#15. Male Infertility. Male Sexual Disorders - Erectile and Ejaculatory Flashcards

1
Q

What is the Definition of Infertility?

A

Inability of Couple to Achieve Pregnancy within 1 Year of Regular, Unprotected Sexual Intercourse

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2
Q

What is the Incidence of Infertility?

A
  • 15% = Couples Don’t Achieve Pregnancy within 1 year
  • 40% = Couples with Male Infertility
  • 40% = Couples with Female Infertility
  • 20% = Couples with Both (M+F) Infertility
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3
Q

What is the Distribution of Male and Female Infertility?

A
  • 40% = Couples with Male Infertility
  • 40% = Couples with Female Infertility
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4
Q

What are the Genetic Causes of Male Infertility?

A

Chromosomal Abnormalities

  • Which are NOT FOUND in Somatic Diploid Cells
  • Trisomies, Kleinfelters = 47,XXY; 46,XY
  • Y-Microdeletions
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5
Q

What is a Normal Temperature of the Scrotum?

A
  • Must be 2-4C LOWER than the Body Temperature
  • For Spermatogenesis to occur
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6
Q

What is a Variocele?

A

Dilation of Testicular Veins in Pampiniform Plexuses

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7
Q

What is the Incidence of Variocele in Healthy Men?

A
  • Occurs in 12 - 15% of ALL Men!
  • Occurs in 30-40% in Men with Male Infertility
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8
Q

What are the Reasons for the Variocele to be more often on the left?

A
  • Left Testicular Vein joins with Left Renal Vein at a RIGHT Angle
  • Whereas Right Testicular Vein joins with RRV at an ACUTE Angle
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9
Q

What are the Indications for Treatment of Variocele?

A
  • Documents Testicular Growth Retardation VIA US Doppler Studies
  • Or IMPAIRED Sperm Count
  • INCREASED DNA Fragmentation
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10
Q

What are the Methods of Obtaining Sperm in case of Obstruction?

A

1) Microsurgical Epididymal Sperm Aspiration (MESA)

2) Percutaneous Epididymal Sperm Aspiration (PESA)

3) Testicular Sperm Aspiration (TESA)

4) Open Testicuar Sperm Extraction (TESE)

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11
Q

What are the Causes of Retrograde Ejaculation?

A

Retrograde E = Sperm enters the bladder, instead of out of the penis, during an orgasm

  • Prostate / Bladder Surgery
  • Diabetic Neuropathy
  • Retroperitoneal Lymph Node Dissection
  • Diseases of Brain / Spinal Cord
  • alpha-blockers
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12
Q

How is Premature Ejaculation Treated?

A

Premature E = Inability to DELAY ejaculation, which always occurs immediately or within a minute of vaginal penetration

1) Selective SEROTONIN Transport Inhibitors
- Fluoxetine (2 - 20mg / Day)
- Paroxetine (10 - 40mg / Day)
- Fluoxatine (10 - 60mg / Day)

2) Non-Selective SEROTONIN Transport Inhibitor = Dapoxetine

3) Topical Anaesthetics = Lidocaine Cream / Spray, applied on GLANS PENIS 20-30mins before Sex

4) Centrally-Acting Analgesics = Tramadol

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