April: Testicular Cancer Awareness Month

Welcome to my April newsletter. This month is dedicated to raising awareness about testicular cancer—the most common cancer in young men aged 15-35. It's a cause deeply important to me, as early detection truly saves lives. I'm also excited to share new developments from my practice and insights from recent medical conferences.

In This Edition

🎗️ Testicular Cancer Awareness Month

As a urologist, I've witnessed firsthand how early detection dramatically improves outcomes for testicular cancer. With survival rates exceeding 95% when caught early, this is one of the most treatable cancers—yet awareness remains surprisingly low among young men, who are most at risk.

Key Warning Signs:

• A painless lump or swelling in the testicle
• A feeling of heaviness in the scrotum
• A dull ache in the lower abdomen or groin

Monthly self-examinations using the TSE method—Touch, Spot changes, Examine thoroughly—take just minutes but could save your life. The best time to perform the exam is after a warm shower when the scrotum is relaxed.

🐾 Jaguar in the Jungle: Part II

Last month, I introduced the metaphor of the "Jaguar in the Jungle" to help explain psychogenic erectile dysfunction. The response has been overwhelming, with many of you sharing how this framework helped illuminate your experiences.

In Part II, I delve deeper into the barriers men face when navigating their health—cultural norms that discourage vulnerability, societal expectations that equate seeking help with weakness, and the personal fears that often keep men silent about their concerns.

Breaking Through Barriers

Throughout my years of practice, I've observed that education and open conversation are powerful tools for dismantling these barriers. By understanding the "jungle" of factors affecting male health, we can begin to clear paths through the underbrush of stigma and silence.

👨‍⚕️ Meet Dr. Edson Nogueira: Endocrinology Consultant at Chelsea and Westminster Hospital NHS Foundation Trust

I'm thrilled to introduce a highly valued member of our multidisciplinary team: Dr. Edson Nogueira, Consultant in Endocrinology, Diabetes, and General Medicine. Dr. Nogueira is a trusted expert in managing complex hormonal conditions, offering vital support to patients facing challenging endocrine issues. At Chelsea and Westminster Hospital, his exceptional expertise in hormonal health beautifully complements my urological practice.

Dr. Nogueira earned his MD in Brazil before completing his PhD with Distinction in endocrinology at the Medical College of Georgia (USA). He further refined his skills during clinical training at Barts Health NHS Trust and Imperial College London.

Areas of Expertise:

• Gender-affirming hormone treatments
• Male hypogonadism (testosterone deficiency)
• Adrenal gland disorders
• Cardiovascular risk management (hypertension, obesity, diabetes)

His patient-centered approach earned him the "Role Model of the Year" award in 2022 from Chelsea and Westminster Hospital NHS Trust—a testament to his dedication to compassionate care. I believe his expertise will be invaluable for many of my patients who require integrated hormonal and urological care.

🏥 Highlights from EAU 2025 Congress

Last month, I attended the 40th Annual European Association of Urology (EAU) Congress in Madrid. These gatherings are vital for staying at the forefront of urological care, and this year's event showcased truly groundbreaking research that I'm excited to incorporate into my practice.

Surgical Complications: The Hidden Pandemic

A powerful spotlight was placed on what experts are calling the "hidden pandemic" of surgical complications in urology. Professor John Kelly emphasized how enhanced recovery protocols (ERPs) can reduce complications and improve patient outcomes. These protocols focus on optimizing the entire surgical journey—from preoperative preparation to postoperative care—through evidence-based strategies. I've already begun implementing many of these principles to ensure the safest possible experience for my patients.

Prehabilitation and Rehabilitation: A Game-Changer

One of the most exciting trends discussed was the integration of prehabilitation and rehabilitation into surgical care. Preparing patients physically and mentally before surgery with tailored exercise regimens, nutritional optimization, and psychological support significantly enhances resilience and recovery. Evidence presented showed that patients who underwent prehabilitation experienced fewer complications and quicker recoveries—a practice I'm committed to adopting more comprehensively.

Peyronie's Disease Management: New Horizons

Peyronie's disease (PD) took center stage with groundbreaking insights into treatment options. New data emphasized individualized surgical approaches, with plaque incision/excision with grafting remaining the gold standard for severe cases. On the medical management front, collagenase clostridium histolyticum (XIAFLEX®) was shown to benefit patients even during the acute phase—a significant shift from traditional "wait-and-see" approaches that could transform how we address this challenging condition.

These advances represent just a fraction of the innovations discussed at EAU 2025. I'm particularly excited about implementing these evidence-based approaches to provide you with the most advanced care possible.

🌐 Website Redesign: Coming Soon!

I'm excited to share that I'm currently undertaking a comprehensive redesign of the GGO Med website. This isn't just a visual refresh—it's a complete structural overhaul aimed at making it easier for you to find the information you need about urological and andrological care.

While these major changes are being implemented, I'm continuing to publish new educational content on the current platform. Recent additions include:

• Penile Low-Intensity Extracorporeal Shock Wave Therapy (LiESWT) – An innovative approach to erectile dysfunction treatment that uses sound waves to improve blood flow and tissue regeneration
• Erectile Dysfunction – Comprehensive overview of causes, diagnosis, and the full spectrum of treatment options available
• Penile Doppler Ultrasound – Detailed explanation of this specialized diagnostic test that assesses blood flow within the penis
• Frenuloplasty – Surgical solutions for frenulum problems, including techniques, recovery, and expected outcomes

Stay tuned for the launch announcement—I think you'll find the new site not only more visually appealing but also much more intuitive to navigate. My goal is to create a resource that truly empowers you with knowledge about your health.

Ready to Discuss Your Health?

Whether you have concerns about testicular health, erectile function, or any other urological or andrological issue, I'm here to help. My approach combines medical expertise with a deep commitment to understanding your unique circumstances and goals.