Andrology is a subspecialty of Urology which involves treatment of various conditions causing male infertility and male sexual dysfunction. In short, Andrology deals with male reproductive health, a counterpart to Gynaecology. The late arrival of the andrological discipline on the stage of modern medicine gave it the advantage of utilizing all the modern achievements of basic and clinical science, from molecular biology to genetics, reaching levels of high quality. NU Hospitals is one of the few centres to proudly have a dedicated Andrology unit with up-to-date infrastructure offering international expertise.

Process

Andrology covers anomalies in the connective tissues pertaining to the genitalia, as well as changes in the volume of cells, such as in genital hypertrophy or macrogenitosomia

From reproductive and urologic viewpoints, male-specific medical and surgical procedures include vasectomy, vasovasostomy (one of the vasectomy reversal procedures), orchidopexy and circumcision as well as intervention to deal with male genitourinary disorders such as the following:

What is andrology?

Andrology is a medical specialty which deals with the male reproductive system and urological problems found only in men. Andrology is the direct equivalent of gynaecology, but unlike gynaecology, it is not widely recognised as its own distinct speciality.

Men's Sexual Health

Sex is an important part of life. For many men, thinking about sex starts early, often before puberty, and lasts until their final days on earth.

On one level, sex is just another hormone-driven bodily function designed to perpetuate the species. On another, it's a pleasurable activity. It's also an activity that can help cement the bonds between two people. Sexual health refers to a state of well-being that lets a man fully participate in and enjoy sexual activity. A range of physical, psychological, interpersonal, and social factors influence a man's sexual health.

Optimal male sexual health includes sexual desire (libido) and the ability to get and sustain an erection (erectile function). Although physiology can affect both the desire for sex and the ability to have sex, mental health and emotional factors also play important roles.

Male sexual health isn't merely the absence of disease. Erectile dysfunction (ED) is the inability to get an erection or to maintain it long enough for satisfying sexual activity. Many things can cause ED, including stress, depression, relationship issues, abnormally low testosterone, damage from urological surgery, and even cholesterol-clogged arteries. In fact, it is often an early warning sign for heart disease. ED can be treated with pills, injections into the penis, or devices. Men can also experience difficulties related to ejaculation, including premature ejaculation, delayed ejaculation, or the inability to experience orgasm upon ejaculation (anorgasmia). Male sexual health also covers the prevention and treatment of sexually transmitted diseases and the assessment and treatment of male infertility.

Male infertility

Nearly 1 in 7 couples is infertile, which means they haven't been able to conceive a child even though they've had frequent, unprotected sexual intercourse for a year or longer. In up to half of these couples, male infertility plays at least a partial role. Male infertility can be caused by low sperm production, abnormal sperm function or blockages that prevent the delivery of sperm. Illnesses, injuries, chronic health problems, lifestyle choices and other factors may contribute to male infertility. The inability to conceive a child can be stressful and frustrating, but a number of treatments are available for male infertility.

Symptoms

The main sign of male infertility is the inability to conceive a child. There may be no other obvious signs or symptoms.

In some cases, however, an underlying problem such as an inherited disorder, hormonal imbalance, dilated veins around the testicle or a condition that blocks the passage of sperm causes signs and symptoms. Signs and symptoms you may notice include:

• Problems with sexual function — for example, difficulty with ejaculation or small volumes of fluid ejaculated, reduced sexual desire, or difficulty maintaining an erection (erectile dysfunction)
• Pain, swelling or a lump in the testicle area
• Recurrent respiratory infections
• Inability to smell
• Abnormal breast growth (gynecomastia)
• Decreased facial or body hair or other signs of a chromosomal or hormonal abnormality
• A lower than normal sperm count (fewer than 15 million sperm per milliliter of semen or a total sperm count of less than 39 million per ejaculate)

Causes

Male fertility is a complex process. To get your partner pregnant, the following must occur:

