakai, Uganda — part of the world’s largest randomized-controlled trial on male circumcision.

Researchers showed that men who were circumcised as part of the study had 33.3 percent less bacteria on their penis than those who remained uncircumcised one year after the study began. Researchers further showed that the decrease was primarily found in 12 types of bacteria, most of which were intolerant to oxygen.

At the same time, understanding the mechanisms that underlie the benefits of male circumcision could help to identify new intervention strategies for decreasing HIV transmission, especially for populations with high HIV prevalence and in places where male circumcision is culturally less acceptable, the study says.

“We know that male circumcision can prevent HIV and other diseases in heterosexual men, but it is important to know why,” said Dr. Lance Price, the Director of TGen Center for Microbiomics and Human Health and the study’s senior author.

“We think that these dramatic changes in the penis microbiome may explain, at least in part, why male circumcision is protective, ” said Dr. Price, who is also a Professor of Environmental and Occupational Health in the School of Public Health and Health Services at the George Washington University.


HIV

In heterosexual transmission of HIV, the virus on the foreskin needs to reach its target cells, the CD4+ T-cells, which reside primarily in blood or the lymph nodes.

Researchers hypothesize that penis bacteria may facilitate this process in two ways: by both recruiting more HIV target cells to the foreskin and by triggering another set of immune cells, the Langerhans cells, to deliver the virus to susceptible T-cells. Without this trigger, the Langerhans cells will simply destroy the virus.

“Our findings are interesting from two perspectives. From a public health standpoint, we were finally able to detail the bacterial changes associated with male circumcision,” said Dr. Cindy Liu, Adjunct Professor at the Pathogen Genomics Division at TGen, and the study’s lead author.

“From an ecological perspective, our study shows how phenomena from the macro-world actually scale to the micro level. When you change a macro environment, such as clear cutting a forest, you affect the animals that live there. That’s intuitive. Here we show that changing the penis environment affects the microbes that live there as well.” said Dr. Liu, who also is a member of the Department of Pathology at the Johns Hopkins School of Medicine.


Currently circumcision among adults is carried out in Africa as a part of the campaign to fight HIV and AIDs. With increasing evidence of health benefits from circumcision, I am seeing more men coming forward to get circumcised voluntarily. These are men who have no medical problems that warrant a circumcision. They simply want to have better hygiene and reduce their risk of infection.

Also read: What Are The Top 7 Reason Men Undergo Circumcision?

At Dr Tan & Partners, we use the Shang Ring Method of circumcision. With this method, there is no need for injections and the procedure is very quick, simple and painless. Only numbing cream is used and after 30 minutes of application, the procedure can commence. The procedure itself takes only 10-15 minutes. Our patients are usually surprised at how painless and quick the procedure is. Most importantly they like how the results look at the end of the day.

Also read: How Does Sutureless Circumcision​ Technique (Shang Ring) Work

Next read: How Is The Adult Circumcision (Foreskin Removal) Procedure Done?

Speak to your doctor if you have any questions regarding circumcision.


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Rectal Douching and Associated Infection Risks

Similar to vaginal douching, rectal douching or anal douching is not something that many people talk about it polite circles. It is commonly practiced by Men-Who-Have-Sex-With-Men (MSM) who receive anal sex. Let’s face it, generally we don’t want our loved ones to have to deal with our faeces while having anal sex. However there is a growing concern about the practice of performing anal douching and its associated risk of STI including HIV infection.
Other Read: Anal Pap Smear for Anal Cancer.
 

