For young adults

The collective term sexually transmitted infections (STD) covers infections caused by bacteria, viruses, fungi or parasites, which are mainly transmitted through sexual contact. If the infection leads to disease, it is called a sexually transmitted disease. Sexually transmitted diseases are among the most significant and common diseases worldwide, with about one million new infections per day.

The most common complaints that indicate a sexually transmitted disease are discharge from the urethra or vagina. In addition, there is burning and itching in the urethra, burning during urination, pain in the genital area and lower abdomen, swelling of the lymph nodes and painless but also painful open sores in the genital area. If left untreated, there is a risk of serious effects and subsequent damage. If a sexually transmitted disease is suspected, laboratory diagnostics are necessary. Due to the large number of possible pathogens, there is no standardized test. Depending on the situation, urine and/or blood tests are performed. In principle, the attending physician must decide which test is necessary and useful.

Treatment depends on the pathogen. Thus, bacterial infections (e.g. gonorrhea, syphilis, chlamydia or ureaplasma) can be treated with antibiotics. Diseases caused by viruses, such as HPV infections, can be treated with medication or surgery (e.g. condyloma removal).

Around 70% to 80% of sexually active women and men become infected with HPV during their lifetime. In 70% of these cases, the virus disappears within one year of infection and in 90% within two years. Those aged 16 to 25 are particularly affected. The frequency of HPV infections increases with the number of sexual partners and the risk of infection is highest at the beginning of sexual activity.

Until now, there have been two different vaccines against HPV: both protect against the two HPV types that most frequently cause cervical cancer and other cancers (16 and 18), and one of the vaccines additionally protects against two other types (6 and 11) that cause genital warts. Since 2019, there is a new vaccine (Gardasil 9®) that protects against five additional cancer-causing HPV types in addition to the previous four.

The benefit of vaccination is greatest when it is completed before the first sexual experience. HPV vaccination is therefore recommended for all adolescents aged 11 to 14 years. HPV vaccination is also useful for 15- to 26-year-olds, which is why it is recommended as a catch-up or supplementary vaccination.

The cost of vaccination is fully covered for girls and boys aged 11-26. For this, the vaccination must be carried out as part of a cantonal vaccination program. The physicians of alta uro support the cantonal HPV vaccination program of the Canton of Basel-Stadt and are included in the list of participating physicians by the Health Department.

Vaccination is most useful before the start of sexual activity and thus before infection with HPV viruses. For optimal protection, two injections at six-month intervals are necessary before the 15th birthday and three injections over a period of at least six months from the 15th birthday.

No. Compared to vaccination, antibody formation occurs less frequently after a natural HPV infection and immunological protection against a new HPV infection is rare. HPV vaccination, on the other hand, reliably stimulates the immune system.

Erectile dysfunction (ED) is a common sexual disorder in men. It represents the inability to establish or maintain penile rigidity sufficient for satisfactory sexual intercourse. Common causes of ED include cardiac or vascular disease, diabetes mellitus, pelvic surgery, neurological disease, or decreased testosterone levels.

First of all, a detailed conversation is the basis of a diagnosis. We go into detail about the patient's medical and sexual history. This serves to accurately assess the severity of the ED and to identify any risk factors. In addition, a physical examination and blood analysis are performed. A more advanced examination is the erectile tissue injection test, which determines the flow rate of blood in the penis after an artificially induced erection.

In the treatment of ED, it is important to understand the causes and consequences of the disease. We include physical and psychological aspects of ED in the treatment. Recommendations for improved lifestyle are at the top of the list of therapy options. For example, stopping smoking or exercising regularly can already lead to a significant improvement in erection.

The so-called phosphodiesterase-5 inhibitors (PDE-5 inhibitors) play an important role in drug therapy. This group of drugs leads to improved blood flow to the penis and an easier erection. Various active ingredients are available for this purpose, which differ in particular with regard to the onset of the effect and the duration of action. Both on-demand and daily use of preparations are available.

As an alternative to drug therapies, alta uro offers extracorporeal shock wave therapy (ESWT) to improve erectile dysfunction. This involves delivering shock waves to different areas in the penis. The therapy can cause constricted or damaged blood vessels to recover permanently. The formation of new blood vessels in the corpus cavernosum can lead to better blood flow to the penis and improved erection. One treatment lasts about 15-20 minutes. Depending on the severity, between 6 and 10 therapy sessions are required. The therapy does not cause any pain and is performed on an outpatient basis in our practice.

Another form of therapy is the so-called MUSE therapy. Here, an applicator is used to apply a pellet of active substance into the urethra, which leads to an erection. In addition, there is the possibility of a corpus cavernosum injection therapy (SKAT). In this form of therapy, a vasodilator is injected directly into the corpus cavernosum using a very fine syringe.

Premature ejaculation (ejaculatio praecox) is when a man permanently "comes too soon". In extreme cases, affected men find it impossible to penetrate their partner at all, or the mere thought of a sexually arousing situation is enough to cause them to have an orgasm.

A distinction is made between a lifelong (primary) form, for which, among other things, genetic, hormonal changes are possible. Premature ejaculation usually occurs at a young age. The acquired (secondary) form is usually due to diseases or risk factors, such as hyperthyroidism, postata inflammation, emotional problems and stress.

Previously, analogous to the assumption that premature ejaculation is mostly psychological, the main focus was on behavioral therapy approaches. Here, the couple jointly interrupts sexual activity when the man feels climax or a painful stimulus is applied to the glans (squeeze), thus suppressing ejaculation. Since behavioral treatment approaches usually show no or only short-term success, drug therapy has become the focus in recent years.

A treatment concept that has been tried and tested for some time is the local application of numbing drugs in the form of ointments, creams or sprays. These are applied to the glans and the foreskin frenulum about 15-20 min before sexual intercourse. The active ingredient dapoxetine (trade name: Priligy) is the only medication in tablet form approved by the drug authorities for the treatment of premature ejaculation. In addition, alta uro works with experienced sex and couples therapists, so that in the vast majority of cases a satisfactory result can be achieved for all concerned through a multimodal treatment concept.

Testicular cancer is a malignant growth in the testicle in which the cells of the testicle change so that they grow unchecked. Later, the testicular tumor can potentially metastasize to other organs through lymphatic channels or the blood. Testicular cancer is the most common malignant cancer in young men between the ages of 20 and 40. Each year, approximately 400 men in Switzerland are newly diagnosed with testicular cancer. Testicular cancer accounts for about 1% of all cancers in men. Risk factors for testicular cancer are, for example, undescended testis, a tumor in the opposite testis, infertility, and a first-degree relative already suffering from testicular cancer.

In addition to an examination of the testicles, an ultrasound examination is standard. With ultrasound, the testicles can be examined excellently and with high resolution and thus a testicular tumor can be excluded or confirmed. If an abnormality is confirmed in the ultrasound, a blood sample of the so-called testicular tumor markers is taken. In addition, a computer tomography of the abdominal cavity and the lungs is performed in order to clarify whether any reducers are present.

If a testicular tumor is suspected, the affected testicle must be surgically exposed and removed via an inguinal incision. This procedure is performed under anesthesia. Subsequently, the tumor is examined by the pathologist and the final diagnosis is confirmed. If the findings are unclear, the tissue can be examined directly by the pathologist during the operation (frozen section). If the suspected tumor is confirmed, the testicle must be removed. Depending on the final tumor findings in the tissue examination, chemotherapy must be administered in certain risk constellations. This will be determined in a tumor case discussion together with experts from other specialties and you will then be assigned to the experts.