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Andrologist

All that concerns the health of men - men, is in the competence of the andrologist. An andrologist is a doctor who must thoroughly study and know the anatomical features of the male body, his embryology and physiology, possible defects and deviations in the development of the genitourinary system.

In addition, the andrologist should possess basic and modern diagnostic techniques, conservative and surgical treatment of the following organs: 

  • Prostate.
  • Urethra (urethra).
  • Seminal vesicles (seminal tubercles).
  • Pénis (penis).
  • Scrotum (scrotum), testicles.

Andrology as a direction and vector in medicine is considered a sub-specialization, located in the field of urology, endocrinology and sexopathology. The term - andrology has Greek roots: ανδρικός, which means masculine, and λόγος - science, teaching. Thus, andrology studies the anatomical, physiological characteristics of the stronger sex, as well as all the problems, diseases, methods of diagnosis and treatment associated with the genital area. Consequently, the scope of andrology is similar to urology, but has certain boundaries, indicated by the specificity of the profession. The question "who is an andrologist" can be answered in this way - this is a doctor with deep knowledge and practical experience as a urologist specializing in the diagnosis and treatment of erectile disorders, prostatitis, urolithiasis, urethritis and many other diseases associated with men's health - urogenital sphere.

When should I contact an andrologist?

When there are uncomfortable signs that indicate possible diseases of the sexual or urethra, it is necessary to contact the urologist and andrologist as soon as possible. The earlier the disease is diagnosed, the more easily and quickly the disturbed functions will be restored, which so painfully affect the general and psychological state of the man.

When should I contact an andrologist? The grounds for consulting a specialist in the field of male health can become such symptoms and conditions:

  • Atypical urethral discharge, including purulent and causing pain, burning.
  • Violation of the process of urination, discomfort, pain when urinating.
  • Change in the structure and volume of urine - color, consistency, odor.
  • Change in the process of sperm excretion (ejaculation) - spermatorrhea.
  • Painful sensations in the groin, perineum, in the head of the penis, in the scrotum.
  • Urinary incontinence.
  • Painful sensations in the lower abdomen.
  • Change in the skin of the genital organs, rashes, ulcers.
  • The increase and soreness of the lymph nodes in the groin area.
  • Increased body temperature, accompanied by pain in the groin.
  • Discomfort or pain in sexual contact.
  • Visual changes in the size, structure of the sexual organ.
  • Erectile disorders - decreased potency.
  • Painful sensations in defecation.
  • Decrease or absence of sexual attraction, cravings (libido, sexual attraction).
  • Persistent infertility. If during the year with constant contact with a healthy woman, conception does not occur, it is necessary to be examined for possible infertility

On the question - when to refer to the andrologue, you can answer this way: 

  • Regularly (annually) undergo preventive examinations and examinations, even if no anxiety symptom is seen from the urogenital system.
  • At the first signs, anxious symptoms, which manifested at least once. The earlier the disease is diagnosed, the faster and painless the treatment will be.

What tests should I take when I call for androlog?

After collecting anamnesis, visual examination, you need to undergo a comprehensive diagnostic examination. What tests should I take when I call for andrologu: 

  • UAC is a general blood test showing the presence or absence of an inflammatory process (the number of leukocytes, hemoglobin, ESR, hematocrit, acid phosphatase, and so on).
  • Urinalysis - clinical, biochemical, samples.
  • According to the indications - biopsy of the tissues of the prostate gland, seminal vesicle, testis, appendage.
  • Bacterial cultures of urethral secretion, secretion of the prostate gland.
  • A blood test for PSA is a prostatic antigen.
  • Blood test for suspected STDs by PCR (polymerase chain reaction) ELISA (enzyme immunoassay).
  • Hormonal screening is the study of blood on hormones.
  • Analysis of the ejaculate - spermogram (MAR-test, antisperm antibodies, Shuwarsky's test - postcoital test).

What tests should be given when referring to the andrologue depends on the symptomatology, which manifests the disease, on the severity of clinical manifestations and the general condition of the patient.

What diagnostic methods does the andrologist use?

Diagnostic complex measures that help to pinpoint the cause of the symptoms and specify the diseases can be divided into seven general stages. What diagnostic methods does the andrologist use? 

Primary examination, physical methods: 

  • Visual inspection of skin, genitals, waist, abdomen.
  • Palpation of the kidneys (in the normal state of the kidneys are not palpable), palpation of a full or enlarged bladder due to a tumor, palpation of the genitals (penis, scrotum).
  • Transplantation of scrotum tissues - diaphanoscopy.
  • PRI - digital rectal examination for evaluation of prostate gland condition.