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A recently published systematic review (essentially this means that the study involves gathering all published studies on a subject and compiling the findings together) in the journal Sexually Transmitted Infections (May 2019), there is evidence to suggest that anal douching can potentially increase the risk of STI and HIV infection among MSM. In the systematic review, it included a total of 28 studies looking at anal douching and the risk of STI/ HIV in MSM population around the world (46% from US, 35% from Europe and the rest from South America, Asia and Africa). 
Also Read: STD Risk From Receptive Unprotected Anal Sex In Men
 


The findings show that men who perform anal douching compared to those who don’t have a 2.8 times higher risk of HIV and close to 2.5 times higher risk of any other types of STIs (Hepatitis B, Hepatitis C, chlamydia, gonorrhoea, syphilis and HPV). With respect to specific STIs, the study found that anal douching increases the risk of chlamydia and gonorrhoea by up to 3.25 times and 3.29 times for Hepatitis B Virus and Hepatitis C Virus.
It is theorised that possible reasons for the association of anal douching with increased risk of STIs and HIV may be due to:

  1. Water and/ or soap causes the delicate lining of the rectum and intestines to become damaged.
  2. Removal of normal flora (bacteria that normally is found in the rectum) due to the action of flushing
  3. Risk of transmission of STIs and HIV through the sharing of douching devices much sharing of needles for IVDU. 

 


The authors also noted that further studies will be needed to further elucidate this association between anal douching and STIs and HIV infection.
Speak to your doctor if you have any questions regarding the associated infection risks from rectal douching or anal douching.
 


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Common Causes Of Bumps & White Spots On Penis & Foreskin

This situation may be familiar to many men: while taking a shower one day, you happen to notice some white spots on your foreskin. You do a double take as you lean down to inspect your manhood. What could it be? How long have they been there? The questions are aplenty as you instinctively reach for your smartphone to begin a Google search.

There are many conditions that can cause white spots to develop on the penis and foreskin. Some men may be born with them, while others may develop them as a result of poor hygiene practices or sexually transmitted infections (STIs). It is important to know what the white spots are due to, as not all conditions require treatment. Listed below are some common causes of white spots on the foreskin and penis.


Pearly Penile Papules

Pearly penile papules (PPP) are small, dome-shaped or projection-like bumps that are located just below the head of the penis, usually arranged in a neat row. They can be white, flesh-coloured, yellow or translucent in colour. They do not cause any pain or itch. PPP is considered as a normal variant of the male penile anatomy, and are harmless bumps. It is not cancerous and there is no cancer risk. It is not a sexually transmitted infection and is not contagious. It is common and can occur in up to 38% of young men up to age 25.

PPP can be left alone and does not require treatment. However, for men who find them unsightly, they can be removed. Treatment options include laser therapy, cryotherapy and electrosurgery. 

READ: What are Pearly Penile Papules?


Fordyce Spots

Also known as Fordyce glands, these are harmless, small white or yellow bumps that are found on the foreskin. They are basically enlarged sebaceous glands, and can occur alone or in clusters. They do not cause any pain or itch. Fordyce spots can also commonly occur on the edges of your lips or on the inside of your cheeks.

Just like PPP, Fordyce spots are not cancerous and infectious, and also does not require treatment. Similarly, they can be removed if men find them unsightly. Treatment options include topical retinoid cream, oral isotretinoin, laser therapy and electrosurgery. 


Tyson’s Glands

Also known as preputial glands, Tyson’s glands are modified sebaceous glands that are found on the inner surface of the foreskin. They occur in pairs and are located on either side of the frenulum. These glands are also present on the hood of the clitoris in females. Tyson’s glands are normal structures and do not require treatment.  


Skin Tags

Skin tags are small, soft, flesh-coloured growths on the skin. They usually have a stalk and hang off the skin, and can vary in size from a few millimetres up to several centimetres. They tend not to grow on the penis itself, but rather, around the groin and scrotum. They often grow in areas where the skin folds and rubs against itself, and as such they are often also found on the neck, armpits, eyelids and under the breast. They affect men and women equally. Obesity, diabetes and pregnancy can increase the chances of occurrence.

Skin tags are benign tumours of the skin and do not require treatment. Occasionally, they may fall off on their own. People often wish to get them removed for aesthetic reasons, or if the skin tags are large and get in the way. Treatment options include cryosurgery, electrosurgery, ligation and excision.  

READ: Skin


Balanitis

Balanitis is inflammation of the foreskin and head of the penis. Spots can appear on the penile head or foreskin, and can be white or reddish. Other symptoms include redness, pain, itching, discharge, swelling and difficulty with retraction of the foreskin, and sometimes pain when passing urine. 

