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. This term comes from ancient greek andros, that means - man; and logos - knowledge. Primarily, its clinical focus is the diagnosis and therapy of male fertility disturbances and andrology as such is the male equivalent of gynecology. According to the definition of the World Health Organization (WHO) andrology is engaged in all aspects of male reproductive health.
What to expect from your first visit to urologist-andrologist?
The first step is always the complete and comprehensive collection of information which will serve to guide the specialist for a diagnosis and, therefore, a therapy.
On your first visit doctor will ask you some questions regarding your urological, sexual and general health and perform physical examination which may include inspection and palpation of the entire genital area. In some cases additional tests are needed for correct diagnosis.
The most frequently performed analysis in andrology clinic is a semen analysis called spermogram.
This test provides a way to evaluate the concentration, structure and motility of spermatozoa. The semen analysis may result in one of the following diagnoses: astenozoospermy (significant decrease of spermatozoon motility), teratozoospermy (more than half of the spermatozoa have structure abnormalities) and oligozoospermy (very low concentration of spermatozoa). In our laboratory semen analysis is performed in accordance with the requirements set by the World Health Organization (WHO).
Sometimes ultrasound examination is a key to a correct diagnosis. In some cases for complete male fertility evaluation scrotal and prostate ultrasound are required.
Scrotal(testicular) ultrasound
Scrotal ultrasound is an imaging test that looks at the scrotum. It is the flesh-covered sac that hangs between the legs at the base of the penis and contains the testicles.
The testicles are the male reproductive organs that produce sperm and the hormone testosterone. They are located in the scrotum, along with other small organs, blood vessels, and a small tube called the vas deferens.
How the test is performed
You lie on your back with your legs spread. The health care provider drapes a cloth across your thighs under the scrotum or applies wide strips of adhesive tape to the area. The scrotal sac will be slightly raised with the testicles lying side by side.
A clear gel is applied to the scrotal sac to help transmit the sound waves. A handheld probe (the ultrasound transducer) is then moved over the scrotum by the technologist. The ultrasound machine sends out high-frequency sound waves. These waves reflect off areas in the scrotum to create a picture.
How to prepare for the test
No special preparation is needed for this test.
How the test will feel
There is little discomfort. The conducting gel may feel slightly cold and wet.
Why the test is performed
A testicle ultrasound is done to:
1) Help determine why one or both testicles have become larger
2) Look at a mass or lump in one or both of the testicles
3) Find the reason for pain in the testicles
4) Show how blood flows through the testicle
Risks
There are no known risks. You will not be exposed to radiation with this test.
Considerations
In certain cases, Doppler ultrasound may help identify blood flow inside the scrotum. This method can be helpful in cases of varicocele and testicular torsion, because blood flow to the twisted testicle may be reduced.
Prostate ultrasound
Ultrasound of the prostate is an imaging test that looks at the prostate gland. The prostate is an exocrine gland of the male reproductive system that is located directly in front of the rectum. It helps to detect abnormalities, and determine whether the gland is enlarged.
How the test is performed
The are two types of prostate ultrasound - transrectal and transabdominal. In case of transabdominal ultrasound, you will be asked to lie down on your back and raise your shirt as the ultrasound transducer will be placed on the suprapubic area of your abdomen.
For a transrectal ultrasound, you will be asked to lie on your side with your knees bent. A disposable protective cover is placed over the transducer, it is lubricated, inserted through the anus and placed into the rectum in order to position the imaging probe as close to the prostate gland as possible.
How to prepare for the test
No special preparation is needed for transabdominal ultrasound. In case of transrectal ultrasound an enema may be taken two to four hours before the ultrasound to clean out the bowel.
How the test will feel
Ultrasound exams in which the transducer is inserted into an opening of the body may produce minimal discomfort.
Why the test is performed
A prostate ultrasound is usually done if patient has:
1) trouble urinating
2) lumps or nodules (excess tissue) around rectum
3) abnormal results from urine test or semen analysis
4) elevated PSA
5) pain and/or discomfort in perineal and genital area
6) infertility
Risks
There are no known risks. You will not be exposed to radiation with this test.
Dr. Andrew Zhivulko is a board certified urologist treating patients throughout Moscow and from other parts of Russia, former republics of the USSR and Europe. Dr. Zhivulko completed his medical degree at the Russian State Medical University. He continued his education at the department of urology at Moscow State University of Medicine where he completed his clinical residency. After completing the residency he worked at the department of Clinical Andrology at the Russian People’s Friendship University. Dr. Zhivulko has been working in the field of reproductive medicine for 7 years and has a number of scientific publications on the topic of male infertility. He is a regular participant and speaker on Russian and international andrology conferences.
Professional interests:
Languages
Russian, English.
Живулько Андрей Романович