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Penile Discharge – Video

Penile discharge

Penile discharge is any substance (other than urine) that comes from the urinary tube, also known as the urethra.

Normal discharge includes pre-ejaculate, or pre-cum, and semen ejaculate. These are usually produced during sexual stimulation.

Abnormal discharge can range from clear to pus-like and usually produced in the presence of an infection. In males, the infection is usually due to a sexually transmitted infection.

This may be accompanied by symptoms such as pain on the passing of urine, ulcers, urinary frequency and urgency.

The most common 2 causatives STI organisms are Chlamydia and Gonorrhea, but there are a variety of other microorganisms that can cause similar symptoms. Read more: STD symtopms

Non-STI organisms that cause urinary tract infections can also present with discharge. These are usually accompanied by urinary frequency, urinary urgency and foul-smelling or cloudy urine.

Similar organisms may infect the prostate causing prostatitis which may present with discharge, fever, urinary symptoms, pelvic pain and even blood in the semen.

If there has been any instrumentation of the urethra, for example with a catheter or after a procedure at the urologist, a discharge may also be produced due to the trauma.

Balanitis

Balanitis is inflammation of the foreskin and head of the penis that can cause some discharge under the foreskin. It may present with a rash, itching or pain, a foul smell and ulcers. The inflammation may be due to infections or irritation. While it is not a true penile discharge as it does not come out of the urethra, it may be confused with true penile discharge by some people.

If you do not clean your foreskin and head of the penis regularly, a layer of dead cells and sebum may build up. This is known as smegma and may also be confused with true penile discharge. While this is not harmful, it is advised to wash this area properly so smegma does not build up as a dirty head of the penis predisposes you to balanitis.

If you do have any of the symptoms that we have mentioned, please visit us at DTAP clinic so we can evaluate your condition.

Penile Piercings

Common types of penile piercings.

Penile piercing is a general term and there are actually many different ways and styles a man can get a piercing on his manhood.

Apadravya: This is a piercing that passes through the glans vertically. It can go from top to bottom or vice versa.

Ampallang: This piercing goes through the glans horizontally. It can go from left to right or vice versa.

Deep shaft: This piercing goes through the penile shaft. It can be pierced like Apadravya or Ampallang and goes through the shaft.

Dydoe/king’s crown: This piercing passes through the ridge or corona of the glans and on to the head of the penis itself. It usually comes in pairs.

Foreskin: This piercing is done through the foreskin of an uncircumcised penis. It is equivalent to a clitoral hood piercing in females.

Frenum: Frenulum is the skin that attaches the foreskin to the head of the penis. A frenum piercing is one that goes through the frenulum horizontally.

Guiche (perineum): This piercing is on the perineum. Perineum is the area between the anus and the scrotum.

Hafada (scrotal): This is a surface piercing done anywhere on the scrotal skin. It does not penetrate deep into the scrotum.

Lorum: This piercing is done horizontally on the underside of the penis at its base.The position is where the scrotum meets the penis.

Magic cross: This piercing is basically an Ampallang and Apadryava combined together. Making it appear like a cross.

Prince Albert: This is one of the most popular penile piercings. It is a ring type of piercing that goes along the underside of the glans from the urethral opening to the part where the glans meet the shaft of the penis.

Pubic: consists of a piece of jewelry through any part of the area around the base of the penis

Reverse PA: the opposite of Prince Albert, with jewelry entering the urethra and exiting through the top of the shaft



Sexual benefits to penile piercings

  • Some men chose piercings to enhance sexual pleasure for him and or the partner. It can increase pleasure during masturbation or sexual intercourse
  • Depending on the type of piercing, some can stimulate the partner more than others. Especially during vaginal or anal intercourse.


Risks associated with penile piercings

  • Increased risk of UTI (Urinary tract infections)
  • Infection at piercing site.
  • Increased risk of STI
  • Injuring your partner’s genitals during intercourse.

Common signs & symptoms of STIs

Genital piercings are getting more exposure and interest nowadays. Before you decide to get one I suggest you make the necessary research before deciding. When choosing to pierce, I would suggest going to a reputable body piercing specialist. One who has experience and also maintains high standards of cleanliness and hygiene. I highly discourage you from doing it on your own. It’s definitely an acquired taste, so make sure you make the right decision.

Also on this site: std screening



7 Things You Need To Know About Anal Cancer In Men

Anal cancer is a rare disease and the understanding of its natural history is evolving. While it is the 26th most common cancer in the USA annually, the incidence rate is increasing at 2% per year over the past decade. Further underpinning its importance in recent times is that it is also one of the cancers that has devastatingly poor outcomes in the late stage while being relatively easy to detect and treat in the early stages.