Balanitis can affect as many as 1 in 10 males, and can occur at any age. It is more likely to occur in uncircumcised men. The most common cause of Balanitis is a bacteria or fungal infection, or a combination of both. This can result from inadequate personal hygiene and/or phimosis (tight foreskin). There are non-infectious causes for balanitis as well. Risk factors for recurrent balanitis include diabetes, HIV and other sexually transmitted infections. 

To investigate balanitis, your doctor may perform swab tests to identify the responsible organism. Treatment involves topical and/or oral anti-fungal and antibiotics. The long term solution to balanitis is a circumcision.

READ: Causes, symptoms and treatment of Balanitis.

Pimples

Pimples develop as a result of the pores of our skin being blocked by dead skin cells, sebum and other debris. The sebaceous gland continues to produce sebum and build up under the blockage, allowing bacteria to grow in the area, resulting in inflammation, infection and pain. They can occur anywhere on the body, including the penis.

Pimples can be left alone and usually resolve on their own without treatment. It is important to resist the urge to pop the pimples as this may lead to superimposed infection, scarring and hyperpigmentation. However, they may end up self erupting and discharge small amounts of pus. Treatments for pimples include topical over-the-counter creams such as benzoyl peroxide, antibiotic creams and, if more severe, oral antibiotics.

READ: Skin


Folliculitis

Folliculitis is an inflammation or infection of the hair follicles. It can occur anywhere on the body, including the penis, where it is frequently seen at the shaft or base of the penis, or the pubic area. Folliculitis tends to result from shaving, waxing or chafing of the hair follicles. The damage to the hair follicles allows bacteria to enter. Sometimes, ingrown hairs can also occur from hair removal treatments, eventually leading to folliculitis as well. Folliculitis can be painful and/or itchy. Treatment options include topical and/or oral antibiotics. 

READ: Common causes of penile itching and pubic itching


Genital Warts

Genital warts are caused by the Human Papillomavirus (HPV). HPV is the most common sexually transmitted infection and can be spread via vaginal, oral or anal sex. They appear as flesh-coloured growths over the genitals that can cluster and resemble a cauliflower. Most of the time they do not have any symptoms but can sometimes itch. Bleeding can also occur during sexual intercourse. 

READ: Causes, symptoms and treatment for Genital Warts
READ: How to get rid of Genital Warts

Left alone, the warts can remain the same or increase in size and number. They will disappear once the body has shed the virus completely, typically over a course of 1 to 2 years. Treatment options include topical medications such as imiquimod, cryotherapy and electrosurgery. Vaccines are available to help prevent HPV infection, consider getting a HPV vaccination. 

READ: HPV Vaccination For Men
READ: Rapid HPV Testing

Genital Herpes

Genital herpes is caused by the Herpes Simplex Virus (HSV) and is a sexually transmitted infection. Itching of the penis is usually the first symptom, and can occur in other areas such as the scrotum, groin, buttocks and anus. Shortly after, tiny clusters of painful blisters develop, which can then rupture and form shallow ulcers with crusts. Other symptoms include painful urination, enlarged groin lymph nodes, fever and body aches. The virus can lie dormant in the body for years without causing any symptoms, therefore some people may not even be aware that they are infected. 

Genital herpes can be diagnosed via swab testing of the lesions. When there are no symptoms, no treatment is required. Flares can be treated with oral and topical antiviral medications. There is unfortunately no cure for genital herpes, as the virus will permanently remain in the body.

READ: Rapid Herpes Testing

Molluscum Contagiosum

This is a benign infection of the skin caused by the Molluscum Contagiosum virus, resulting in painless, small, shiny pearl-shaped lesions. They can happen anywhere on the body as a result of physical contact, but when they occur on the genital area, it is usually as a result of sexual contact. The virus is thus spread via sexual contact, or even to another part of the person’s own body, from scratching the lesions and touching another part of the body. They can appear alone, or in clusters. They usually do not cause any symptoms, but can sometimes itch. 

