What are the three main reasons for urological consultation during confinement

In these days of quarantine I have recorded an exponential increase in requests for consultation by patients, especially young men, for three reasons. Firstly, testicular pain. These are men between 25 and 45 years of age who present with pain in one or both testicles, with no apparent cause and that persists over the days.

Also very frequent are patients with urinary discomfort, such as itching, a feeling of urgency, frequent urination and irritative symptoms of the glans and scrotum. Lastly, I receive many patients, especially in video consultations, who complain of episodes of erectile dysfunction, which they have never had before.

Are these urological consultations related to isolation?

The confinement of the last few weeks has forced us to change habits and customs. This abrupt and radical change of life, undoubtedly, has consequences on health aspects in general and on our uro-genital apparatus.

Most of us have stopped doing sports and spend many hours sitting in the same position while teleworking. Prolonged sedentary lifestyle, together with the increased basal muscle tone, due to the stress we all have these days, can be responsible for a tension of the scrotum and pelvic floor, which generates testicular pain by compression.

Being in the same position for many hours can affect the ability of the bladder to empty completely when urinating. This is called post voiding residue, and it can irritate the bladder itself, which reacts by sending a feeling of urgency and pain to the brain. In addition, a bladder residue can be the cause of urinary tract infections, also favored by the poor hydration that is normal at home.

Regarding triggering, a correlation can be identified with the state of confinement. It is not easy to manage emotions as strong as the ones we have during these weeks, especially considering that it is extremely difficult to have moments of healthy regenerative solitude. Despite the efforts to be positive, these are days of fear and stress, which in the body are converted into adrenaline. Adrenaline is a potent vasocostrictor and inhibits the erectile phenomenon, which is based on vasodilation of the vascular structures of the penis.

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What do you recommend these men do while waiting until they can return to normal?

The confinement may be just a coincidence. This is why, in all cases, it is advisable to see a specialist to rule out an organic pathology.

This is the case, for example, of testicular cancer. It is obvious that most patients with testicular pain these days are not hiding anything serious but it is worth remembering that testicular pain is the first symptom in 20-27% of cases. In the same way it is necessary to rule out a urinary tract infection or an onset of prostatic hyperplasia in those patients who complain of irritative urinary symptoms.

Once a urologist has been consulted and the patient’s state of health is assured, the solution can begin with a short daily sports session, including muscle stretching, in order to relax the pelvic floor muscles. Also try some relaxation technique to reduce the amount of adrenaline in the blood.

Regarding episodes of erectile dysfunction, it is mandatory to find a way to reduce stress. To do this the key is to plan the days, trying to balance the various activities. Waking up early and making a plan is a good start: deciding how many hours to dedicate to teleworking and agreeing with your partner on times to dedicate time to each other is fundamental. However, learning to deny yourself in bed can also be a tool to reduce nervousness. The fact that we spend so much time with our partner does not mean that we have to desire her every moment. We all have to assume that an occasional rejection in bed is not a rejection of the person, but of the specific sexual moment.