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Andrology

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Andrology

It is a branch that deals men’s health. It is the male counterpart of gynecology and primarily deals with the management of disorders of the male reproductive tract eg. male sexual dysfunction, male infertility, penile fracture, vasectomy, orchidopexy etc.


Male Sexual Dysfunction

Sexual dysfunction is a common problem. It is more prevalent in women (43%) than men (31%). Inspite of the high prevalence, physicians as well as patient are hesitant to discuss sex related issues. Sexual dysfunction can lead to distress to both partners and may have a negative impact of their relationship. It can be a result of a physical or a psychological problem.


The common sexual problems affecting men are premature ejaculation and erectile dysfunction. Evaluation for sexual dysfunction involves a thorough history of symptoms and a physical exam. Investigations may be required to rule out any medical problems that may be contributing as a cause of sexual dysfunction.


Treatment: Most cases of sexual dysfunction are treatable. Many cases can be corrected by treating the underlying physical or psychological problems. The treatment needs to be individualized for each patient.


  • Education about sex, sexual behaviors and responses helps to clear misconceptions.
  • Communication with your partner about your needs and concerns helps to overcome many barriers to a healthy sex life.
  • Psychological therapy can address feelings of anxiety, depression, stress, fear or guilt that may have an impact on sexual function
  • Treatment options for erectile dysfunction are
  • Medical treatment: eg Tadalafil, Testosterone replacement therapy if testosterone levels are low

    Intra Cavernosal Injection Therapy

    Vacuum Erection Devices

    Penile Implants

  • Treatment options for premature ejaculation:
  • Dapoxetine.

    Topical lignocaine spray may help to control ejaculation by reducing sensitivity.


    Male Infertility

    Infertility is a common problem. The introduction of Assisted Reproductive Techniques (ART) has opened up the barriers in this field. Male factor etiology is responsible for 50 % of the cases. Management of male infertility starts with a detailed history and examination. Semen analysis is the most important investigation for evaluation of male infertility. Additional tests may be required which may include ultrasound, testicluar biopsy etc.


    Some common causes for male infertility are

  • Varicocle
  • Idiopathic
  • Obstruction in genital tract
  • Cryptorchidism
  • Testicular failure
  • Endocrinopathy

  • Treatment:

    Whenever possible the treatment is directed to correction of a specific problem and the costly ART is kept as a last option.


  • Varicocele is the commonest cause for male infertility and requires a surgery namely varicocelectomy.
  • Medical treatment may be given for idiopathic cases but the overall success rates are not very encouraging.
  • Obstruction in genital tract may require a micro surgery eg Vaso-Vasal Anastomosis or ART.
  • ART is the option for those in whom no therapy is available or if previous treatments have been unsuccessful. ART may include artificial insemination or In-Vito fertilization (Test Tube Baby). The clinical success rate of these techniques is upto 45 %. If ART is not successful then the remaining options are use of donor sperm or adoption.