Left alone, the lesions will eventually disappear once the body has shed the virus completely, typically over a course of several months to a year. Treatment options include topical medications such as salicylic acid, cryotherapy, laser therapy and curettage.

READ: Everything you need to know about Molluscum Contagiosum

In conclusion, do not panic if you notice white spots on your penis, as not all white spots require treatment.  Speak to your doctor for advice on white spots or bumps and request for an examination. 

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How to Perform Testicular Self Exam

There are doctors that recommend all men examine their testicles monthly after puberty, but because testicular self-exams have not been studied enough to know if they reduce the death rates from testicular cancer, no clear guidelines exist on whether or not they should be recommended to everyone.
Each man has to decide for himself if he wants to examine himself. This might be more important if you have any of the risk factors listed above. Seek medical attention immediately if you do find a lump. Your doctor will advise as appropriate.
Testicular cancer is comparatively rare when putting side by side with other cancers, but testicular cancer is the most common cancer in males between the ages of 15 and 35.

How to Perform Testicular Self-exam

Step 1: Clean up, Warm-up


(Testicular Self-exam)
The testicles are easiest to examine when the skin of the scrotum is relaxed. The skin is usually relaxed when you are relaxed, or after a warm shower or bath.

Step 2: Roll it Gently between Your Fingers


(Testicular Self-exam)
You can examine yourself lying down or standing up. Most doctors will examine your standing up.
Hold your penis away. Hold your testicle one at a time between your thumb and fingers. Roll it gently between your fingers.

Step 3: Feel for any Lumps, Bumps or Fluid


(Testicular Self-exam)
Check for any lumps, bumps or unusual features. If you do examine your testicles regularly, you will eventually know what is normal for you and what is different.

Step 4: Feel for any change in the Size, Shape, or Consistency


(Testicular Self-exam)
Feel for any change in the size, shape, or consistency of your testicles. Seek medical attention if you notice any difference.

What is normal

  • One testis may be slightly larger than the other
  • One side may hang lower than the other
  • Part of the testicle is known as the epididymis where sperm are stored. This may be felt as a bump at the posterior upper or posterior middle aspect of the testicles
  • Above the testicles you may feel a cord-like structure – this is the spermatic cord where sperm is carried.

What is abnormal

  • Abnormally large testes compared to the other side
  • A hard lump
  • Fluid around the testicle
  • Dilated veins above the testicles which may feel like worms
  • Tender lumps

Not all the above abnormalities are related to cancer. But if you do find such abnormalities, please visit your doctor for a consultation. One of the easiest ways to characterize a lump is with an ultrasound, which is completely painless.

Speak to our doctors for more information or professional advice on testicular cancer at our Men’s Health Clinic.

Happy Movember everyone!

Movember (Moustache + November)

Movember (Moustache + November) is a global movement by the Movember Foundation which puts the spotlight on men’s health, especially prostate cancer, testicular cancer, mental health and suicide prevention.
The Movember Foundation recognized that males of all ages may hide their pains and suffering and ultimately result in greater problems, including an untimely demise. Unlike females, males are unlikely to share their deeply personal pains and suffering with others, including loved ones or professionals. This is why it is important for fellow males to stand up for each other, and lift them up from the fog of suffering and silence.

Cancer and Suicide – Not a pretty picture

Prostate Cancer

Prostate cancer now makes up one in seven cancers in Singapore males and is the third most common cancer now. In the five years from 2011 to 2015, almost 20% of those diagnosed with prostate cancer died. What is worse is that prostate cancer in the early stages has no symptoms at all. The earlier the cancer is diagnosed, the more likely the treatment will be successful for patients and help them remain in remission.

