What does andrology treatment mean?
Branch of medical specialty dealing with the physiology and pathology of the male reproductive system majorly is known as andrology. On a minor note, the male urology issues also fall in the andrology treatment. In other words, it is analogous to gynecology i.e study of female reproductive system. Various infections, tumors and connective tissue disorders may affect the reproductive organs in men at any stage of their life. These parts include:
· A pair of testicles
· Ductal system including epididymus and vas deferens
· Accessory glands like seminal vesicles and prostrate gland
MedcureIndia provides guidelines to its readers on the various aspects of andrologic issues and their treatment in the following lines.
Causes of andrology disorders:
These may affect any of the reproductive organs in men, at any stage of their life cycle. Disorders may occur due to:
- High stress levels, excessive smoking, alcohol, drug abuse, uncontrolled hypertension may lead to erectile dysfunction (ED).
- Trauma in the groin or pelvic region leads to swelling, pain, twisting of ducts in the scrotum.
- Gnetic mutations may lead to male infertility.
- Varicocele i.e swelling in testicular veins, testicular cancer may also lead to infertility
- Prostrate cancer may occur due to genetic alterations or secondary bacterial/viral infections in old age
Signs & symptoms of andrology disorders:
· Loss of libido (sexual urges)
· Pain or discomfort while erection
· Decreased sperm count, reduced quantity of semen
· Painful/uncomfortable/premature ejaculation
· Pain, swelling or lump in the testicular area
Diagnostic tests for andrology disorders:
- Medical and Sexual history: Ruling out any cardiovascular pathology and diabetes is routinely done. The interrogation on frequency of sexual urges and intercourse become a part of sexual history.
- Physical examination: This includes careful palpation of the penis and testicles for sensation. Any visible pathology such as swelling or lump, damage to arteries/nerves is also examined.
- Lab tests: The seminal fluid is examined for the count and motility of sperms. Sperms maybe adequate in number, but may have reduced motility and hence fail to enter vagina completely. This maybe a major cause for impotence.
- Ultrasound of the scrotum and penis is advised in cases of trauma to detect the location of pathology, a prime test in cases of testicular cancer.
Types of andrology disorders:
Involving the penis:
- Erectile Dysfunction ED: It is one of the major issues faced by men in the modern era. It is an inability to maintain erection of the penis during sexual intercourse. Primarily occurs due to high stress, depression, anxiety levels. It may also occur due lack of self confidence and performance pressures. ED may also occur secondary to damage to nerves and arteries innervating the penis, underlying medical conditions such as high blood pressure and increased blood glucose levels.
- Sexual dysfunction: Not typically related to penis, it is the inability to enjoy sexual intercourse owing to psychosomatic issues. Loss of sexual desires, unsustained orgasm and difficulty in ejaculation are the major signs.
- Penile fracture: The core of penis is formed by corpora cavernosa which is covered by a fibrous sheath. A breach or tearing between these two may occur due to forceful vaginal penetrance or aggressive masturbation leading to fracture of the penis.
- Premature ejaculation: It is an early orgasm stage leading to early release of seminal fluid. Quite a common condition, it is the female counterpart who remains sexually unsatisfied; may lead to relationship issues. The penile erection is not affected in such conditions, however the hormonal levels are quite possibly so shooted up that they actually prevent pleasure during sex, with probably no foreplay and a too early orgasm.
Involving the ductal system:
These are a system of ducts, one on each side called vas deferens and epididymus carrying sperms from the testicles to the urethra for ejaculation. The diseases they encounter include:
- Ejaculatory duct obstruction: It occurs due to narrowing of the ductal system secondary to pressure in the scrotal region or progressive thinning of the ductal epithelium. As a result, there is obstructed flow of semen during ejaculation along with pain and gradual loss of libido.
