Andrology | Medical Centre of Sexual Health, Dr Thanos Askitis

Andrology

Andrology is the medical specialty that studies male health and particularly problems of the male reproductive system as well as urological problems that are unique to males. Andrology deals with male sexual dysfunctions, infertility problems and other health issues like andropause (also known as male menopause) and cancer in the male genital area.

Erectile dysfunction, also known as impotence, is a very common type of sexual dysfunction for men, mainly characterized by the inability to develop or maintain an erection during sexual activity.

  • Metabolic syndrome and erectile dysfunction

Metabolic syndrome is a condition which involves different risk factors for both erectile function and the general health of men. For decades research has focused on major public health problems, such as cardiovascular disease, hypertension, increased cholesterol, diabetes and obesity as factors influencing erectile function.

Premature ejaculation occurs when a man ejaculates sooner, during sexual intercourse, than he or his partner would like. Approximately 1 out of 3 men experience this problem at some time.

Delayed ejaculation occurs when a prolonged period of sexual stimulation or activity is needed for a man to ejaculate. In several cases, ejaculation cannot be achieved at all, causing distress to both partners.

  • Retrograde ejaculation

Retrograde ejaculation occurs when semen, which would, in most cases, be ejaculated via the urethra, is redirected to the urinary bladder. In this case men feel the orgasmic pleasure but without visible ejaculation.

  • Peyronie Disease

Peyronie's disease is a connective tissue disorder involving the growth of fibrous plaques in the soft tissue of the penis. As a result, gradually, the penis becomes curved causing problems to the erectile function, difficulty at penetration and sometimes painful erections.

  • Penis size and micropenis

Micropenis is an unusual small penis, meeting the common criterion of a dorsal erect penile length smaller than 7 cm for an adult, when compared with the average length erection of 12-15cm. The condition is usually recognized shortly after birth.

  • Frenulum breve (tight frenulum)

Tight frenulum is a condition in which the frenulum of the penis, which is an elastic band of tissue under the urethra that connects the glans penis to the foreskin and helps contract it over the glans, is too short and thus restricts the retraction of the foreskin. This condition causes pain during erection and can lead to erectile dysfunction.

  • Phimosis

Phimosis is a condition in which the foreskin of the penis cannot be pulled back past the glans. It may result in pain during an erection but is otherwise not painful. Those affected are at greater risk of inflammation or cancer of the glans.

  • Paraphimosis

Paraphimosis is an uncommon medical condition in which the foreskin of a penis becomes trapped behind the glans penis and cannot be reduced (pulled back to its normal position covering the glans). If this condition persists for several hours or there is any sign of a lack of blood flow, paraphimosis should be treated as a medical emergency.

  • Prostate diseases
  1. Benign prostatic hyperplasia is the most common prostate disease. It begins at the age of 40 years, with 30-40% of men aged 40-50 years experiencing histological alterations of prostate hyperplasia.
  2. Prostate cancer is the most common neoplasm in men and the second most common cause of death from cancer after lung cancer.
  3. Prostatitis is an inflammatory disease of the prostate that affects more often young, sexually active men and causes pain or discomfort in the perineum and the scrotum area. It is the most common urological condition in men under 50 years of age.
  • Varicocele

Varicocele is the abnormal stretch of veins that removes blood from the testicles. Most commonly, it appears on the left, but it may also appear right, or both sides. It is the most common and easily identifiable cause of infertility in men.

  • Penile fracture

The penile fracture is the most common blunt penis injury. The fibrous lining surrounding the corpus cavernosum is cracked and this is perceived by the patient with intense pain, characteristic dry sound and loss of erection. The penis swells and forms a hematoma that occupies the penis and the scrotum and can extend to the abdominal wall.

Low libido can occur in a man's sexual life either occasionally or with stability. Sexual desire occurs when the person start to engage in sexual activity. Sexual desire manifests itself predominantly with specific stimuli and fantasies. In this disorder there is a reduction or even absence of sexual fantasies and mood for sexual intercourse.

  • Hypogonadism

Hypogonadism is the clinical syndrome caused by androgen deficiency and adversely affects the functioning of many organs as well as the quality of life for men.

  • Male infertility

In order for a couple to be considered infertile, there should be a 12-month interval in which there will be no successful clinically recognizable pregnancy after unprotected sex. As for the male factor, the problem focuses on the quality of the sperm. Most common problems for men are related to:

  1. low sperm count (oligospermia),
  2. low sperm motility (asthenospermia)
  3. sperm morphology (teratospermia).

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