Andrology
Andrology is a branch of urology, it relates to all male genital and reproductory systems treatment.
Infertile male study
Tailoring a highly detailed clinical history and carrying out a meticulous physical exploration general as well as genital, allows the andrologist to establish the problem relating to the male’s infertility, directing the subsequent diagnosis study indicating the necessary tests required.
At our institute we have at our disposal the most relevant diagnosis techniques; among them we can highlight testicular Doppler Ultrasound to assess among others, the existence of testicular varicocele or dilation of the testicular veins (frequently causes male infertility); the seminogram or semen test, this allows us to determine the number and characteristics of the spermatozoids taken; general test blood and assessment of the male’s sexual hormones; genetic study (karyotype, FISH; TUNEL) and the testicular biopsy
Through these tests we get, in most cases, accurate diagnosis as to why male infertility is happening, therefore, formulating personalized treatment in coordination with other departments involved in the area of fertility in our Centre.
Impotence and erectile dysfunction
A third of the adult male population suffers from impotence and erectile dysfunction, this situation gets worsen with age. Cardiovascular factors are the main reasons for the appearance of it; arterial hypertension, diabetes, tobacco, high levels of cholesterol, and the taking of some medicaments, are also other known factors. The first step to take in order to establish the study of this problem is to assist to an andrologic consultation in which a confidential psychological and medical history is written down; it is recommended that the partner of the person being assessed is also present for the said report. The study sometimes requires a full blood test to measure the level of male sexual hormones, among others.
Nowadays, Instituto Bernabeu has at its disposal, several options for the treatment of male impotence as well as the necessary medical control to keep a close eye on the risk factors mentioned above. These alternatives include the use of orally administered drugs, penis injections to make erection happen, surgical implantation of prosthetics for the penis with personalized indications for every patient.
Ejaculation disorders
Ejaculation disorders are a very frequent matter for andrologic consultation, with anxiety being, in some cases, a big psychological problem for men. Medical check ups, mostly through a clinical interview, allows in the majority of cases, an accurate diagnosis that will point out to the treatment required, whether by using orally taken drugs or by using topically applied medicines or through the attendance to a psychological therapy session.
Penis and scrotum illnesses
The presence of penis or scrotum alterations, that have appeared recently, means that an andrologic valuation is required. In many occasions, and just through a physical genital exploration, it is possible to determine the existence of any pathology around this area or indicate the necessity to complete the study through, among others, testicular Doppler ultrasound or analysing semen germs cultures.
It is frequent the presence of varicocele, associated or not to men’s infertility, testicular cysts, hydrocele, or the increasing quantity of liquid around the intra-scrotal area, cryptorchid or failure of the testes to descend to the scrotum, Phimosis, anatomical defects of the penis. Another reason for consulting an andrologist is the appearance of blood in the semen.
In many cases, it will be enough just to calm the patient down as often the finding has no medical importance however it is advisable that in some other cases a more thorough study gets done and even special medical or surgical treatments applied.
Andropause and Late onset hypogonadism in aging males
Men’s age, is sometimes, associated with the appearance of symptoms linked to a decreasing number in the male sexual hormones or androgen deficiency that can trigger quality life deterioration in the adult males. A decrease in body mass or muscular strength, increase of abdominal fat, loss of sexual interest, or sexual impotence can be related to low levels of testosterone in the blood.
The medical diagnosis of the androgenic deficit in males, particularly in men older than 50 years of age, is based on the presence of the syndrome valuated through several validated questionnaires and the analysis of the masculine sexual hormones, principally testosterone and its related factors. Treatment, when is considered necessary, will be based on a hormonal substitution therapy that will require a medical follow up by the andrologist, in order to adjust the doses and to avoid possible adverse effects.
Vasectomy revision or vasovasostomy
Vasectomy is a vastly used and efficient technique to suppress male fertility. When this is performed, it’s meant to be a definitive solution to prevent fertility in males, even though there are certain circumstances that might motivate the reversion of this process like, changing partner or the psychological assimilation of not being fertile anymore, etc. in these cases and as long as the time such vasectomy was performed is less than 6-8 years old, the reversion can be done using a technique called vasovasostomy. In our institute we have a vast experience in this field, with excellent outcomes resulting in successful natural pregnancies.
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