What is Anal Cancer?

Anal cancer like all cancers start when the cells lose the ability to maintain their original form. Precancerous changes such as aberrant growth soon occurs as these cells no longer serve their original function and a tumor develops. 

The anal canal is a 4 cm structure that continues from the rectum. Embryologically, this canal develops from 2 distinct stem cells that originate from different parts of the body. As the embryo develops into a fetus, these 2 stems cells develop into either Squamous Cells (outside of canal) or Columnar Cells (inside of anal canal). These 2 cells meet and develop into the anal canal. This is important because the junction at which these 2 cells converge while forming your anal canal all those years ago is also the most susceptible site for developing anal cancer. 


Although not entirely analogous, anal cancer shares many similarities with cervical cancer in women. Both cancers occur most frequently at the junction where 2 normally distinct cells meet and majority of both tumors are found to be co-infected with Human Papilloma Virus (HPV) sub-type 16.

Men who have sex with Men (MSM) and immuncompromised patients (transplant, cancer patients and HIV patients) are more prone to this cancer. Compared to the general population, MSM with no HIV have 2 times the risk of developing anal cancer, MSM with HIV have up to 25 times the risk while transplant patients have 5 times the risk and a patient with previous colon cancer has 20 times the risk. Other risk factors include previous ano-genital warts, previous STD infection and high risk sexual activity.

Anal Cancer In The Early Stages

In its early stages, anal cancer does not produce any symptoms. The early signs of of developing anal cancer is pre-cancerous cell changes. This is detected by direct visualization and sampling of the area. The core principle of screening for anal cancer is hence looking for these pre-cancerous changes. This can be done through a variety of methods depending on the expertise available, each method has different levels of specificity in detecting anal cancer. 

Anal Pap Smear & HPV Testing

Currently, the Anal PAP smear and HPV testing is considered to be the most practical means of screening for anal cancer. This involves a swab inserted into the anal canal and cells from the area are sampled and looked under a microscope for any pre-cancerous changes, further processing of the sample via HPV DNA PCR is also used to detect any presence of HPV in these cells. Once the patients with potential risk of developing anal cancers are pick out with this screening, a further diagnostic test is required. The current diagnostic standard is High Resolution Anoscopy where a high magnification scope is used to examine the tissue. Different reagents are also used to differentiate normal tissue from pre-cancerous tissue. 

There are no established guidelines for how frequent screening should be carried out but current expert opinions recommend every 1 – 2 years for MSM with HIV and 2 – 3 years for MSM without HIV. 

Treatment of Anal Cancer

Treatment of anal cancer can be considered in 2 categories – Pre-cancerous treatment and Cancer treatment. Precancerous changes, once detected by screening and diagnosed with Anoscopy can be treated with either Topical Therapy such to eradicate the precancerous tissues. Local Ablative Therapy that involves Radiofrequency Ablation can also be used to destroy the any precancerous tissue. Cancer treatment for pre-cancerous changes that have progressed to cancer, on the other hand requires surgery.

In both situations, close monitoring post treatment is essential as the recurrence rates are significant especially in high grade pre-cancerous changes. 

Preventing pre-cancerous changes is essential to the approach of reducing anal cancer rates. HPV vaccination is shown to reduce pre-cancerous changes with a recent study showing 75% reduction in both Low and High grade changes in MSM population. There is also data suggesting that vaccination after precancerous changes have been detected is also able to reduce the rate of recurrence by approximately 20%.

In summary, anal cancer is disease in which majority of the tumors are driven by the HPV virus and in which pre-cancerous changes in the patients can accurately predict the chances of developing cancer especially in high risk populations. This makes screening and detection of early disease together with vaccination essential to reducing the rates of anal cancer.

Next read: PENILE CANCER – 7 THINGS YOU NEED TO KNOW!

What happens if you tear or injure your Frenulum?

The frenulum is the piece of skin that attaches the foreskin to the head of the penis (glans penis). In some men, this part may be short or tight. During intercourse it may be at higher risk of getting torn. 


I feel pain and there is bleeding, did I injure or tear my frenulum?

One of the most common symptoms of a torn frenulum is pain with or without bleeding. It may appear very shocking or scary as blood may be dripping or it may cause a very messy situation in the bedroom.

Common causes for Frenulum injuries/ tear

These tears or injuries are basically caused by a sudden or strong pulling back the foreskin. This causes a strong tension in the frenulum causing it to tear or get injured. This usually occur during intercourse or aggressive masturbation.

