Male Infertility Vs Male Sexual Dysfunction – The Knowledge to Avoid the Needless Trauma

There is a common misconception that Male Infertility is a direct fall out of Male Sexual Dysfunction; nothing could be farther from the truth. For the most part, Male Infertility and Male Sexual Dysfunction are two distinct conditions which are caused by diverse factors; the treatments for each of them differ too. Let’s take a look how? It is absolutely normal to for a male to have fertility issues even though he has no problems in his sexual relations with his partner; simultaneously a male having some form of sexual dysfunction may be completely fertile.

Male Infertility refers to the inability to impregnate a fertile woman after a year of unprotected physical relation. In humans, male infertility quite naturally accounts for over 40% of all fertility issues that couples face.

Male Sexual Dysfunction refers to the challenges faced by a male during the course of sexual activity which prevents him from experiencing satisfaction from the act.

Infertility only becomes an issue when the male wants to have children but sexual dysfunction has an adverse impact on the normal adult life of a male. Male Infertility primarily stems from physiological causes while Male Sexual Dysfunctions for the most part have their roots in psychological causes and to a lesser extent on physiological causes.

Let us now look at the main causes of Male Infertility:

1.            Low sperm count

2.            Low sperm motility (movement)

3.            Malformation of the sperms

4.            Volume of semen produced by the body

5.            Age

6.            Lifestyle Fallacies such as smoking, alcohol consumption and the intake of recreational drugs.

7.            Obesity

8.            Blocked Vas Deferens (tubes which carry the sperms)

9.            Varicoceles (Enlargement of the testicular cord due to the accumulation of blood)

10.          Birth defects such as Cryptorchidism (the testes fail to descend from the stomach into the scrotum) and Hypospadias(where the urinary opening is on the underside of the male private part which prevents the sperm from reaching the cervix)

11.          Genetic Disorders

12.          Retrograde Eject (where the muscles of the bladder push the sperm backward into the bladder instead of out). Incidentally retrograde eject is the only cause which is common for infertility as well as sexual dysfunction.

Male Infertilitymay be improved but not reversed through some lifestyle changes such maintaining an ideal weight through a balanced diet and exercise, avoiding smoking, alcohol and recreational drugs and also by reducing stress. Certain drugs may be administered under medical supervision to improve the quality of the semen. Surgical intervention is helpful for reversing the condition of blocked tubes, Varicoceles and Cryptorchidism.

However Assisted Reproductive Techniques such as IUI (Intra-uterine Insemination), IVF(In Vitro Fertilization) and ICSI(In Vitro Fertilization with Intra-Cytoplasmic Sperm Injection), are still the best ways of overcoming Male Infertility.

Male Sexual Dysfunction may be broadly categorized under the following three headings:

1.            Eject Disorders :

(i)            Premature Eject – where the eject occurs too soon.

(ii)           Inhibited or Retarded Eject – where the eject is slow to occur.

-              The causes for this could be a lack of attraction for the partner, stress, some past traumatic event which has been deeply embedded in the memory and other psychological factors.

2.            Erectile Dysfunction or the inability to attain or maintain erection.

-              The causes for this are mainly diseases which affect blood flow, nerve disorders, performance anxiety, stress, depression or some penile injury.

3.            Lack of Desire for Sex (Lack of desiring hormones)

-              The most common cause for this is depression, followed by stress, fatigue from overwork and relationship issues. Other causes are substance abuse, alcoholism, hormonal imbalances to some extent and diseases such as diabetes.

Where a certain disease has been identified as the cause of a male sexual dysfunctio the treatment focuses on the disease. Of course, we now have drugs which help to improve the blood flow and help overcome erectile dysfunction. Hormone supplements especially testosterone are effective in certain extreme conditions. However the main supportive treatment for sexual dysfunction lies in psychological therapy and counseling.

In conclusion, we must reiterate that rather than assuming things, it is most advisable to seek the counsel of a trusted medical practitioner who is experienced and qualified to make the correct diagnosis and advise the further course of treatment. There is no stigma that needs to be attached to a person who has to deal with either male infertility or male sexual dysfunction as both are medical conditions with adequate avenues for treatment and improvement. These two conditions are in no way a limitation for a man to live his life completely and happily.

This article is written by Dr Taneja, senior urologist in Delhi deals in Holmium Laser in Urology, endourology, pediatric urology, reconstructive urology, urogynecology (Female urology), neurogenic bladder, Interstitial Cystitis and male infertility expert. Ask your queries, visit at http://www.drrajeshtaneja.com/.

Enlarged Prostate And Its Treatment

The prostate gland is a walnut sized organ located just below the urinary bladder, in the passage of exit of urine. It secretes the fluids that support the sperms in semen.

It is not unusual as men age for problems to develop in the prostate and although probably the most well-known is cancer, there are other non-malignant conditions that can affect the gland. A complex and delicate balance of hormones control this gland and sometimes with age result in an enlargement of the Prostate.

