Yes . It does in 40% of primary infertility cases, and 80% in secondary infertility cases.
How many day should one abstain from sexual activity before submitting a semen test?
Commonly from 2-5 days is enough. But more than 1 week is not advised.
Can one do his semen test at home?
Yes you can do the semen test at home but the sample should be in the lab. in less than 1 hour. It should also be protected from weather effects (keep sample close to your body).
What is the best treatment for infertility due to varicoceles?
Does smoking cause male infertility?
Yes smoking is a known cause of male infertility. Smoking has also been associated with failure of embryo implantation, early miscarriages, and failure of ICSI.
What are the causes of absent sperms in the semen or what is medically called azoospermia?
Azoospermia can either be due to testicular failure or obstruction in the passage of sperms.
What tests are required to evaluate the azoospermia case?
Usually repeated semen test to confirm the azoospermia is essential as well to assess the semen volume. Then some hormonal tests are important. Then chromosomal tests including karyotype and Y chromosome microdeletion test. Then lastly patients will need a testicular biopsy which should be done for sperm retrieval for ICSI as well as diagnostic.
What is the overall semen improvement aftermicroscopic varicocelectomy?
A round 70% of the cases have semen improvement after microscopic varicocelectomy. This usually starts after 3 months postoperatively and can continue to improve up to 1 year.
Does patients with azoospermia and varicocele benefit from varicocelectomy?
Yes around 40-50 % of the cases benefit from the operation. This can happen as appearance of sperms in the semen or after TESE.
What treatments are used to treat decreased sperm concentration?
Some medical treatments are used to improve the sperm count including some multivitamins as well as some hormonal affecting treatments that stimulate the testicle.
Sexual Dysfunction Questions
What are the common conditions that cause erectile dysfunction (ED)?
Diabetes, high cholesterol, hypertension, vascular disease , low testosterone, high prolactine hormones can cause erectile dysfunction (ED). Also anxiety, depression can also cause ED.
What medications can cause ED?
Different medications can cause ED including some of the antihypertensive treatments especially beta blockers. Also most psychiatric medications can cause some sort of sexual dysfunction including decreased libido, ED, delayed ejaculation.
Does smoking cause erectile dysfunction?
Yes smoking can cause erectile dysfunction.
What are the medical treatments for ED? And what are the common side effects?
The commonest medical treatments for ED are under PDE-5 inhibitor group including Viagra, Cialis, and Levitra. The common side effects are headache, nasal congestion. Cialis can cause back, shoulder and leg pain. Patients who have heart conditions must discuss with their doctor if they can take these pills, since the sexual physical activity and the tablets may not be suitable for some patients.
What are the other treatment options if the pills do not work?
If pills do not work , then consider injection of prostaglandin into the penis. This may cause discomfort or pain and less commonly may be associated with painful erection. If this happens then this needs urgent care. Other options include the vacuum device. If patient is not satisfied then consider penile prosthesis surgery.
What are the available types of penile prosthesis?
There are two main types: the malleable and inflatable. The malleable has two firm rods which are flexible to be bent for concealment. The inflatable has either 2 or 3 parts which can be inflated and deflated. Usually the pump which controls that is put in the scrotum.
How long does it take to do the prosthesis operations? How long do patients stay in the hospital?
Usually the malleable takes around 1-1.5 hours. The inflatable can take from 2-3 hours. Usually patients stay for 1 days but occasionally some may stay 2 days. Patients can leave as day case i.e. less than 24 hours if this are well and they desire that.
What are the main complications of the penile prosthesis surgery?
Recent advances in prosthesis has cause the complications to be very low reaching around 3% of infection rate. If this happens then the prosthesis needs to be removed. Then another insertion surgery can be done in 3-6 months.
Benign Prostatic Hyperplasia (BPH) and Prostate Related Pain
When does BPH start? what are the common symptoms related to it?
Commonly patients complain of BPH related symptoms at age 50 and later. But the BPH can start at late 30 and early 40,s . The common symptoms are weak urine stream, frequency of urination, incomplete emptying, urinating frequently at night.
Who is the diagnosis of BPH is done and how are patients evaluated?
Usually BPH is diagnosed clinically by asking about symptoms. Then physical examination with digital rectal assessment. Urine test as well as PSA are routine. Also checking the urine flow with a special machine and then evaluating the bladder volume after urination is helpful. Occasional cystoscopy may be needed.
What are the medications that can help patients with BPH?
Patients with BPH can typically receive a treatment as alfa blocker like tamsulosin , alfuzosin, Silosidin. These can lead to improvement in symptoms in 70% of the cases. Side effects include : dizziness , retrograde ejaculation.