Is It Pus?

April 4th, 2011 § 2 comments § permalink

Your semen analysis results came back, and it says that you have a lot of white blood cells.  What does it mean?

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White blood cells are the body’s soldiers to fight invaders like bacteria and viruses, and their presence in semen might signal an infection.  White cells also produce superoxide radicals, bullets that riddle sperm and its precious DNA cargo.

Here’s the problem: you might not have white blood cells at all.  If you put semen under the microscope, white blood cells look exactly like immature sperm cells that aren’t a problem at all.  A technician needs to stain the cells to see which cells are the bad actors.  In the picture, an innocuous cell is on the left, and to its right lies an angry white blood cell.  It’s easy to tell the difference because they’ve been stained.  But without the coloration from staining, it would be impossible to say which was which.

Unfortunately, not all labs routinely stain semen if large round cells cells are present in high amounts. Specialized semen analysis labs typically will, but general laboratories performing many different kinds of tests may not.

If your test, with staining, confirms that you do have an unhealthy amount of white blood cells in the semen, what can you do? Culturing semen in the lab doesn’t usually reveal the bacterial invaders.  The prostate turns out to be remarkably good at hiding infection, making it a difficult job to find the bug causing the problem.  Doctors often try a course of broad spectrum antibiotics to attack anything that may be lurking.  Another strategy is to use an antioxidant like coenzyme Q10 to protect the sperm from the white blood cell’s superoxide radicals.

But first you have to know if you’re dealing with white blood cells.

Banning Circumcision in San Francisco

March 7th, 2011 § 2 comments § permalink

The news is heating up lately over one San Franciscan’s attempts to ban circumcision in his city.  Is circumcision so bad that it’s worth banning?  Studies support health benefits of circumcision, including reducing the risk of human papilloma virus in men and cancer of the cervix in their female partners and lessening the chance of urinary tract infections in boys.  Three large studies in Africa (Auvert, Gray and Bailey) all show that circumcision cuts by half the risk of transmission of HIV from a woman to a man.

Foreskin contains nerve endings lost during circumcision, but removing it can’t be seriously equated to clitorectomy, the practice in some cultures of removing a girl’s clitoris at birth.  The equivalent of clitoretomy in the male would be to remove the entire glans penis, which would obviously have profound consequences on sexual sensation.  The question is, does removing the foreskin inflict such harm to a young boy that it ought to be prohibited?  LIke all medical questions, the answer comes from weighing the risks against the benefits.

The majority of circumcised men would tell you that their penises work fine without the foreskin, and so the risk of circumcision, while there, is small.  The benefits, lessening the chance of infection and cancer, are real.  It seems to me that parents choosing to circumcise their newborn boys are balancing the benefits against the risks and making a sensible choice.  If the voters in San Francisco do get a chance to vote on a ban on circumcision, I hope that they preserve that choice for parents.