At UC Health Urology, the care of male fertility encompasses several issues, including male infertility, vasectomy, and vasectomy reversal to re-establish fertility. Our urologists also treat male sexual dysfunction, which involves a variety of conditions that may contribute to abnormal sexual function including erectile dysfunction (ED, also known as impotence), premature ejaculation, Peyronie’s disease (curvature of the penis), and hypogonadism. These are non-cancerous concerns and may involve a variety of treatments that include medication, surgery and counseling.
Fertility Options for Men by Expert Urologists
Male Infertility
Infertility effects approximately 15% of couples who are trying to conceive. In at least half of all cases of infertility a male factor is a major or contributing cause. Infertility in men refers to the inability to impregnate a fertile woman from unprotected intercourse after 12 months. There is no one cause to male infertility as it can be due to a varying range of causes, including medical, environmental and lifestyle factors.
Our urologists’ evaluation of male fertility will begin with a complete medical history and physical. Basic blood and semen analysis tests are performed to determine whether the male is a contributing factor in a couples’ inability to conceive. The results of these exams and screenings will help our physicians reach a diagnosis and determine an appropriate treatment plan for each individual patient and couple.
The most common and reversible cause for male infertility is varicocele, a swelling in the veins in the scrotum. This condition is similar to having varicose veins in the legs and occurs when too much blood collects in the veins. There are usually no symptoms associated with this condition, but some men report discomfort. It is not known exactly why varicocele causes fertility problems for males; however, it is believed that the swelling of the veins causes a rise in temperature, which can cause low sperm count and poor sperm production. Sperm count typically bounces back after treatment, which is done through multiple surgical options. These surgical procedures are minimally invasive and can be performed on an outpatient basis.
If varicocele isn’t the cause behind male infertility, other diagnostic tests may be performed to gain a better understanding of the individual’s health situation. Infection, hormone imbalances or sexual dysfunction issues may be to blame; however, the underlying cause for infertility may never be discovered. Individualized treatment options are available, including assisted reproductive therapy, medication therapy, surgery, emotional counseling, or a combination of multiple options in an attempt to help the male and his partner conceive.
Vasectomy
Vasectomy is a simple, safe outpatient procedure that renders a man sterile (unable to conceive a child). It is currently the most effective birth control method for men. To perform this procedure, our urologists use a minimally invasive method to cut and seal the vas deferens, which are the tubes that carry the sperm to the penis. By cutting and sealing off the vas deferens, the sperm is prevented from traveling from the testes to the penis. This is the only change made to the male reproductive system during a vasectomy and will make no noticeable change in the patient’s sexual response.
One important piece of information to note, however, is that it takes approximately 3 months for all active sperm to be completely removed from the body; therefore, be sure to use additional forms of birth control during this time period to prevent pregnancy. Your physician will schedule a follow up exam with you approximately 7 weeks post surgery to ensure that the procedure was successful and the semen is clear of active sperm.
Vasectomy Reversal (Vasovasectomy)
For men who have chosen to have a vasectomy and later find themselves wanting to have children, considering the option of surgical vasectomy reversal is a good first step before exploring artificial conception methods. UC Health urologists explain that receiving a vasectomy reversal could result in faster pregnancy than with other artificial reproductive methods. It also gives couples a more cost-effective option than assisted and/or artificial reproductive methods. The National Institutes of Health reports that one in six men over 35 choose to have a vasectomy. Of those men, it is estimated that 10% eventually seek reversal. In instances that include a healthy female partner, vasectomy reversal results in a 70% pregnancy success rate.
Unlike vasectomy, which is performed in an outpatient clinical setting, vasectomy reversal is typically performed in a surgical center or hospital. Under general anesthesia, the urologist will reattach the vas deferens tubes that were cut during the initial surgery to reestablish sperm flow. The procedure takes approximately 1 ½ – 2 ½ hours. Patients typically return home the next day and are able to return to normal activities – including sex – within three weeks.
Discreet, Compassionate Treatment for Male Sexual Dysfunction
Erectile Dysfunction
Erectile dysfunction (ED) is defined as the inability to get an erection firm enough or maintain an erection long enough for intercourse. While ED is most prevalent in men ages 40-70, it can happen to any man at any age, due to health problems that can lead to ED becoming more common as a man ages. It can be common for men to experience the occasional failure to achieve an erection due to a variety of external circumstances, such as drinking too much alcohol or being extremely tired; however, failure to achieve an erection more than 50% of the time signals a larger issue and could be a sign of ED.
The first step to treating ED is finding the underlying cause. ED is sometimes the first sign of some other health problem, so it is necessary to discuss your overall health. Our urologists may perform a battery of tests to determine the cause of ED, including blood tests, hormone tests, and a prostate exam. Based on the findings, an appropriate treatment plan can be implemented. These treatments may include medication, vacuum devices, intra-urethral medication, penile injections, and penile prosthesis. Although studies have shown that surgical therapy offers the highest patient satisfaction with the best chance of success, it is never the first choice of treatment because it is not reversible and carries some risk.
Premature Ejaculation
Premature ejaculation is ejaculation that occurs sooner than a man or his partner wishes.When this becomes a recurring and debilitating problem, a urologist should be seen to discuss any underlying health problems and potential treatment options.
We realize that sexual satisfaction is an important part of your quality of life and, therefore, our urologists offer several options for treating premature ejaculation, including sexual therapy, medications and psychotherapy. Often, a combination of multiple methods will work best to treat this condition.
