Sexual function Flashcards
Vasectomy
Bilateral surgical ligation or resection of ductus deferens for purpose of sterilization
-local anesthesia; outpatient procedure; takes 15 to 30 mins
Although meant to be permanent, reversals are common
-vasovasotomy or vasoepididymostomy
After vasectomy
Ejaculate has similar look and feel; made of seminal and prostatic fluid
- alternate contraception required until no sperm in semen
- sperm cells are made but stored in epididymis and reabsorbed by body
Hormone production and ability to ejaculate/orgasm are unaffected
Psychological adjustment might be a thing
- some consider vasectomy as castration
- psychogenic ED
- increased sexual activity to prove masculinity
Erectile disfunction
Inability to attain or maintain an erection that allows for satisfactory sexual activity; HCP should address
In US over 10 mil suffer –> more likely the older you get
50% men bt 40 and 70 have it to some degree
- young men: usually due to substance abuse, stress, anxiety
- mid age: chronic med conditions or treatments for the conditions
Risk factors for ED
Common: diabetes, vascular disease, med side effects, result of surgery, trauma, chronic illness, stress, relationship issues, depression
Results from less blood to penis –> maybe associated with cardiovascular disease bc of similar risk factors of both
underlying cause for some men maybe physiologic age related changes
ED clinical manifestation
Typical: self report
- may be occasional; continual with gradual onset or sudden
- Gradual = associated with physiologic factors
- sudden = associated with psychologic factors
Inability to perform sexually leads to distress in relationships and self-concept –> can lead to anger/anxiety/depression
Younger men may have diabetes, HTN, depression, or cholesterol abnormalities
Infertility definition
Inability to conceive after 1 year of frequent, unprotected intercourse
- disorder of a couple; not one person
- both pp lshould be involved in determining the cause
- male related factors 20-30% (some ppl say 12%)
Infertility
diagnostic studies
Cultural considerations
Studies
- semen analysis –> sperm concentration, motility, morphology
- hormone studies –> testosterone, LH, FSH
Cultural
-Fertility = masculinity
Both partners should have simultaneous evaluations to avoid delays in treatment