- Epididymitis: It is condition of severe inflammation and swelling of the epididymus. May also be seen as a lump behind the scrotum (sac carrying the testicles). It mainly occurs due a severe blow or trauma in the scrotal region, may also occur as a result of infection. In such conditions, urination and ejaculation both become very painful.
- Congenital absence: Very rarely, one or both the vas deferens maybe absent since birth, or maybe poorly developed. In such cases the scrotal sacs are quite enlarged but function properly.
Involving the testicles:
- Testicular cancer: It is very common in men in the age group of 35-70. A nodule/lump/hard mass is seen in the scrotal region which is painful on palpation. It may involve either one or both the testes. Sperm and testosterone levels highly fluctuate in such cases.
- Testicular trauma and torsion: In cases of accidents, fights, trauma may occur in the groin region. This may lead to rupture of blood vessesl in the testicular area, tenderness and very frequently causes torsion or twisting of the ducts attached to the scrotum.
- Hydrocele: Excessive collection of fluid in the scrotal sac is termed a hydrocele. It may occur as an internal injury within the scrotum or as a response to external trauma. These conditions are quite unpainful, however discomfort and heaviness along with a visibly enlarged scrotum are the signs.
- Varicocele: These are engorged and entangled blood capillaries within the scrotum giving it a bluish appearance. They may often lead to decreased sperm count along with reduced seminal fluid levels.
Treatment of andrology disorders:
- Medications, exercise and counseling: A host of medicines are available in the market which increase the libido, prolong the sexual pleasure time by enhancing blood supply to the penis. This in turn increases the erection and sustains it for a longer time. On similar lines, medications are also given to increase the sperm count or quantity of the seminal fluid.
- Infections of vas deferens and Varicocele too are subsided completely by medicines and very rarely require surgical intervention.
- Monitoring of the diet, regular exercises of the groin region promoting increased vascular supply to the scrotum and penis are often advised by the andrologist. Patients are also councelled to quit smoking/alcohol, yoga/mediatation to reduce anxiety/stress disorders.
- Penile implants/prosthesis: It is the placement of an implant or a medical device called prosthesis surgically into the corpora cavernosa of the penis. These consist of a cylinder inserted into the penis and a pump into the testes. In a semirigid type of implant, the penis feels hard during most time of the day and the hardest during having sex. In an inflatable type of implant, the penis enlarges by vigorous rubbing during masturbation and vaginal penetration. Excessive use of the cylineror improper rubbing, may cause early failure or dislocation of the implant.
- Orchiectomy: This is the first line of treatment in testicular cancer to prevent the invasion in the adjacent tissues. In this procedure, either one or both the testicles are surgically removed. Production of sperms and the ability to reproduce is possible with one testes too. However, men become infertile after removal of both the testes. It is procedure performed under general anaesthesia and patient gets discharged after complete healing.
- Lymph node surgery: This involves surgical removal of the affected lymph nodes in testicular cancer. It may be done either in a single surgery or maybe done along with orchiectomy.
- Radiation and Chemotherapy: Either of the two can be done pre or post the surgical removal of testes depending upon the stage of testicular cancer.
- Suction and drainage of the scrotum under general anaesthesia is done in cases of hernia.
Complications & risk factors associated with andrology disorders:
- Medications usually do not pose any risk, however prolonged and excess dose may lead to permanent infertility.
- Underlying systemic diseases like hypertension and high blood glucose levels pose a threat even after surgical intervention.
- Penile implants are at a risk of infection, dislocation due to trauma.
Success Rate in India:
Orchiectomy opted for surgical removal of testes shows 97 percent success rate. Penile implants however wear out after a period of 10-12 years in 78 percent of men. In approximately 2.6 percent of men, implants may fail.
MedcureIndia is one of the finest health tourism groups in the country, dealing with both natural and prosthetic surgical approaches. With andrology issues affecting 45.89 percent of the world’s male population, our team believes in extending a helping hand in the complete eradication of this stigma. We direct our clients to the highly equipped and intellect professionals ensuring complete recovery from the pathology.