What laboratory diagnostic methods are used by the andrologist: 

  • UAC (general blood test).
  • OAM (general urinalysis).
  • Microscopy of prostate secretion (with the help of prostate massage).
  • Microscopy of urethral discharge.
  • Sample cups are urine tests.
  • The hemorrhoid test (Reberga), which determines the concentration of endogenous creatinine in the serum and urine.
  • Urinalysis by the Nechiporenko method.
  • Analysis of urine, Zimnitsky's trial.
  • BAC is a biochemical blood test.
  • Analyzes for infertility - MAR-test, detection of antisperm antibodies, postcoital test (immunological compatibility of sexual partners).
  • PCR study (polymerase chain reaction method).

Morphological, structural methods: 

  • Biopsy.

Methods of instrumental examination:

  • Diagnostic catheterization of the bladder, urethra, ureter.
  • Diagnostic bougie (stretching) of the urethra.
  • Endoscopic urethroscopy.
  • Cystoscopy.
  • Pyeloscopy.

What diagnostic methods does the andrologist use to change the urodynamic parameters: 

  • Cystometry is an estimate of the ratio of the volume of vesica urinaria - the bladder and the level of urine pressure during filling.
  • UFM - screening, uroflowmetry, which allows to evaluate the parameters and state of the urine flow.
  • EMG - electromyography, which allows to estimate biopotentials of skeletal muscles.
  • KUDI - multichannel urodynamics, combined urodynamic study, which allows simultaneously to record such parameters as bladder pressure, abdominal pressure, urine flow rate, UFM, EMG and pressure-flow ratio.
  • Video dynamics.

Methods of radiation diagnostics:

  • Ultrasound - ultrasound.
  • TRUS - transrectal ultrasound.
  • Ultrasonic examination of the kidneys and urinary tract.
  • Ultrasound of the scrotum, testicles and penis.
  • Ultrasound of the bladder.
  • Three-dimensional ultrasound - 3D-ultrasound.
  • Urorentgenodiagnostics.
  • General (overview) picture.
  • Survey urography.
  • Excretory, retrograde, antegrade ureteropyelography.
  • Urethrography.
  • Cystography.
  • Cavernosography and cavernosometry.
  • Angiography of the kidneys.
  • Computer urotomography.
  • Computed tomography of the pelvis.
  • MRI (MRI) - magnetic resonance imaging of the urogenital system.
  • Static and dynamic methods of radioisotope renography, scintigraphy.
  • PET - positron emission tomography.
  • Immunoscintigraphy is a new radionuclide method that allows to identify possible metastases and their localization.

What does the andrologist do?

The list of problems describing what the andrologist is doing is quite large, but the most common diseases that are treated with a narrow specialist are prostatitis, which according to statistics in one form or another affects every second man over 30 years old, as well as infertility.

The basis for asking for advice and assistance to the andrologist is the following problems: 

  1. Violation of childbearing function, infertility or childless marriage. This problem is not covered widely in the press, because it is essentially intimate, personal, and quite painful, but the number of infertile couples increases every year. Statistics say that about 20% of families, despite the conscious desire to have children and a regular high-quality sexual life, can not conceive a child. More than 50% of the reasons preventing conception are related to women's health, about 40% are related to the condition of the male sexual sphere. 
  2. Erectile dysfunction (decreased potency, premature, early ejaculation), conditions accompanied by loss of sexual traction, cravings (libido) associated with inflammatory diseases or psychoemotional stress. 
  3. Abnormal development (underdevelopment) of internal and external genital organs, secondary sexual characteristics, atony of genitals (decrease in tone). 
  4. Hormonal imbalance (hypogonadism). 
  5. Age-related physiological androgen deficiency.
  6. Advice on family planning and the preparation of the male body for conception.
  7. Consultation and selection of donor sperm for IISD (artificial insemination with donor sperm).
  8. Inflammatory processes in the genitourinary, urinary system of various etiologies. 
  9. Sexually Transmitted Infections (STDs, STIs).
  10. Oncological diseases of the urinary system. 
  11. Prophylactic dispensary examinations.

The list of directions that signify what the andrologist is engaged in is large enough and grows every year, an example of this can be sex-change operations that were impossible and unavailable a few dozen years ago.