How long does it take for it to heal?

Generally if left alone, it takes around 1-2 weeks for it to heal completely. Rate of healing varies between men. If there is any bleeding, it usually stops on its own. If still bleeding, one may need to apply pressure for a few minutes to stop the bleeding.

Treatment options

Conservative: It can heal on its own but will take some time. Even if healed, it will develop a scar and this causes thickening of the frenulum. When thickened, it will become even tighter and hence higher risk of it tearing again. Most of my patients who came to see me report the tears happening several times.

Medical treatment: There is no medical treatment for a torn frenulum. Antibiotic cream may be applied to prevent infection.Surgical: In some cases, pain or bleeding may not stop on its own. In certain instances it may repair with sutures by a medical doctor. This depends on the severity and anatomy of the injury.

How do I avoid getting a Frenulum injury/ tear?

Men with short frenulum or frenulum breve are at higher risk of renulum tears. So the key here to lengthen the frenulum

Conservative: Can try regular stretching of the foreskin and frenulum but this is usually not very useful or successful.

Frenulectomy: This is a simple procedure where the frenulum is cut to release the tension and lengthen the space between the foreskin and the head. The remaining tissue is then stitched together to avoid bleeding and promote faster healing. After this procedure is done, the foreskin can easily move back and forth without risk of tearing the frenulum.

Circumcision: For some men, a frenulectomy procedure may not be enough. They may also have tight foreskin (phimosis) on top of a tight frenulum. This procedure will be able to solve both problems of phimosis and tight frenulum. Circumcision in adults is a simple procedure and can be done at any age. There is no age limit to this procedure.

 

So if you experience any torn frenulum or pain and or bleeding at the frenulum, do consult your doctor. He will have to first do an assessment and physical examination so that he can advice which more of treatment is best for you.


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Why Is My Semen Green Or Yellow?

Here’s a guide to unusual semen colours and when you should be concerned. 

The quality of a man’s semen is a maker of their overall health. So the next time after sex/masturbation, it might be worthwhile to take a glance at the condom/kleenex before disposing of it. Who knows, you might just detect an underlying medical condition by yourself!


Colour of semen is White, Clear or Grey

Normal semen is a whitish, cloudy even greyish fluid with the consistency of egg whites.


Colour of semen is Yellow or Green

#1 Medications/Supplements

Certain medications and supplements will tint the semen yellow. This is usually not a problem as the colour is caused by the by-product of the metabolism of the medication. Common medications include rifampicin, an antibiotic which can stain the semen yellow or orange and metronidazole which can turn the semen brownish. Other common medications are senna, a commonly used laxatives and Vitamin B supplements.

#2 Urine in the semen

Urine and semen travel through a common tube, known as the urethra. In cases of urinary retention, when urine is left behind in the urethra, semen can be mixed with urine giving rise to yellow urine.

#3 Jaundice

Jaundice is a condition where there is a build-up of bilirubin from red blood cell destruction. Other than staining the semen yellow, patients also do find yellowing of their skin as well as the whites of their eyes. The other symptoms of jaundice also include abdominal pain, nausea/vomiting

#4 Leukocytospermia

Leukocytospermia happens when too many white blood cells are present in the urethra. This can happen in the setting of an infection, for example a sexually transmitted infection like gonorrhea or chlamydia. Leukocytospermia can also happen in a prostatic infection causing a yellowish-green semen. Other symptoms of prostatitis includes difficulty in urination, pain on urination/ejaculation, pain near the rectum, fever. 


Pink/Red

#1 Fruits and Vegetables

Consuming beetroots and red dragon fruits can give semen a pinkish-reddish tinge. 

#2 Hematospermia

Hematospermia refers to blood in the semen. It’s an alarming phenomenon but studies have suggested that the majority of hematospermia are benign. It is almost never a sign of cancer in younger patients.

The most common cause of hematospermia is after a procedure for example after a prostate biopsy. It will last for 3 to 4 weeks with spontaneous resolution.

Uro-genital infections and prostatitis can also lead to reddish urine by irritating the lining of the urinary tract and causing bleeding. Other associated symptoms are pain with urination or pus discharge. Once diagnosed and treated, resolution of reddish urine is common. 

However, if hematospermia is persistent for more than a month and the patient is more than the age of 50, it is still advisable to see the doctor for prostate cancer evaluations.

Also read: WHAT IS HEMATOSPERMIA (BLOOD IN SEMEN)?


Black/Dark-coloured

#1 Hematospermia

Black semen is likely old blood in the semen that has been in the body for a long time. 

