Andrology

Andrology is the medical specialty that deals with male health, particularly relating to the problems of the male reproductive system and urological problems that are unique to men. It is also known as "the science of men". It is the counterpart to gynaecology, which deals with medical issues which are specific to the female reproductive system.

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Erectile dysfunction:

Erectile dysfunction (ED), also known as impotence, is a type of sexual dysfunction characterized by the inability to develop or maintain an erection of the penis during sexual activity in humans. A penile erection is the hydraulic effect of blood entering and being retained in sponge-like bodies within the penis. The process is most often initiated as a result of sexual arousal, when signals are transmitted from the brain to nerves in the penis. The most important organic causes of impotence are cardiovascular disease and diabetes, neurological problems, hormonal insufficiencies and drug side effects.

Pathophysiology:

Penile erection is managed by two mechanisms: the reflex erection, which is achieved by directly touching the penile shaft, and the psychogenic erection, which is achieved by erotic or emotional stimuli. The former uses the peripheral nerves and the lower parts of the spinal cord, whereas the latter uses the limbic system of the brain. In both cases, an intact neural system is required for a successful and complete erection. Stimulation of the penile shaft by the nervous system leads to the secretion of nitric oxide (NO), which causes the relaxation of smooth muscles of corpora cavernosa, and subsequently penile erection. Additionally, adequate levels of testosterone and an intact pituitary gland are required for the development of a healthy erectile system.

Epididymitis:

Epididymitis is a medical condition characterized by inflammation of the epididymis, a curved structure at the back of the testicle. Onset of pain is typically over a day or two. The pain may improve with raising the testicle. Other symptoms may include swelling of the testicle, burning with urination, or frequent urination. Inflammation of the testicle is commonly also present. In those who are young and sexually active gonorrhea and chlamydia are frequently the underlying cause. In older males and males who have sex with males enteric bacteria are common. Diagnosis is typically based on symptoms. Conditions that may result in similar symptoms include testicular torsion, inguinal hernia, and testicular cancer. Ultrasound can be useful if the diagnosis is unclear.

Orchitis:

Orchitis is inflammation of the testes. It can also involve swelling, heavy pains and frequent infection, and is more rarely known as didymitis.

Causes:
  • Orchitis can be related to epididymitis infection that has spread to the testicles, sometimes caused by the sexually transmitted diseases chlamydia and gonorrhea.
  • It has also been reported in cases of males infected with brucellosis.
  • Orchitis can also be seen during active mumps, particularly in adolescent boys.
  • Ischemic orchitis may result from damage to the blood vessels of the spermatic cord during inguinal herniorrhaphy, and may in the worst event lead to testicular atrophy.

Cryptorchidism:

Cryptorchidism is the absence of one or both testes from the scrotum. It is the most common birth defect of the male genital. About 3% of full-term and 30% of premature infant boys are born with at least one undescended testis. Cryptorchidism is distinct from monorchism, the condition of having only one testicle. The condition may occur on one or both sides; it more commonly affects the right testis. Undescended testes are associated with reduced fertility, increased risk of testicular germ cell tumors and psychological problems when the boy is grown. Undescended testes are also more susceptible to testicular torsion and inguinal hernias.