Creating a highly detailed clinical history and carrying out a meticulous physical examination including the genitalia, allows the andrologist to establish the problem relating to the male’s infertility, directing the subsequent diagnostic study while indicating the necessary tests required.
At our Institute we have at our disposal the most up-to-date diagnosis techniques. Among these techniques we have 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 obtain, in most cases, an accurate diagnosis as to why male infertility is occuring, and consequently, formulating a personalised treatment plan in coordination with other departments involved in the area of fertility in our Centre.
A third of the adult male population suffers from impotence and ED. This situation worsens with age. Cardiovascular factors are the main reasons for its occurence; arterial hypertension, diabetes, tobacco, high levels of cholesterol, and the taking of some medication, are also other known factors. The first step to take in order to establish the study of this problem is to consult an andrologist who will take a confidential psychological and medical history; it is recommended that the partner of the male being assessed is also present. The study sometimes requires a full blood test to measure the level of male sexual hormones, among other things.
Todays, Instituto Bernabeu has at its disposal, several options for the treatment of male impotence as well as the necessary medical monitoring to keep a close eye on the risk factors mentioned above. These alternatives which are specific to each patient’s case include the use of orally administered drugs, penile injections to provoke an erection, surgical implanted prosthetics for the penis, etc.
Ejaculation disorders are a very frequent matter for andrology consultations, with anxiety playing a major role for many men. Medical check-ups, mostly through a clinical interview, allow in the majority of cases, an accurate diagnosis that will lead to the treatment required, whether by using orally taken drugs or by using topically applied medication or through the attendance of psychological therapy sessions.
The appearance of penis or scrotum alterations requires a visit to the andrologist. On many occasions, and via a simple physical genital examination, it is possible to determine the existence of pathologies around this area or indicate the necessity to complete a study through, among others, testicular Doppler ultrasound or the analysis of semen germ cultures.
Frequently varicocele is present, which can be associated to male infertility, testicular cysts, hydrocele, or an increasing quantity of liquid around the intra-scrotal area, cryptorchid or failure of the testes to descend to the scrotum, Phimosis, or anatomical defects of the penis. Another reason for consulting an andrologist is the appearance of blood in the semen.
In many cases, there is no clinical cause and it is enough to just reassure the patient. However it is advisable that in some other cases a more thorough study is completed and even special medical or surgical treatments undergone.
Sometimes a male’s age is associated with the appearance of symptoms linked to a decreasing number in male sexual hormones or androgen deficiency that can trigger deterioration in the quality of life of 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 cited in several validated questionnaires and the analysis of the masculine sexual hormones, principally testosterone and its related factors. Treatment, when it is considered necessary, is via 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 is a widely used and efficient technique to suppress male fertility. It is performed as a definitive solution to prevent fertility in males, even though there are certain circumstances that might motivate the reversal of this process, for example, changing partner or the psychological assimilation of not being fertile anymore. In these cases and as long as the time in which the vasectomy was performed is less than 6-8 years, the reversion can be done using a technique called vasovasostomy. At our Institute we have a great deal of experience in this field, with excellent results, leading to successful natural pregnancies.
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