Male infertility – urological problems

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Publication date: 10.03.2021

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Among the urological problems, in terms of male infertility, the following factors are worth noting:

VARICOCELE – a pathological condition when the veins of the testicles of men are enlarged. Its cause is an increase in pressure in the veins and develops mostly during puberty, when the genitals grow. It is characterized by pain, a feeling of heaviness and cramping, although it can also be asymptomatic. Varicocele can cause significant deterioration of sperm quality and decrease in its quantity, which is one of the common causes of male infertility. The pathophysiological mechanism of sperm quality is unknown, although it is believed to be a blood supply disorder.

EJACULATION DISORDERS – RETROGRADE EJACULATION. This is a pathological condition where ejaculate flows backwards during orgasm and goes up into the bladder instead of coming out. It is also called a dry orgasm. It is clinically manifested by the absence of ejaculate or a small volume of ejaculate. Retrograde ejaculation is not painful and does not cause erectile dysfunction. The only goal of its treatment is to restore male reproductive function.

CRYPTORCHIDISM – failure of the testicle to descend into the scrotum. As a rule, this pathology is unilateral, although in 10% it occurs bilaterally. Statistically, cryptorchidism occurs in 2-5% of term newborns, and in 30% of premature newborns. Almost 70% of cases resolve spontaneously by the age of 1 year, and 30% require surgical intervention. In terms of infertility, the temperature effect on the testicles, which is higher than its physiological norm, and injuries caused by surgical intervention are important.

OBSTRUCTION OF SPERM TRANSPORT TUBES.  Several tubular structures are responsible for sperm transport. Their obstruction or suffocation is the basis of obstructive azoospermia. Clogged tubules can be caused by: infectious diseases, trauma, damage caused by surgery or simply due to anatomical defects that occur in a number of genetic diseases.

SEXUAL DYSFUNCTION includes several pathological conditions that can cause male infertility. These are: erectile dysfunction, premature ejaculation, painful intercourse, anatomical features and psycho-emotional problems of the couple that affect the sexual relationship.

HISTORY OF UROLOGICAL AND PROCTOLOGICAL OPERATIONS. A specific surgical intervention, such as a vasectomy, causes the absence of sperm in the ejaculate. Operations on the scrotum, testicle, epididymis, and rectum can cause male infertility, both as a surgical norm and as a complication.

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