#2 Heavy Metals 

High levels of heavy metals, such as lead, manganese and nickel in the blood can lead to dark coloured urine. This is important for workers in related industries who might have possible exposure.

#3 Spinal Cord Injury

Patients with previous spinal cord injuries are known to have brown coloured semen on at least one ejaculation.  

There are still many other causes that can lead to discolouration of semen. If you have any particular concerns or any symptoms, it’s best to see your healthcare provider for advice.

Next read: ANAL WARTS: WHAT YOU HAVE ALWAYS WANTED TO KNOW, BUT WERE TOO EMBARRASSED TO ASK.


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Anal Warts: What you have always wanted to know, but were too embarrassed to ask.

Anal warts are definitely not a topic for polite conversation. As an affliction upon one of the more intimate parts of the human body, patients frequently have multiple concerns regarding cosmetic appearance, stigmatization, personal health and sexual relationships. It is also not commonly brought up to their spouses or doctors. We are here to find out more about this extremely common condition and dispel common misconceptions about it.


What are Anal Warts?

Anal warts are common skin growth around or inside the anal canal caused by a virus known as the Human Papillomavirus (HPV). They come in all shapes and sizes, ranging from a small pinhead-like growth to big cauliflower-like lesions. They usually do not cause patients much pain or discomfort and patients might not be aware that anal warts are present because of the nature of the location


What is HPV and how is it spread?

HPV is the most common sexually transmitted disease (STD) in the world. It is a family of viruses with more than 200 types. They are typically divided into low-risk and high-risk types based on associated risk for cancer in any body areas. The low-risk types HPV 6 and/or 11 are detected in around 90 percent of anal warts.

HPV is transmitted through contact with infected skin. Anal HPV infection is almost always acquired through sexual contact. Anal warts by themselves are not required for transmission but are highly infectious.


Common myths about anal warts

Myth #1 – My partner has anal warts, he/she is cheating on me!

This myth is responsible for a great deal of anxiety and anger. HPV infection can lie dormant in the body for months and years before causing anal warts. There is no way to find out when the infection was acquired. 

Myth #2 – Anal warts can lead to anal cancer.

Anal warts are almost always benign. They are caused by low-risk HPV types 6, 11, 42, 43 and 44 and do not develop into cancer. 

Myth #3 – HPV is incurable, and recurrence of anal warts are common.

It is indeed true that there is no known cure for HPV. However, warts and precancerous lesions can be easily treated when detected. Recurrence of anal warts is not a given, and some patients might find recurrence getting less frequent and eventually stopping with time. 

Myth #4 – Condoms use during sex will prevent HPV transmission

Unfortunately, that is not the case. Condom use will prevent transmission of pathogens such as HIV and syphilis that are spread through bodily fluids. They are not so effective against other pathogens such as herpes or HPV as they are spread through skin-to-skin contact. This is because condoms do not cover the entire external genitalia.

Nonetheless, condom use can still lower the risk of HPV transmission and other STDs. They still play an important role in sexual health and STDs prevention strategies. 


Diagnosis of anal warts

Diagnosis of anal warts is normally done at the doctor’s office clinically through a thorough history and physical examination. The majority of anal warts do not require a biopsy for diagnosis.

HPV screening for anal warts is not routinely recommended. This is because all commercial laboratories will only test for high-risk HPV types and not low-risk HPV types that causes anal warts.


Treatment

Anal warts treatment depends on the size, number, site as well as patient’s preference.

Home treatment with preparations such as Imiquimod cream or Podofilox solution are available. However, they are limited in utility due to the locations of the warts which might not be easily reached by the patient. 

Cryosurgery is the use of extremely low temperature through liquid nitrogen to destroy the abnormal anal wart cells. It can be done as an office procedure but will require multiple cycles for treatment depending on the size of the warts.

Radiofrequency ablation is a procedure in which heat, which is generated through an electric current, is used to destroy the abnormal anal wart cells. It can also be done as an office procedure. An injectable pain-killer is commonly given before the procedure to numb the area and commonly a single session will be sufficient for anal warts removal.

Finally, if the anal warts are too large or too extensive, surgical excision under general anasthesia might be considered by a surgeon. 


Prevention 

By observing safe sexual practices such as use of condoms during sex and limiting the number of sex partners, patients can reduce their chance of contracting HPV.

A vaccine (Gardasil 9) is available for males and females to prevent ano-genital warts but it will not treat existing HPV or ano-genital warts. This vaccine can prevent most cases of genital warts in persons who have not yet been exposed to wart-causing types of HPV.