Testicular Cancer

While testicular cancer only accounts for 1 to 2% of all cancers in males, it is the most common cancer in young males between ages 20 to 40 – at the prime of their lives. Like prostate cancer, the earlier testicular cancer is diagnosed, the more likely that a cure is achievable.
See:  How to Perform Testicular Self-Exam

Suicide Prevention

More than 70% of all suicides in Singapore for 2018 were males. This is not unique to Singapore. In Australia, males accounted for 75% of suicides. The number of male suicides in Singapore is twice that of women and the majority were aged 65 years old and above.
It is generally believed that many factors contributed to these statistics. Societal pressures for males to “Man Up” means that males may feel isolated and have nowhere to turn to for help.
In addition, many males may feel that if they seek the help they will lose status or identity and they fear that they may lose independence, competence, control, and autonomy, all of which are perceived norms expected of males.

Mental Health

Finally, a previous study by Oogachaga (a non-profit community-based organisation that works with LGBTQ individuals) in Singapore showed that 3 in 5 LGBT individuals who participated in the survey reported facing some form of discrimination as a result of their sexual orientation. This may be part of the reason why in 2015 a study in CDC found gay and bisexual youths in the U.S. are 4 times more likely to have attempted suicide than their straight peers.

What can you do?

Now, anyone, especially males, can step forward and support your buddies and families by:

  1. Growing a moustache or beard for the month of November.
  2. Pledge to walk 60 km for the month of November – for the 60 men that are lost every hour globally due to suicides.
  3. Spend time with your buddies – be it having a night out or playing a favourite sport or whatever activity you enjoy doing together.

For the whole month of November, Dr. Tan & Partners (DTAP) is proud to support the Movember 2019 initiative with a supportive and friendly environment throughout all its clinics for men of all ages to seek help for all men’s health issues.
Dr. Julian Ng

Dr Julian Ng has 10 years of medical practice experience. He currently serves as the Chief Medical Officer of the DTAP Group of clinics in Singapore, Malaysia and Vietnam. He is also a member of the Singapore Men’s Health Society. His special interests are in the field Andrology, especially sexual health. He is currently practising at Dr Tan and Partners (DTAP) clinic at Novena Medical Centre.

5 Things a Weak Erection is Telling You

Erectile Dysfunction (ED) is the inability to achieve or maintain an erection sufficient for satisfactory sexual performance. So if your erection is not able to satisfy you and/or your partner, you may have ED.
If your erection is weak, bedroom performance might not be the only problem that you are suffering from. It might be an indicator of another health condition.

What is Erectile Dysfunction

How Do I know If I have Erectile Dysfunction?

You can also use the below following questions to help yourself in determining whether you could possibly be suffering from Erectile Dysfunction:

1 – Almost never, (1 point)

2 –  A few times, (2 points)

3 – Sometimes, (3 points)

4 – Most times, (4 points)

5 – Almost always, (5 points)

 

Questions:

  • How confident do you feel that you can get and keep an erection?
  • When you have erections, how often are they hard enough for sex?
  • Were you able to maintain your erection after penetration?
  • Were you able to maintain your erection until orgasm?
  • Are you satisfied with your sex life?

If you scored between 1-7 points, you likely have severe Erectile Dysfunction.
8-11 points moderate Erectile Dysfunction, 12-16 points are mild to moderate Erectile Dysfunction, 17-21 mild Erectile Dysfunction and lastly 21-25 points no Erectile Dysfunction.

Below are the top 5 things that a weak erection may be telling you.

1. Diabetes

Men with type 2 diabetes tend to develop ED 10-15 years earlier than men without diabetes.
As men with diabetes age, the occurrence of ED becomes more common. 50-60% of men above 50 years of age with diabetes gets problem with erection. For those above 70, more than 95% are affected.
Diabetes may damage nerves, blood vessels that control erection. So having a weak erection may be an indicator of diabetes.

2. Hypertension

Hypertension or high blood pressure is one of the top causes of weak erections.
A study published in the Journal of the American Geriatrics Society found that 49% of men between 40-79 years of age with high blood pressure had erectile dysfunction. Another study in Journal of Urology found that 68% of men with hypertension had some degree of erectile dysfunction.
Hypertension affects the blood flow and the normal physiology of the male erection. On a side note, some drugs used to treat hypertension may also cause ED. So do speak to your physician if you are experiencing weak erection and on anti-hypertensive medication.

