Andrologist

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

In addition, the andrologist must have basic and modern methods of diagnostics, conservative and surgical treatment of the following organs:

• Prostate.
• Urethra (urinary canal).
• Seminal vesicles (seminal tubercle).
• Penis (penis).
• Scrotum (scrotum), testicles.

Andrology as a direction and vector in medicine is considered a subspecialization in the field of urology, endocrinology and sexopathology. The term andrology itself has Greek roots: ανδρικός, which means male, and λόγος - science, teaching. Thus, andrology studies the anatomical, physiological characteristics of the representatives of the stronger sex, as well as all problems, diseases, diagnostic methods and treatments related to the sexual sphere. Consequently, the scope of andrology is similar to urology, but has certain boundaries designated by the specifics of the profession. The question "who is an andrologist" can be answered as follows - this is a doctor with deep knowledge and practical experience as a urologist, specializing in the diagnosis and treatment of erectile dysfunction, prostatitis, urolithiasis, urethritis and many other diseases related to men's health - the genitourinary sphere.

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When should you see an andrologist?

If discomfort symptoms appear that indicate possible diseases of the genital or urinary organs, it is necessary to contact a urologist or andrologist as soon as possible. The sooner the disease is diagnosed, the easier and faster the impaired functions will be restored, which have such a painful effect on the general and psychological state of a man.

When should you see an andrologist? The following symptoms and conditions may be grounds for consultation with a specialist in men's health:

• Atypical urethral discharge, including purulent and causing pain and burning.
• Disruption of the urination process, discomfort, pain when urinating.
• Changes in the structure and volume of urine – color, consistency, odor.
• Changes in the process of sperm secretion (ejaculation) - spermatorrhea.
• Pain in the groin, perineum, head of the penis, scrotum.
• Urinary incontinence.
• Painful sensations in the lower abdomen.
• Changes in the skin of the genitals, rashes, ulcers.
• Enlarged and painful lymph nodes in the groin area.
• An increase in body temperature, accompanied by pain in the groin.
• Discomfort or pain during sexual intercourse.
• Visual changes in the size and structure of the genital organ.
• Erectile dysfunction – decreased potency.
• Painful sensations during defecation.
• Decreased or absent sexual desire, cravings (libido, sexual attraction).
• Persistent infertility. If conception does not occur within a year of constant contact with a healthy woman, it is necessary to undergo examination for possible infertility.

The question of when to see an andrologist can be answered as follows:

• Regularly (annually) undergo preventive examinations and tests, even if there are no alarming symptoms from the genitourinary system.
• At the first signs, alarming symptoms that have appeared at least once. The sooner the disease is diagnosed, the faster and more painless the treatment will be.

What tests should you take when visiting an andrologist?

After collecting anamnesis and visual examination, you need to undergo a comprehensive diagnostic examination. What tests should you take when visiting an andrologist:

• OAC – a complete blood count that shows the presence or absence of an inflammatory process (number of leukocytes, hemoglobin, ESR, hematocrit, acid phosphatase, etc.).
• Urine analysis – clinical, biochemical, samples.
• According to indications - biopsy of tissues of the prostate gland, seminal vesicle, testicle, and epididymis.
• Bacterial cultures of urethral secretions, prostatic secretions.
• Blood test for PSA – prostate-specific antigen.
• Blood tests for suspected STDs using PCR (polymerase chain reaction) and ELISA (enzyme-linked immunosorbent assay) methods.
• Hormonal screening is a blood test for hormones.
• Ejaculate analysis – spermogram (MAR test, antisperm antibodies, Shuvarsky test – postcoital test).

The tests that need to be taken when visiting an andrologist depend on the symptoms that the disease manifests itself in, the severity of the clinical manifestations, and the general condition of the patient.

What diagnostic methods does an andrologist use?

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

Initial examination, physical methods:

• Visual examination of the skin, genitals, lower back, abdomen.
• Palpation of the kidneys (in a normal state, the kidneys are not palpable), palpation of a full or enlarged bladder due to a tumor, palpation of the genitals (penis, scrotum).
• Transillumination of scrotal tissues – diaphanoscopy.
• DRE – digital rectal examination to assess the condition of the prostate gland.