Next read: WHY IS MY SEMEN GREEN OR YELLOW?

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Sclerosing Lymphangitis

Sclerosing lymphangitis is a skin condition that manifests as a firm cord-like structure encircling the coronal sulcus, which is the circumference of the base of the penile head.

Sclerosing lymphangitis is observed usually in the second or third decade, although cases as young as 18, and as old as 66 years of age have been reported. The condition is thought to be fairly common, but significantly under-reported because it is usually asymptomatic and resolves spontaneously, therefore most patients do not visit a doctor.

Various other terms have been used for this condition, including non-venereal sclerosing lymphangitis of the penis, circular indurated lymphangitis of the penis, lymphangiosclerosis and sclerotic lymphangitis.


Causes

Sclerosing lymphangitis is thought to occur from prolonged or frequent vigorous sexual intercourse or masturbation. The resulting microtrauma leads to obstruction of a large lymphatic vessel. 

Signs and symptoms

Sclerosing lymphangitis presents as a skin coloured, serpiginous cord-like thickening encircling the coronal sulcus of the penis. It can feel like a hardened, almost calcified vein. There are no signs of inflammation, and the lesion is painless. It usually develops within a few days to a week after the sexual activity. 

Treatment

Sclerosing lymphangitis can cause anxiety and embarrassment due to its genital location, alarming appearance and association with sex. However, it is self-limiting and does not require treatment aside from reassurance and advice to restrain from vigorous sexual activity until the condition subsides. In most cases it resolves spontaneously after 2 to 3 weeks, but can last up to 6 weeks or longer. Investigations such as ultrasound scan or biopsy are not necessary. In recurring cases, surgery can be performed to excise the affected vessel.

Although the condition is by definition not associated with sexually transmitted infections (STIs), patients are advised to consider basic STI screening.

Next read: COMMON CAUSES OF BUMPS & WHITE SPOTS ON PENIS & FORESKIN


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.


Find a doctor | Make an appointment

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.

How Do You Inject Caverject?

Caverject

Caverject is a medication that is used for Erectile Dysfunction (ED).

Also read: TOP 7 MYTHS AND FACTS ABOUT ERECTILE DYSFUNCTION

What’s in Caverject?

The main ingredient is Alprostadil. This medication increases blood flow into the penis and dilates the blood vessels. By so doing, it will improve erection in the penis.

Unboxing Caverject

What is included in a box of Caverject?

  • One bottle of powder – the medication
  • Two needles, one big and one small
  • A paper manual to refer to
  • A syringe that contains the diluent which will be used to dilute the medication powder
  • 2 packets of alcohol swabs

Dr Taufiq, Resident Doctor, DTAP Clinic, will be sharing on how to properly administer Caverject.


How do you inject Caverject?

Step 1: Open the vial of the powder and use an alcohol swab to clean the top of the vial.

Step 2: Break open the seal for the syringe with diluent

Step 3: Open the packaging for the large needle and attach the large needle to the syringe. Make sure it’s sealed tightly together. Pull off the cap of the needle and be careful, the needle is very sharp, do not accidentally poke yourself.

Step 4: Inject the needle into the vial and fill the vial with the diluent.

Step 5: Remove the needle and slightly shake the bottle, mixing the solution with the powder.

Step 6: Once the diluent and powder in the vial is mixed, draw out the liquid and put back the cap of the large needle in order to remove it. When putting on the cap, make sure you hear a cap sound before proceeding to turn it anticlockwise to remove it.

Step 7: Remove the smaller needle from the packaging and attach the syringe turning it clockwise until it fits. You will need to remove the excess air inside the diluent.

To do so, remove the cap of the needle, make sure the liquid goes up to the top and the air goes all the way up. Put back the cap and check with your doctor for the right dose. Inject the right dose by looking at the measuring lines at the side of the syringe.

Step 8: Preparing for the injection.

The area of injection is the top and side of the penis. Do not inject directly into the top but slightly to the right into the muscle of the penis. Clean area of injection with an alcohol swab and inject at a 45 degree angle towards the cleaned area. Go in directly and inject and once it is complete, remove it.

Step 9: After the injection you are advised to press on the injection wound and massage the medication upwards to distribute the medication into the penis muscle.

[Always dispose of sharps into a sharps box or in a container or plastic bottle.]

Potential risks or side effects?

Potential risks or side effects from using Caverject includes bleeding and pain in the penis. The risk of pain can be alleviated by pressing onto wound. If you are allergic you are advised not to use it, do speak to your doctor before using this medication.

When should I use Caverject?

Caverject is to be used 15 minutes before sexual intercourse.

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