Common genitourinary health issues that arise in the care of male patients
include prostatitis, benign prostatic hyperplasia, urogenital cancers, prem
ature ejaculation and erectile dysfunction. Bacterial infections are respon
sible for only 5 to 10 percent of prostatitis cases. Benign prostatic hyper
plasia is present in 90 percent of men by the age of 85. Common urogenital
cancers include prostate cancer, transitional cell carcinoma of the bladder
and testicular cancer Although an estimated 10 percent of men eventually d
evelop prostate cancer, screening for this malignancy is one of the most co
ntroversial areas of health prevention. Premature ejaculation occurs in as
many as 40 percent of men. Treatment with tricyclic: antidepressants, selec
tive serotonin reuptake inhibitors, counseling or behavioral therapy may be
helpful. Erectile dysfunction affects up to 30 percent of men between 40 a
nd 70 years of age. Stepped therapy is a useful approach to this common mal
ady. Good treatment results have been obtained with orally administered sil
denafil and intraurethrally administered alprostadil.