Testicular health awareness in pubertal males.
PURPOSE: We examined the knowledge and understanding of male teenagers of the necessity for genital examination, and signs and symptoms of serious testicular pathology. Furthermore, current national guidelines for health education were reviewed to understand better the curriculum used by the educational system and to assess its effectiveness. MATERIALS AND METHODS: In 1998, a 5-question survey was administered privately and confidentially to male athletes before a sports physical examination. The athletes were 12 to 18 years old, attended middle or high school, and were sampled randomly. The National Health Education Standards benchmark for grades 9 through 11 was examined with specific attention to male self-health education standards. RESULTS: A total of 318 athletes responded revealing that 54% did not know why the genitals were examined on a sports physical examination, 45% did not use appropriate testicular protection and the majority did not respond appropriately to symptoms of serious testicular pathology. Despite the fact that 46% of respondents answered that checking for a hernia is reason for a genital examination there was no mention of tumor, infection or varicocele. Review of the benchmarks revealed no standards referring to a minimum understanding of anatomy or physiology. Generalized guidelines for high risk behaviors were provided without specific mention of testicular torsion, cancer, varicocele or sexually transmitted diseases. CONCLUSIONS: Young males are at higher risk for testicular torsion, cancer and varicocele than other age groups, and yet our population was universally unaware of these as a reason for genital examination. Furthermore, the majority did not respond appropriately to questions regarding serious testicular pathology. Review of national guidelines reveals poorly defined, nonspecific provisions for male self-health care. Therefore, we have developed a curriculum for male self-health to address this problem.