A third of infertility cases involve issues with the male partner. It is important that the patient seek medical care at the onset of fertility problems to discover what the main cause may be. Testing men, compared to women, is less invasive and helps zero in on a fertility issue among a couple.
There are a number of urologic conditions which can affect a patient’s fertility. A hydrocele is a sac filled with fluid that surrounds a testicle, which causes the scrotum to swell. Although common in newborns, older patients may develop a hydrocele from injury or inflammation inside the scrotum. A hydrocele is usually harmless, but it can sometimes be a sign of an underlying testicular condition. If the patient has a tumor or infection that creates a hydrocele, it can reduce a patient’s sperm production. A urologist will perform a physical exam to determine whether a patient has a hydrocele. It typically goes away on its own within a few months. If a hydrocele is large and causes disfigurement or discomfort, it may need to be surgically removed.
A varicocele, the enlargement of veins in the scrotum, is another common cause of infertility, although not all cases affect a patient’s sperm quality or quantity. It is comparable to varicose veins in a patient’s leg. There are no symptoms associated with a varicocele, and it infrequently causes pain. A physical exam is performed by a urologist to conclude whether a patient has a varicocele. A urologist may also use an ultrasound if the physical exam is inconclusive. An ultrasound determines whether there’s another reason for the swollen veins, such as a tumor pressing on the spermatic vein.
If a patient has a varicocele, and it is causing infertility, a urologist may perform a varicocelectomy. During this procedure, a small incision is made to access the veins that create the varicocele. These veins are then cut to stop blood flow to the varicocele.
Erectile dysfunction (ED) is a condition that may affect patients on a short-term or long-term basis. Roughly 5% of 40-year-old men and an estimated 15-25% of 65-year-old men continually experience erectile dysfunction. Erectile dysfunction is caused by one of the following items being affected:
Peyronie’s Disease is the growth of scar tissue inside the penis, is one of the few conditions in which erectile dysfunction is a symptom. The fibrous scar tissue is the result of repeated injury to the penis. This causes the penis to curve, and the patient may experience painful erections, or difficulty maintaining one. A urologist will perform a physical exam to determine whether a patient has Peyronie’s disease. Upon diagnosis, a urologist will monitor a patient’s condition to see if their symptoms worsen over time. If the symptoms increase in severity, a urologist will suggest medication to alleviate symptoms and to reduce scar tissue formation.
Hypospadias is a urologic condition where the opening of the urethra is located on the base of the penis rather than the tip. Although this condition is congenital, it can cause an adult patient to experience erectile dysfunction if left untreated. To treat this condition, a urologist will perform surgery to correct the placement of the urethral opening.
Phimosis is a urologic condition that causes the foreskin of the penis to tighten so much that it cannot retract, which can cause painful erections and erectile dysfunction. This condition is predominantly seen in children, but adult patients may experience it as well. Infection and scar tissue from an injury can case phimosis in adults. There are a variety of treatment options for phimosis, depending on the severity of it. A medication applied on-site may be used to loosen the foreskin. A urologist may also consider surgical interventions such as circumcision to remove the foreskin entirely.
Patients that experience infertility or erectile dysfunction may find it difficult to seek treatment based on the sensitive nature of these conditions. The urologists at Academic Urology strive to make the diagnosis and treatment processes as comfortable and informative as possible. Call us today to learn more about the treatment options we offer for a broad range of urologic conditions.