Hypogonadism
Male hypogonadism is a condition in which the body doesn’t produce enough testosterone, the hormone that plays a key role in masculine growth and development during puberty. This can occur during fetal development or can present later in life during adolescence or adulthood. Because hypogonadism can occur at different points in development, the outcome is different depending on what stage of development is affected. For adults, the following symptoms typically occur:
Adulthood:
Erectile dysfunction
Infertility
Decrease in body hair and muscle mass
Development of breast tissue
Fatigue
May decrease sex drive
Difficulty concentrating
In adults, hormone replacement therapy is the most appropriate treatment for hypogonadism. By replacing the testosterone that has been missing from the body, normal sexual function is restored and other negative effects, such as hair and bone loss, can be prevented. Assisted reproductive techniques can also be used if infertility is an issue. For men who do not wish to reproduce in the future, testosterone injections or topical applications are another treatment option.
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Male Fertility & Sexual Dysfunction
Fertility Options for Men by Expert Urologists
Male Infertility
Infertility effects approximately 15% of couples who are trying to conceive. In at least half of all cases of infertility a male factor is a major or contributing cause. Infertility in men refers to the inability to impregnate a fertile woman from unprotected intercourse after 12 months. There is no one cause to male infertility as it can be due to a varying range of causes, including medical, environmental and lifestyle factors.
Our urologists’ evaluation of male fertility will begin with a complete medical history and physical. Basic blood and semen analysis tests are performed to determine whether the male is a contributing factor in a couples’ inability to conceive. The results of these exams and screenings will help our physicians reach a diagnosis and determine an appropriate treatment plan for each individual patient and couple.
The most common and reversible cause for male infertility is varicocele, a swelling in the veins in the scrotum. This condition is similar to having varicose veins in the legs and occurs when too much blood collects in the veins. There are usually no symptoms associated with this condition, but some men report discomfort. It is not known exactly why varicocele causes fertility problems for males; however, it is believed that the swelling of the veins causes a rise in temperature, which can cause low sperm count and poor sperm production. Sperm count typically bounces back after treatment, which is done through multiple surgical options. These surgical procedures are minimally invasive and can be performed on an outpatient basis.
If varicocele isn’t the cause behind male infertility, other diagnostic tests may be performed to gain a better understanding of the individual’s health situation. Infection, hormone imbalances or sexual dysfunction issues may be to blame; however, the underlying cause for infertility may never be discovered. Individualized treatment options are available, including assisted reproductive therapy, medication therapy, surgery, emotional counseling, or a combination of multiple options in an attempt to help the male and his partner conceive.
Vasectomy
Vasectomy is a simple, safe outpatient procedure that renders a man sterile (unable to conceive a child). It is currently the most effective birth control method for men. To perform this procedure, our urologists use a minimally invasive method to cut and seal the vas deferens, which are the tubes that carry the sperm to the penis. By cutting and sealing off the vas deferens, the sperm is prevented from traveling from the testes to the penis. This is the only change made to the male reproductive system during a vasectomy and will make no noticeable change in the patient’s sexual response.
One important piece of information to note, however, is that it takes approximately 3 months for all active sperm to be completely removed from the body; therefore, be sure to use additional forms of birth control during this time period to prevent pregnancy. Your physician will schedule a follow up exam with you approximately 7 weeks post surgery to ensure that the procedure was successful and the semen is clear of active sperm.
Vasectomy Reversal (Vasovasectomy)
Unlike vasectomy, which is performed in an outpatient clinical setting, vasectomy reversal is typically performed in a surgical center or hospital. Under general anesthesia, the urologist will reattach the vas deferens tubes that were cut during the initial surgery to reestablish sperm flow. The procedure takes approximately 1 ½ – 2 ½ hours. Patients typically return home the next day and are able to return to normal activities – including sex – within three weeks.
Discreet, Compassionate Treatment for Male Sexual Dysfunction
Erectile Dysfunction
Erectile dysfunction (ED) is defined as the inability to get an erection firm enough or maintain an erection long enough for intercourse. While ED is most prevalent in men ages 40-70, it can happen to any man at any age, due to health problems that can lead to ED becoming more common as a man ages. It can be common for men to experience the occasional failure to achieve an erection due to a variety of external circumstances, such as drinking too much alcohol or being extremely tired; however, failure to achieve an erection more than 50% of the time signals a larger issue and could be a sign of ED.
The first step to treating ED is finding the underlying cause. ED is sometimes the first sign of some other health problem, so it is necessary to discuss your overall health. Our urologists may perform a battery of tests to determine the cause of ED, including blood tests, hormone tests, and a prostate exam. Based on the findings, an appropriate treatment plan can be implemented. These treatments may include medication, vacuum devices, intra-urethral medication, penile injections, and penile prosthesis. Although studies have shown that surgical therapy offers the highest patient satisfaction with the best chance of success, it is never the first choice of treatment because it is not reversible and carries some risk.
Premature Ejaculation
Premature ejaculation is ejaculation that occurs sooner than a man or his partner wishes.When this becomes a recurring and debilitating problem, a urologist should be seen to discuss any underlying health problems and potential treatment options.
We realize that sexual satisfaction is an important part of your quality of life and, therefore, our urologists offer several options for treating premature ejaculation, including sexual therapy, medications and psychotherapy. Often, a combination of multiple methods will work best to treat this condition.
Hypogonadism
Male hypogonadism is a condition in which the body doesn’t produce enough testosterone, the hormone that plays a key role in masculine growth and development during puberty. This can occur during fetal development or can present later in life during adolescence or adulthood. Because hypogonadism can occur at different points in development, the outcome is different depending on what stage of development is affected. For adults, the following symptoms typically occur:
Adulthood:
In adults, hormone replacement therapy is the most appropriate treatment for hypogonadism. By replacing the testosterone that has been missing from the body, normal sexual function is restored and other negative effects, such as hair and bone loss, can be prevented. Assisted reproductive techniques can also be used if infertility is an issue. For men who do not wish to reproduce in the future, testosterone injections or topical applications are another treatment option.