What laboratory diagnostic methods does an andrologist use:

• OAC (complete blood count).
• OAM (general urine analysis).
• Microscopy of prostate secretion (using prostate massage).
• Microscopy of urethral discharge.
• Sample glasses - urine tests.
• Hemorrenal test (Reberg), which determines the concentration of endogenous creatinine in the blood serum and urine.
• Urinalysis using the Nechiporenko method.
• Urine analysis, Zimnitsky test.
• BAC – biochemical blood test.
• Infertility tests – MAR test, detection of antisperm antibodies, postcoital test (immunological compatibility of sexual partners).
• PCR test (polymerase chain reaction method).

Morphological, structural methods:

• Biopsy.

Instrumental examination methods:

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

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

• Cystometry is an assessment of the relationship between the volume of the vesica urinaria – the urinary bladder – and the level of urine pressure during filling.
• UFM – screening, uroflowmetry, allowing to evaluate the parameters and state of urine flow.
• EMG is an electromyography that allows one to evaluate the biopotentials of skeletal muscles.
• KUDI – multichannel urodynamics, a combined urodynamic study that allows for the simultaneous recording of the following parameters: bladder pressure, abdominal pressure, urine flow rate, UFM, EMG and pressure-flow ratio.
• Videourodynamics.

Methods of radiation diagnostics:

• Ultrasound – ultrasound examination.
• TRUS - transrectal ultrasound examination.
• Ultrasound examination of the kidneys and urinary tract.
• Ultrasound of the scrotum, testicles and penis.
• Ultrasound of the bladder.
• Three-dimensional ultrasound – 3D ultrasound.
• Uro-X-ray diagnostics.
• General (overview) photo.
• Survey urography.
• Excretory, retrograde, antegrade ureteropyelography.
• Urethrography.
• Cystography.
• Cavernosography and cavernosometry.
• Renal angiography.
• Computerized urotomography.
• Computed tomography of the pelvis.
• MRI (MRI) – magnetic resonance imaging of the genitourinary system.
• Static and dynamic methods of radioisotope renography, scintigraphy.
• PET – positron emission tomography.
• Immunoscintigraphy is a new radionuclide method that allows identifying possible metastases and their localization.

What does an andrologist do?

The list of problems that describe what an andrologist deals with is quite large, but the most typical diseases that people turn to a specialist with are prostatitis, which, according to statistics, every second man over 30 suffers from in one form or another, as well as infertility.

The following problems are grounds for seeking advice and help from an andrologist:

1. Impaired reproductive function, infertility or childless marriage. This problem is not widely covered in the press, since it is essentially intimate, personal, and also quite painful, but the number of infertile couples increases every year. Statistics say that about 20% of families, despite a conscious desire to have children and regular quality sex life, cannot conceive a child. More than 50% of the reasons that prevent conception concern women's health, about 40% are related to the state of the male reproductive system.
2. Erectile dysfunction (decreased potency, premature, early ejaculation), conditions accompanied by loss of sexual desire, attraction (libido), associated with inflammatory diseases or psycho-emotional stress.
3. Abnormal development (underdevelopment) of the internal and external genital organs, secondary sexual characteristics, genital atony (decreased tone).
4. Hormonal imbalance (hypogonadism).
5. Age-related physiological androgen deficiency.
6. Advisory assistance on issues of family planning and preparing the male body for conception.
7. Consultation and selection of donor sperm for AISD (artificial insemination with donor sperm).
8. Inflammatory processes in the genitourinary and urinary systems of various etiologies.
9. Sexually transmitted infections (STDs, STIs).
10. Oncological diseases of the urinary system.
11. Preventive medical examinations.

The list of areas that indicate what an andrologist does is quite large and is increasing every year, an example of which is sex change operations, which were impossible and inaccessible several decades 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 an andrologist does as a surgeon:

• Plastic reconstruction of the frenulum of the genital organ.
• Surgery (excision) for paraurethral cyst.
• Circumcision, or excision of the foreskin.
• Surgical intervention for hydrocele using various techniques – Winkelmann, Lord, Bergman or by puncture.
• Microsurgery for varicocele - varicose veins of the spermatic cord.
• Testicular ectomy or reconstruction (prosthesis).
• Change in the size of the penis (lengthening).
• Epididymectomy is the removal of the epididymis.
• Orchidopexy – treatment of cryptorchidism.
• Reconstruction of a deformed penis.
• Excision of spermatic cord cyst, testicular cyst.
• Plastic reconstruction of the urethra.
• Urethral stenting.
• Testicular prosthetics.
• Endoscopic polypectomy.
• Vasoresection (sterilization).
• Surgery for oleogranuloma (inflammation of the tissues of the genital organ).
• Cystostomy.
• Endoprosthetics of the genital organ (phallic endoprosthetics).
• Endoscopy of prostate diseases.
• Surgery for ureterocele (hernia, cyst of the ureter wall).
• Endoscopy of the ureter.
• Ureteral stenting.
• Endoscopy of ureteral stricture.

It is difficult to list in detail what an andrologist does, since andrology as a field of medicine is developing rapidly, each year including new methods and ways to solve problems of the intimate genitourinary sphere in men.

What diseases does an andrologist treat?

Everything that concerns the reproductive, genitourinary, and urinary systems is the responsibility of an andrologist. What diseases does an andrologist treat, what problems do people turn to him for?

• Familial infertility associated with diseases of the male genitourinary system.
• Erectile, sexual dysfunctions, decreased libido.
• Disorders of ejaculatio - ejaculation (retrograde, delayed, premature ejaculation).
• All diseases associated with the organs of the scrotum, testicles, distal parts of the funiculus spermaticus (spermatic cords) – orchitis, vesiculitis, tumors, cysts, hydrocele, varicocele.
• Inflammatory processes in the head or foreskin of the penis (phimosis, balanoposthitis).
• Incontinence – various types of urinary incontinence.
• Congenital anatomical genital abnormalities (aesthetic reconstruction).
• Gender reassignment.
• Spermatorrhea (leakage of ejaculate from the urethra without objective reasons).
• Oncological diseases of the prostate gland.
• The need for urethral reconstruction.
• Hormonal disorders, andropause (physiological hypogonadism).
• All diseases associated with the prostate gland, adenoma, vesiculitis, prostatitis.
• STDs (sexually transmitted diseases), including those of infectious etiology.
• Children's andrological problems.

Advice from an andrologist

Prevention of diseases of the male genitourinary system are preventive methods that help maintain the quality and functionality of almost all organs and systems of the male body.

Advice from an andrologist is a set of recommendations that primarily relate to the culture of sexual relations and compliance with personal hygiene rules. Also, prevention of pathologies of the urinary and reproductive systems is the general rules of a healthy lifestyle, physical activity and regular medical check-ups.

• Physical activity is the key to men's health and prevention of congestion in the prostate gland. This advice is especially relevant for those whose work involves a sedentary, motionless body position.
• If a man’s activity, on the contrary, is associated with heavy physical exertion, including static, a regimen is necessary that involves short breaks, with warm-ups or passive rest.
• An important psycho-emotional factor influencing men’s health is adequate rest and sleep.
• Maintaining a reasonable diet, including a balanced menu, helps maintain the normal condition of the vascular system and internal organs. It is necessary to limit the consumption of spices, spicy, fried, pickled and fatty dishes, giving preference to plant foods, protein dishes from veal, fish, poultry. Also, the advice of an andrologist concerns the inclusion in the menu of vegetable oils, fats rich in PUFA - polyunsaturated fatty acids.
• Quitting smoking and alcohol abuse will help reduce the risk of developing genitourinary pathologies.
• It is necessary to regularly take showers or baths with decoctions of medicinal herbs - oak bark, chamomile, horsetail. Maintaining personal hygiene is one of the ways to maintain the activity and quality of sexual function for a long time.
• An important factor influencing the health of the genitourinary system is regular, quality sexual activity, preferably with the same sexual partner, to avoid STIs.
• The enemy of the genitourinary system is cold, hypothermia, vibration, overheating, and compression.
• Prevention of STIs, STDs, and venereal diseases is proper contraception and avoiding casual sexual contact.
• Regular annual examinations by a urologist and andrologist help to minimize the risk of disease.

The above recommendations apply to 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, there is an increase in diseases associated with the genitourinary system throughout the world.

Over the past 50 years, the average sperm quality has been steadily declining – by 1.5% and by 2% annually. This is an alarming signal indicating a total decline in male fertility, which can be maintained with the help of advice from an andrologist.