3. Low testosterone

If your weak erection is also accompanied by other symptoms like low libido, low energy levels, low mood, you might be suffering from low levels of testosterone. Testosterone production slows down as men age. On top of that, there are other lifestyle factors that may also affect testosterone levels like physical activity, obesity, stress levels etc.
Do seek advice from a doctor who is familiar with treatments of testosterone deficiency. Check your levels and seek advise whether testosterone replacement may help with your condition.

4. Heart Disease

There is a very strong link between erectile dysfunction and heart disease. Many studies have shown that men with heart disease have a higher chance of having ED.
In one study, 57% of men who had bypass surgery and 64% men who had a heart attack, had ED. On the other hand, having ED also puts you at high risk of developing heart disease.
Heart disease can be detected early or prevented with regular health screening and also healthy lifestyle habits. Keeping a healthy weight, regular physical activity, healthy balanced diet are some of the ways to prevent heart disease. If you do have other chronic diseases like high blood pressure, high cholesterol or diabetes, do get treated and get them under controlled.
Read: Getting Heart Attack at a Young Age

5. Depression

Depression is a condition that is indicated by persistent sadness, a feeling of hopelessness and a pessimistic outlook.
Symptoms of depression include:

  • Fatigue
  • Loss of interest in formerly pleasurable activities
  • Low self-esteem
  • Changes in appetite
  • Apathy
  • Sleep disturbances

In cases of depression in men, sometimes it may not be as easily recognised as in women. Men who are depressed may spend more time talking about physical symptoms than their emotions.
One of the physical symptoms that may happen is ED. Journal of Sexual Medicine published a review of 42 studies looking at ED and depression. It was reported that men with depression had a 39% increase risk for ED.
So a weak erection may also mask an underlying psychological condition like depression.

All in All

The above 5 things are an indication that a weak erection may be a symptom to another condition that you are suffering from. So don’t be too quick to brush it off or just solve it with a pill, speak to a doctor who is experienced with managing ED and make sure you don’t have an underlying medical condition.
If you need to speak to our doctors, please visit our men’s clinics.  Alternatively, you can email us hello@dtapclinic.com or call us for an appointment.
Take Care.


Other Read:

 

8 Myth About Hair Loss

Hair loss is nothing new to us. Since the dawn of ages up until the present day, hair loss has been an issue troubling both men and women alike, but mostly men. Along the way, tons of myths about hair loss have been created. Without further ado, let us look at eight common myths about hair loss.

Hair loss only happens with age

Myth about Hair Loss #1

Androgenetic alopecia, also known as male or female pattern balding, knows no age. It is genetically predetermined, and while it tends to happen in older people, can happen in those as young as their teens or early 20s.
According to the American Hair Loss Association, two-thirds of American men will have some degree of appreciable hair loss by age 35, and approximately 85% of men have significant balding by age 50.
Regenera Activa for pattern hair loss treatment: Regenera Activa uses your own hair that contains cells that help to activate the follicles around the balding area. In other words, it uses your own body’s ability to procedure new hair.

Masturbation causes hair loss

Myth about Hair Loss #2

Good news, guys! There is absolutely no scientific evidence linking masturbation to hair loss, or even hair health in general.
Our body requires protein for the growth of new body tissues, and this includes hair growth as well. So it has been postulated that as semen contains high levels of protein, frequent ejaculation causes a reduction in protein levels, therefore contributing to hair loss. The truth is, the average male produces just 3.7 millilitres of semen per ejaculation, and the amount of protein lost in each ejaculation is very insignificant compared to the amount of protein consumed daily.

You’re losing your hair due to stress

Myth about Hair Loss #3

It is true that excess stress and anxiety can lead to certain types of hair loss, namely telogen effluvium and alopecia areata. These conditions are often temporary and after the stressful period is over, the hair usually grows back. Male pattern balding, however, is a long-term condition and is not due to stress.

Direct sunshine is bad for your hair

Myth about Hair Loss#4

Sustained exposure to sunlight does not contribute to hair loss. Also, direct heat from using a hairdryer does not cause hair loss if used correctly. It is important to keep the dryer at an appropriate distance from the scalp and avoid using high heat mode too frequently. Also, direct the dryer towards the tip of the hair instead of the scalp and roots.

