Urology


Andrology (Sexual Dysfunction Diagnosis and Treatment)

Andrology is a medical branch that studies male and female sexual health and male infertility. Its areas of interest can be listed as follows:

  • Erectile Dysfunction in Men

Erectile dysfunction is a common problem affecting one in every ten men.

Erectile dysfunction is defined as the inability to reach a stiffness level that can provide a successful sexual intercourse or the inability to maintain this stiffness level as much as required. It seems to be more common in men over the age of 40. Other sexual functions of men experiencing erectile dysfunction are often normal.

The causes of erectile dysfunction can be listed as follows:

  • Psychological causes: Depression, stress and anxiety are among major psychological causes.
  • Vascular diseases
  • Nervous system disorders
  • High blood pressure and diabetes
  • Smoking
  • Medications: Many drugs used for high blood pressure, heart diseases and psychiatric disorders may be the cause of erectile dysfunction.
  • Hormonal causes:

Erectile dysfunction can only be diagnosed by a doctor after the examination. It is often diagnosed by information given by the patient and physical examination. Some simple tests which help making a diagnosis may be required.

Selection of treatment depends on whether the cause is physical or psychological. If the problem is psychological, psychologists who specialize in sex therapy should be consulted.

There are 4 main treatment methods used for erectile dysfunction due to physical causes:

  • The drugs used orally
  • The vacuum apparatus
  • Injection into the penis: Vasodilating drugs are injected using a fine needle. These drugs act by loosening the tissues of the penis and blood vessels.
  • Penile prosthesis: Penile prosthesis consists of two synthetic cylinders surgically placed into the penis. The prosthesis does not affect urination and sexual functions such as ejaculation, orgasm.

These treatment methods do not eliminate the cause. However, they help one achieve the erection level that will provide sexual contact.

  • Penile structure disorders(curvature , etc.)
  • Sexual aversion
  • Female sexual dysfunction (reluctance, pain syndromes, disorders of arousal, etc.)

Sexual dysfunction may occur as a result of a variety of organic and psychological causes. Its incidence in women is at the level of 40%. Sexual dysfunction in women is classified as follows:

  • Sexual desire disorders (disgust, etc.)

It can be seen as lack of / absence of sexual desire, and even as an aversion to sexuality. It may occur as a result of organic and psychological causes.

Sexual aversion may be against sexual activity, sexual organs or fluids. Among the reasons are obsessions of developmental period during childhood, incorrect / inadequate sexual information, exposure to rape or trauma, inappropriate and abusive approach of partner, fear and anxiety against sexuality.

  • Arousal Disorders

In women experiencing arousal disorder, arousal enough to take pleasure during foreplay and sexual intercourse does not occur. Its causes may include systemic diseases (such as diabetes), hormonal problems, menopause, medication use, nerve injuries that can occur as a result surgical procedures.

  • Painful Sexual Intercourse (Dyspareunia )

Defined as " dyspareunia " in medical language, it means feeling pain during sexual intercourse. Dyspareunia of 30% develops in women after surgical intervention in genitals and medical problems of reproductive organs are detected in 40% of women admitted to the clinic with this complaint.

  • Vaginismus

Vaginismus involves involuntary contraction of 1/3rds of the outer potion of the vagina during sexual intercourse, preventing introduction of the penis. It may be caused by trauma, rape and surgeries one underwent in the past. Apart from this, it may also occur as a result of tissues that have formed in the area opening during childbirth and being stitched afterwards, inflammatory diseases related to sexual organs and sexual glands and vaginal changes during menopause.
Vaginismus often emerges due to psychological reasons or conditions of being brought up. It requires medical treatment, psychotherapy and sex therapy.

In the case of sexual dysfunction, first the grounds are established and a treatment method that will eliminate the grounds is applied.

It involves a range of treatments from medication or therapies with devices such as vacuum to psychotherapy. Studies on new treatment methods still continue.

  • Male infertility ( infertility )

Infertility is generally defined as failure to fulfill reproductive function.

Male infertility is dependent on many factors. Abnormalities in sperm production, clogged sperm ducts, presence of antibodies against sperm, testicular trauma, hormonal disorders, anatomical problems, varicocele, past illnesses, infections and certain medications can lead to infertility. In addition, smoking and alcohol use, the rise in testicular temperature (for reasons including high fever, wearing tight pants, etc.), external causes such as being overweight and excessive exercise may also cause this condition.

For diagnosing infertility, first of all, patient's medical history and habits (smoking, etc.) are evaluated. Then a physical examination is conducted. Diagnostic is supported by tests, including semen analysis, urine analysis, hormone analysis.

Treatment is usually conducted by aiming at the source of the problem. Infections and hormonal disorders are treated by administering medication.

60% of infertile men have varicoceles . If it affects sperm production or causes testicular downsizing, it is treated. Varicocele surgery should be performed under a microscope. In this way, connection of invisible small vessels increases the success of the operation and prevents recurrence of varicocele.

If it is found what causes narrowing in the part of sperm ducts opening to prostate, it is cut open by endoscopic method. Regions of clogging in other levels are found and removed under a microscope.

Auxiliary reproduction techniques are used for pregnancy. IVF is the most common method of auxiliary reproduction techniques.