Andrology/Male Treatment

Azoospermia

Azoospermia, or zero sperm count, occurs in 1% of the general population, and in 10-15% of the infertile male population. It may be functional or non-obstructive (NOA) or Obstructive (OA)

Non-Obstructive Azoospermia

The management of non-obstructive azoospermia (NOA) depends on finding sperm in the testes and retrieving the sperm surgically so it can be used in IVF treatment. This because men with NOA may have patchy areas inside the testes where there is some sperm production that is not enough to appear in the ejaculate.

At Bedaya Hospital we offer the best and most advanced technique of finding sperm in men with NOA, which is;  testicular sperm extraction (Micro-TESE) which is superior to any other technique in men with NOA. This technique uses state of the art surgical microscope, under high magnification an experienced andrologist will identify the areas that are most likely to contain sperm and selectively take tiny pieces from these areas to give it to the embryologist.

Obstructive Azoospermia

Some of the causes of obstructive azoospermia (OA) can be treated by microsurgical procedures (epididymo-vasostomy in epididymal blockage and vaso-vasostomy in blockage of the vas deferens) these procedure aimed at reconnecting the seminal ducts and bypassing the blockage.

If this is not indicated or fails, surgical sperm retrieval is offered and the sperm is extracted for use in IVF.

Several techniques may be used depending on the site of obstruction such as per epididymal sperm aspiration (PESA), Micro-surgical sperm aspiration (MESA), testicular sperm aspiration (TESA), percutaneous testicular sperm extraction (Perc TESE) and window testis biopsy.

Sperm retrieval in OA is easier than NOA because sperm production is normal.

Our Consultants are experienced andrologists with special interest in male infertility surgery. Their skill and advanced techniques offer males with zero sperm count the best chances of conceiving.

 

Oligozoospermia

‏Oligozoospermia (Low sperm count) is a common finding when conducting infertility investigations. Male factor related infertility usually accounts for about 40 % of the causes of infertility.

The underlying causes of low sperm count can be hormonal, obstructive (related to the sperm transfer and ejaculation) or unknown cause. Our team of specialists can help to identify the cause, rectify it if possible, and recommend the best management option to help the couple to conceive.

If surgery is favored then it will be discussed with our specialized team of andrologists.

 

Ejaculation problems

At Bedaya Hospital we offer treatment for ejaculation problems.

 

  • Anejaculation & Retrograde Ejaculation

Some conditions such as diabetes, neurological disease, spinal cord injury, certain medication, abdominal and pelvic surgery makes patients unable to ejaculate or ejaculate into the bladder. Some of these cases may be treated by giving medicine which helps ejaculation.If this fails patients may have surgical sperm retrieval 

  • Premature ejaculation

Premature ejaculation is a common condition that may affect 40% of males. Sometimes premature ejaculation can be so severe that the patient would ejaculate before penetration “Ante portal premature ejaculation”.

Premature ejaculation can be treated medically by giving medicine which delays ejaculation.

  • Erectile dysfunction

Almost half of the men above the age of 50 will have varying degrees of Erectile Dysfunction (ED), however ED can affect any age group.

ED is associated with other health problems such as diabetes, high blood pressure and heart disease. Several lines of therapy are available including pills, injections and surgery.

It is observed that many men who are undergoing fertility treatment with their partners develop ED, however this is a transient form due to the performance anxiety of having intercourse at certain periods or the pressure of having to provide a sample at a particular time.

  • Varicocele

The scrotum is a skin-covered sac that holds your testicles. It also contains the arteries and veins that deliver blood to the reproductive glands. A vein abnormality in the scrotum may result in a varicocele. A varicocele is an enlargement of the veins within the scrotum. These veins are called the pampiniform plexus.

A varicocele only occurs in the scrotum and is very similar to varicose veins that can occur in the leg. A varicocele can result in decreased sperm production and quality, which in some cases can lead to infertility. It can also shrink the testicles.Varicoceles are common. They can be found in 15 percent of the adult male population and around 20 percent of adolescent males. They’re more common in males aged 15 to 25.

What causes a varicocele to develop?

A spermatic cord holds up each testicle. The cords also contain the veins, arteries, and nerves that support these glands. In healthy veins inside the scrotum, one-way valves move the blood from the testicles to the scrotum, and then they send it back to the heart. Sometimes the blood doesn’t move through the veins like it should and begins to pool in the vein, causing it to enlarge. A varicocele develops slowly over time.

You may have no symptoms associated with a varicocele. However, you might experience:

  • a lump in one of your testicles
  • swelling in your scrotum
  • visibly enlarged or twisted veins in your scrotum, which are often described as looking like a bag of worms
  • a dull, recurring pain in your scrotum

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This condition can have an effect on fertility.

Your andrologist usually diagnoses the condition after a physical exam. A varicocele can’t always be felt or seen when you’re lying down. Your doctor will most likely examine your testicles while you’re standing up and lying down.

Your doctor may need to perform a scrotal ultrasound. This helps measure the spermatic veins and allows your doctor to get a detailed, accurate picture of the condition.

Once the varicocele is diagnosed, your doctor will classify it with one of three clinical grades. They’re labeled grades 1 through 3, according to the size of the lump in your testicle. Grade 1 is the smallest and grade 3 the largest.

It’s not always necessary to treat a varicocele. However, you may want to consider treatment if the varicocele causes pain, causes testicular atrophy, causes infertility.

If a varicocele needs treatment a varicocelectomy is done.It is a minor surgery that’s done in a hospital. An andrologist will go in through your abdomen or pelvis and clamp or tie off the abnormal veins. Blood can then flow around the abnormal veins to the normal ones.

 

Urinary incontinence (UI) in women

The definition of urinary incontinence in women is the unintentional loss of urine. Urinary incontinence occurs more often in women than in men. Pregnancy, childbirth, and menopause may contribute to urinary incontinence in women.Weak bladder muscles, overactive bladder muscles, and nerve damage may also cause urinary incontinence in women.Urinary incontinence in women is common and treatable.

Diagnosis of urinary incontinence in women may involve a physical exam, an ultrasound, urodynamic testing, and tests including cystoscopy, urinalysis, and a bladder stress test. The doctor will also take a medical history and may recommend keeping a bladder diary.

  • Treatment of urinary incontinence in women may include behavioral or nonpharmacologic treatments, like bladder training and Kegel exercises, medication, biofeedback, neuroomodulation, surgery, catheterization, or a combination of these therapies.

Bedaya hospital has an extensive team of uro-gynecologists that will diagnose you properly and treat you accordingly!

 

  • Genitourinary Reconstruction

Erectile dysfunction (ED) is the inability to get and keep an erection firm enough for sexual intercourse. Estimates suggest that one of every 10 men will suffer from ED at some point during his lifetime. It is important to understand that in most cases, ED is a symptom of another, underlying problem. ED is not considered normal at any age, and may be associated with other problems that interfere with sexual intercourse, such as lack of desire and problems with orgasm and ejaculation.

Andrology/Male Treatment