Elevated testosterone levels are causing you to lose your hair

Myth about Hair Loss #5

People believe that raised testosterone levels, in turn, leads to increased levels of dihydrotestosterone (DHT), which is the hormone responsible for androgenetic alopecia. However, high testosterone levels does not necessarily mean high levels of DHT.
The amount of testosterone that is converted to DHT varies from person to person. Even if a man has high DHT levels, it still does not automatically lead to male pattern balding. Ultimately, it depends on how sensitive the hair follicles are to DHT.

Using loads of hair products is bad for your hair

Myth about Hair Loss#6

Hair products, no matter how much or how often you use them, will not lead to male or female pattern balding.

Shampooing your hair is causing you to go bald

Myth about Hair Loss #7

Using hair shampoo when showering helps to clean your scalp and keep the hair healthy. It certainly does not cause you to lose hair. It is perfectly normal to see some fallen strands of hair when shampooing. These are hairs that have reached the end of its cycle and it was likely time for them to fall out anyway.

Wearing a hat too often suffocates your hair

Myth about Hair Loss #8

Some people think that wearing a hat does not allow your hair to “breathe” and over time can cause hair loss. While this is completely untrue, if your hat is very dirty and has not been washed for some time, dirt, dust and bacteria can accumulate. This can lead to scalp irritation or infection.

If you want to speak to us about hair loss & hair loss treatment, please call or visit our clinics or drop us an email at hello@dtapclinic.com

医生对男性包皮环切术的讨论和解释

什么是男性成人包皮环切术?

男性成人包皮环切术, 是在阴茎上去除多余的包皮。

进行包皮环切术的原因有很多。

  • 包皮环切术的好处:
  • 预防龟头炎(阴茎感染)
  • 更好的卫生
  • 降低艾滋病和其他性病的风险
  • 降低尿路感染的风险
  • 预防包茎(无法缩回包皮或且包皮缩回,无法恢复原位)

谁应该割包皮?

在医学方面,有绝对和相对适应症进行手术。包皮环切术只有2种绝对适应证- 瘢痕形成和严重感染。

然而,对于相对适应症,这些是考虑包皮环切术的原因

  • 曾今有过或且或复龟头炎(阴茎感染)的患者
  • 那些无法完全收回包皮的人
  • 那些长而多余的包皮,诱捕尿液和污垢
  • 那些在包皮下积聚污垢的人
  • 包皮过紧,无法收缩的人(包茎)
  • 那些想要降低性病,尿路感染或阴茎癌风险的人
  • 那些有勃起疼痛和不舒服的人

手术如何进行?

我们使用无缝线技术进行手术. 手速过程需要10-15分钟完成。并也在局部麻醉下完成。使用这种技术,与传统的包皮环切方法不同,伤口受保护并且不会撕裂或出血。

手术过后会这么样呢?

我们所有动过环切手术的病人都可以在手术后立即恢复正常活动,不会影响到工作或学习,但是需要减少过度操劳的活动,至少运动大概3周。

在 Dr Tan and Partners(DTAP Clinic)所做的包皮环切手术有很多优点

  • 跟传统手术相比,手术时间从一个小时缩短到十分钟
  • 不需要缝针缝合
  • 手术时间短(约10分钟)
  • 出血最少
  • 能够保存阴茎系带,完好
  • 手术并发症的风险非常低
  • 手速过后的伤口,优秀的美容
  • 动过手术的人满意度高

税前的手术费用$ 1800.00,包括手术后所有的复诊费。

费用不包括第一次的门诊费和药物。这个费用大概$200.00 除了这些之外,没有其他费用。

立即联系我们预订您的健康检查!


在这些诊所提供男性包皮环切术:

  • Dr Tan & Partners @Somerset – +65 6262 0762
  • Dr Tan & Partners @Holland V- +65 6235 1339
  • Dr Tan & Partners @Novena – +65 6397 2095