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Given the wide spectrum in practice standards and patterns, array of covered versus out-of-pocket conditions, and role of adjunct streams of revenue, the business landscape of men’s health is diverse. Fundamental to the fiscal success of many providers is the efficacy of direct to consumer marketing in the setting of inelastic demand for solutions to aging, erectile dysfunction (ED), and Peyronie’s disease; this has created enormous markets surrounding supplemental testosterone, online platforms for ED treatment, and out-of-pocket products such as platelet-rich plasma, stem-cell therapy, and shock wave treatments. The contemporary story of men’s health has been defined by the gender health gap; uncovering the link between coronary artery disease (CAD) and ED unveiled a touchpoint for establishing holistic men’s health. University and large hospital systems have the infrastructure to support comprehensive Men’s Health Centers and have therefore maximized the downstream revenue associated with prescriptions, long-term screening, and future hospitalizations.
The internet constantly evolves and facilitates the development of new avenues for users to interact and communicate internationally. Social media and search engines represent the forefront of internet technologies that enable users to produce content, develop digital participatory networks, and share information across various topics. These internet tools are reshaping the continuum of care by enabling patients to acquire medical information, consult peers and healthcare practitioners, and even make treatment decisions without leaving their connected device. The consequences of circumventing traditional pathways to care are amplified in men’s health due to the fact that men frequently do not engage with the healthcare system and that erectile dysfunction and male infertility are stigmatized. The focus of this chapter is to evaluate the emerging online landscape for common men’s health conditions including male infertility, erectile dysfunction, hypogonadism, and Peyronie’s disease.
This chapter discusses the sites of genitourinary tract infections, infectious organisms, the numerous ways in which leukocytes may impair male reproduction, and the diagnosis and treatment of leukocytospermia and bacteriospermia. Infections of the urethra are most common due to sexually transmitted pathogens, and they are separated into two broad categories: gonococcal urethritis (due to Neisseria gonorrhoeae ) and nongonococcal urethritis (Chlamydia trachomatis, Mycoplasma species, Trichomonas vaginalis). Immunohistology employs monoclonal antibodies (mAb) targeted against white blood cell (WBC) surface markers. Flow cytometry, when used in conjunction with monoclonal antibodies, can provide rapid analysis of scant WBC subpopulations without purification procedures. Leukocytes, monocytes, and granulocytes are differentiated by using the light-scatter properties of the WBCs and the density of the leukocyte marker antibody, CD45. The chapter suggests that abnormal concentrations of leukocytes are a common finding in the semen of men with spinal cord injury (SCI).
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