Andrology is not only conservative, but also surgical methods of treatment, which include the following types of modern endoscopic, reconstructive surgeries, that is, what the andrologist is doing as a surgeon: 

  • Plastic restoration of the frenulum of the reproductive organ.
  • Operation (excision) in occasion of a paraurethral cyst.
  • Circumvention, circumcision or excision of the foreskin.
  • Operative intervention in occasion of a dropsy testicle by means of various techniques - Winckelman, Lord, Bergman or by puncturing. 
  • Microsurgery for varicocele - varicose veins. 
  • Ectomy or reconstruction (prosthetics) of the testicle.
  • Change in the size of the genital organ (lengthening).
  • Epididemectomy - the ectomy of the epididymis.
  • Orchidopexy is the treatment of cryptorchidism.
  • Reconstruction of the deformed penis.
  • Excision (excision) of the cyst of the spermatic cord, testicles.
  • Plastic reconstruction of the urethra.
  • Stenting of the urethra.
  • Prosthesis of testicles.
  • Endoscopic polypectomy.
  • Vasorezection (sterilization).
  • Surgery for oleogranuloma (inflammation of the genital tissue).
  • Cystostomy.
  • Endoprosthetics of the genital organ (phalloendoprosthetics).
  • Endoscopy of diseases of the prostate.
  • Surgery for ureterocele (hernia, cysts of the ureter wall).
  • Endoscopy of the ureter.
  • Stenting of the ureter.
  • Endoscopy of ureter stricture.

It is difficult to list in detail what an andrologist does, since andrology as a medical field develops rapidly, with each year including all new methods and methods for solving problems of the intimate genitourinary sphere in men.

What diseases are treated by the andrologist?

Everything related to reproductive, genito-urinary, urinary systems is the responsibility of the andrologist. What diseases are treated by the andrologist, with what problems are they treated? 

  • Family infertility associated with diseases of the male genitourinary system.
  • Erectile, sexual disorders (dysfunctions), decreased libido.
  • Violations of ejaculatio - ejaculation (retrograde, late, premature ejaculation).
  • All diseases associated with the organs of the scrotum, testicles, distal sections of funiculus spermaticus (spermatic cord) - orchitis, vesiculitis, tumors, cysts, hydrocele, varicocele.
  • Inflammatory processes in the head or foreskin of the genital organ (phimosis, balanoposthitis).
  • Incontinence - various types of urinary incontinence.
  • Congenital anatomical genital disorders (aesthetic reconstruction).
  • Sex change.
  • Spermatorrhea (efflux of the ejaculate from the urethra without objective reasons).
  • Oncological diseases of the prostate.
  • Need for reconstruction of the urethra.
  • Hormonal disorders, andropause (physiological hypogonadism).
  • All diseases associated with the prostate gland, adenoma, vesiculitis, prostatitis.
  • STDs (sexually transmitted diseases), including infectious etiology.
  • Children's andrological problems.

Tips andrologist doctor

Prevention of diseases of the male genito-urinary area is a preventive method that helps to preserve the quality and functionality of virtually all organs and systems of the male body.

The advice of an andrologist is recommendations that primarily relate to the culture of sexual relations and the observance of personal hygiene rules. Also, prevention of pathologies of the urinary and reproductive system - these are the general rules of a healthy lifestyle, physical activity and regular dispensary examinations at the doctor.

  • Motor activity is the guarantee of male health and the prevention of stagnation in the prostate gland. Especially this advice is relevant for those whose work is related to the motionless, sedentary position of the body. 
  • If the activity of a man is on the contrary connected with heavy physical loads, including static ones, a regime is needed that involves short breaks, with warm-ups or passive rest. 
  • An important psycho-emotional factor that affects men's health is proper rest and sleep. 
  • Observance of a reasonable diet, including a balanced menu, helps maintain the normal state of the vascular system, internal organs. It is necessary to limit the use of spices, spicy, fried, marinated and fatty dishes, preferring vegetable food, protein dishes made of veal, fish, poultry. Also, the andrologist's advice relates to the inclusion in the menu of vegetable oils, fats, rich PUFAs - polyunsaturated fatty acids. 
  • Refusal to smoke and abuse of alcoholic beverages will help reduce the risk of developing genito-urinary pathologies. 
  • It is necessary to take regular shower or baths with broths of medicinal herbs - oak bark, chamomile, horsetail. Observance of personal hygiene is one of the ways for a long time to preserve the activity and quality of sexual function. 
  • An important factor affecting the health of the genitourinary sphere is regular, qualitative sexual activity, preferably with the same sexual partner, in order to avoid STDs.
  • The enemy of the urogenital system - cold, hypothermia, vibration, overheating, squeezing.
  • Prevention of STIs, STDs, sexually transmitted diseases - this is literate contraception and avoidance of casual sexual contacts.
  • Regular annual examinations in urologist, andrologist help to minimize the risk of diseases.

The above recommendations concern all representatives of the strong half of humanity who have reached puberty. According to WHO analysts, under the influence of various factors - from environmental to socio-economic, the world is experiencing an increase in diseases associated with the genitourinary system.

Over the past 50 years, the average statistical quality of sperm has been steadily declining - speed by 1.5%, and concentration by 2% per year. This is an alarm signal, indicating a total decrease in male fertility, which can be saved by the advice of an andrologist.

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Medical expert editor

Portnov Alexey Alexandrovich

Education: Kiev National Medical University. A.A. Bogomolets, Specialty - "General Medicine"

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