Overcoming barriers to prostate cancer care in the Philippines

Prostate cancer (PCa) is a health concern affecting millions of men globally, with a concerning rise in incidence in the Philippines, a country that faces a complex set of barriers to equitable access to quality PCa care. In this article, we describe the unique geographic, economic, socio-cultural, and political factors that influence access to screening, diagnosis, treatment, and supportive services in the country, and explore avenues for development. The country lacks a nationwide PCa registry to inform resource allocation and guide PCa cancer care programs and policy. Misconceptions, cultural barriers and negative attitudes about PCa among Filipino men adversely influence health-seeking behavior. Inadequate insurance coverage, and high out-of-pocket costs obstruct access to essential care. Geographic and political factors contribute to the uneven distribution of healthcare resources needed for comprehensive PCa care, including access to medical specialists, essential medicines, and surgical and radiotherapeutic equipment. Overcoming these challenges requires a collaborative effort encompassing robust data collection, awareness campaigns to reshape societal norms, policy and economic reforms, infrastructure improvements, and enhanced collaboration among healthcare professionals to provide evidence-based care. Addressing these issues holistically can pave the way to better outcomes and improved quality of life for Filipino men with this life-altering disease

Consensus and Diversity in the Management of Varicocele for Male Infertility: Results of a Global Practice Survey and Comparison with Guidelines and Recommendations

Varicocele is a common problem among infertile men. Varicocele repair (VR) is frequently performed to improve semen parameters and the chances of pregnancy. However, there is a lack of consensus about the diagnosis, indications for VR and its outcomes. The aim of this study was to explore global practice patterns on the management of varicocele in the context of male infertility

Consensus and diversity in the management of varicocele for male infertility: Results of a global practice survey and comparison with guidelines and recommendations

Purpose: Varicocele is a common problem among infertile men. Varicocele repair (VR) is frequently performed to improve semen parameters and the chances of pregnancy. However, there is a lack of consensus about the diagnosis, indications for VR and its outcomes. The aim of this study was to explore global practice patterns on the management of varicocele in the context of male infertility. Materials and Methods: Sixty practicing urologists/andrologists from 23 countries contributed 382 multiple-choice-questions pertaining to varicocele management. These were condensed into an online questionnaire that was forwarded to clinicians involved in male infertility management through direct invitation. The results were analyzed for disagreement and agreement in practice patterns and, compared with the latest guidelines of international professional societies (American Urological Association [AUA], American Society for Reproductive Medicine [ASRM], and European Association of Urology [EAU]), and with evidence emerging from recent systematic reviews and meta-analyses. Additionally, an expert opinion on each topic was provided based on the consensus of 16 experts in the field. Results: The questionnaire was answered by 574 clinicians from 59 countries. The majority of respondents were urologists/uro-andrologists. A wide diversity of opinion was seen in every aspect of varicocele diagnosis, indications for repair, choice of technique, management of sub-clinical varicocele and the role of VR in azoospermia. A significant proportion of the responses were at odds with the recommendations of AUA, ASRM, and EAU. A large number of clinical situations were identified where no guidelines are available. Conclusions: This study is the largest global survey performed to date on the clinical management of varicocele for male infertility. It demonstrates: 1) a wide disagreement in the approach to varicocele management, 2) large gaps in the clinical practice guidelines from professional societies, and 3) the need for further studies on several aspects of varicocele management in infertile men