• You must produce healthy sperm. Initially, this involves the growth and formation of the male reproductive organs during puberty. At least one of your testicles must be functioning correctly, and your body must produce testosterone and other hormones to trigger and maintain sperm production.
• Sperm have to be carried into the semen. Once sperm are produced in the testicles, delicate tubes transport them until they mix with semen and are ejaculated out of the penis.
• There needs to be enough sperm in the semen. If the number of sperm in your semen (sperm count) is low, it decreases the odds that one of your sperm will fertilize your partner's egg. A low sperm count is fewer than 15 million sperm per milliliter of semen or fewer than 39 million per ejaculate
• Sperm must be functional and able to move. If the movement (motility) or function of your sperm is abnormal, the sperm may not be able to reach or penetrate your partner's egg.

Medical causes

Problems with male fertility can be caused by a number of health issues and medical treatments:

• Varicocele A varicocele is a swelling of the veins that drain the testicle. It's the most common reversible cause of male infertility. Although the exact reason that varicoceles cause infertility is unknown, it may be related to abnormal blood flow. Varicoceles lead to reduced sperm quantity and quality.
• Infection Some infections can interfere with sperm production or sperm health or can cause scarring that blocks the passage of sperm. These include inflammation of the epididymis (epididymitis) or testicles (orchitis) and some sexually transmitted infections, including gonorrhea or HIV. Although some infections can result in permanent testicular damage, most often sperm can still be retrieved.
• Ejaculation issues Retrograde ejaculation occurs when semen enters the bladder during orgasm instead of emerging out the tip of the penis. Various health conditions can cause retrograde ejaculation, including diabetes, spinal injuries, medications, and surgery of the bladder, prostate or urethra.
• Antibodies that attack sperm Anti-sperm antibodies are immune system cells that mistakenly identify sperm as harmful invaders and attempt to eliminate them.
• Tumors Cancers and nonmalignant tumors can affect the male reproductive organs directly, through the glands that release hormones related to reproduction, such as the pituitary gland, or through unknown causes. In some cases, surgery, radiation or chemotherapy to treat tumors can affect male fertility.
• Undescended testicles In some males, during fetal development one or both testicles fail to descend from the abdomen into the sac that normally contains the testicles (scrotum). Decreased fertility is more likely in men who have had this condition.
• Hormone imbalances Infertility can result from disorders of the testicles themselves or an abnormality affecting other hormonal systems including the hypothalamus, pituitary, thyroid and adrenal glands. Low testosterone (male hypogonadism) and other hormonal problems have a number of possible underlying causes.
• Defects of tubules that transport sperm Many different tubes carry sperm. They can be blocked due to various causes, including inadvertent injury from surgery, prior infections, trauma or abnormal development, such as with cystic fibrosis or similar inherited conditions. Blockage can occur at any level, including within the testicle, in the tubes that drain the testicle, in the epididymis, in the vas deferens, near the ejaculatory ducts or in the urethra.
• Chromosome defects Inherited disorders such as Klinefelter's syndrome — in which a male is born with two X chromosomes and one Y chromosome (instead of one X and one Y) — cause abnormal development of the male reproductive organs. Other genetic syndromes associated with infertility include cystic fibrosis and Kallmann's syndrome.
• Problems with sexual intercourse These can include trouble keeping or maintaining an erection sufficient for sex (erectile dysfunction), premature ejaculation, painful intercourse, anatomical abnormalities such as having a urethral opening beneath the penis (hypospadias), or psychological or relationship problems that interfere with sex.
• Celiac disease Celiac disease is a digestive disorder caused by sensitivity to a protein found in wheat called gluten. The condition may contribute to male infertility. Fertility may improve after adopting a gluten-free diet.
• Certain medications Testosterone replacement therapy, long-term anabolic steroid use, cancer medications (chemotherapy), some ulcer drugs, some arthritis drugs and certain other medications can impair sperm production and decrease male fertility
• Prior surgeries Certain surgeries may prevent you from having sperm in your ejaculate, including vasectomy, scrotal or testicular surgeries, prostate surgeries, and large abdominal surgeries performed for testicular and rectal cancers, among others.