An enlarged prostate may not always require treatment, but it is likely that if a man’s elder brother or father has had treatment then he will also. One of the first signs of enlargement of prostate is waking up from sleep to pass the urine at night, although there can be other causes of increased urinary frequency at night like diabetes.

Enlargement of the Prostate can result in the restriction of the flow of urine and symptoms can include increased frequency of urination, hesitancy in passing urine, a sense of incomplete evacuation of urinary bladder, urgency to pass urine and occasionally loss of control over urination.

All these can cause considerable distress and discomfort and in the most severe cases can cause backpressure on to the kidneys leading to their failure.

Changes to the prostate should not be ignored and a doctor should be consulted. Leaving a condition untreated out of fear or worry is not wise and it may be that a visit to the doctor will bring peace of mind with the knowledge that the worst fears will not be realised.

Your family GP should refer you to an expert urologist, who will be able to establish whether the enlargement is cancerous or benign using techniques such as clinical examination along with simple investigations like ultrasonography, which will provide information about the size of the prostate and its pattern of growth.

Uroflowmetry is another investigation employed to assess the obstruction caused by enlarged prostate. During this test, a person is asked to hold urine till the bladder is full when he is required to pass urine in a computerized container which generates a graph indicating flow rate of the urine.  The results will help the consultant decide on the correct course of treatment.

If benign enlargement of Prostate (BPH) is diagnosed at an early stage, medical treatment can be effective for relieving the symptoms and retarding its further growth but if the diagnosis comes at a later stage surgical treatment is generally required.

The latest treatment is called HoLEP (Holmium Laser Enucleation of Prostate). For the last half a decade Holmium laser has established its role in the treatment of enlarged prostate gland.

Holmium laser fibre is passed through a telescope into the natural urinary passage. Laser energy delivered through this fibre is used to cut large chunks of prostate gland in a blood less manner. These chunks of prostate tissue are then further fragmented into smaller bits by using a ‘morcellator’, which can then be easily recovered through the urinary passage itself.

The procedure involves an overnight stay in hospital and is carried out with spinal anaesthesia.  Usually, a catheter is inserted then removed the following day.  Once the patient has been able to discharge a full bladder of urine, they can be discharged, usually on the day after the procedure has been carried out.

Dr. Rajesh Taneja is Senior Consultant Urologist Which Provide Treatment For :- enlarged prostate & benign enlargement of prostate & laser treatment & Holmium laser & prostate treatment & consultant urologist

Treatment Of Urinary Stone Disease And Other Disease

In the era of advanced ultrasound scanning, most renal stones (kidney stones) are diagnosed without any symptoms. Renal stone disease is a significant health problem in men. It is mostly found in persons whose diet is low in vitamins. The pain typically starts in your side or back, just below your ribs, and radiates to your lower abdomen and groin (the area where the abdomen ends and the legs begin).

Anyone who has suffered with kidney stones knows how painful they can be. A kidney stone begins in the center of the kidney as a tiny particle. As other waste particles cling to the initial particle, a stone forms. These stones can be as large as an inch in diameter. However, small stones are usually excreted from the body, but stones larger than 1/5 of an inch are likely to stay within the kidney.

Symptoms :-1)Until a kidney stone moves into the ureter — the tube connecting the kidney and     bladder — you may not know you have it

                        2)Pain in the side and back, below the ribs

                        3)Fluctuations in pain intensity, with periods of pain lasting 20 to 60 minutes..

                        4)Pain waves radiating from the side and back to the lower abdomen and groin.

                                                                                                                                      

Facts :-1)Men are affected by renal stones more commonly than women.

              2)The male-to-female ratio is approximately 3:1.

              3)It affects two out of every thousand people

              4)It occurs commonly between 30-50 years of age.

Treatment option :-

1)For detecting kidney stones X-rays or sonograms are done. However, both of these may not pickup all the stones in urinary tract. In fact the results of these screening investigations need to be confirmed by a plain spiral CT scan. In case CT scan facility is not available, an IVU (intravenous urogram) may be done.

2)Surgery is not the first option. Many kidney stones pass through the urinary system with the drinking of sufficient water.

      3)The surgical intervention could be in the form of Endoscopic (or Endourological) treatment       wherein a fine telescope is passed through the natural urinary tract upwards upto the kidneys and   the stones encountered could be fragmented using Laser energy. These then can be retrieved using fine instruments passed through the same telescope. If the stones in the kidney are large, a  passage is made through the back (flank) and telescope of the size of a pen could be passed up to the stone which could be broken into fragments by Laser and removed piecemeal.

     4)“Lithotripsy” is a non invasive method of breaking down the kidney stones using sound   waves focused on to the stone. The fragments of stone are then expected to flow out along the  passage of urine. This modality has its own limitations and is used for small and recurrent stones.

    5)High fluid intake of at least three to four litres a day can flush urinary tract. The best way to assess your fluid requirement is to look at the colour of urine that you are passing.

Rajeshtaneja provides:- Lithotripsy  &  urinarystone disease  &  Endoscopic treatment