Patient-Focused Philosophy

The strength and history of innovation at Arkansas Urology stems from a patient-focused philosophy and a dedication to the most advanced technology.

Sexual Health

Overview

Sexual dysfunction is a broad category that affects both men and women directly. Male sexual dysfunction is a problem regarding one of the four main components of male sexual function: libido, erection, ejaculation or orgasm. These problems interfere with interest in or ability to engage in sexual intercourse. Many drugs and numerous physical and psychological disorders affect male sexual function.

Sexual dysfunction for women includes desire, arousal, orgasmic and sex pain disorders. Long-term medical diseases, minor ailments, medications and psycho-social difficulties, including prior physical or sexual abuse, are risk factors. Gynecologic problems and cancers, including breast cancer, are also sources of sexual dysfunction. Patient education and reassurance, with early diagnosis and intervention, are essential for effective treatment.

Vasectomy

Vasectomy

A vasectomy is a procedure in which the vas deferens tube, which transports sperm from the testicles to the semen, is cut and removed, making a man sterile. The procedure lasts only 30 to 45 minutes and requires one or two small incisions in the scrotum.

Education/General Information

It takes a period of eight to 10 weeks and 12 to 20 ejaculations after the procedure to become permanently sterile. A semen test is required two months after the operation to determine if semen is free of sperm. Though the procedure should result in permanent sterility, in rare cases, the tubes can grow back together and the patient is no longer sterile. Your sex drive should not be negatively affected by a vasectomy. Some couples even find that their sex life improves after the procedure.

Though you sometimes hear about men having a vasectomy reversed in order to father a child, the reversal procedure does not always work. It is important to carefully consider your decision to have a vasectomy before choosing to go through with the procedure.

Surgical Options

The vasectomy procedure lasts only 30 to 45 minutes and requires one or two small incisions in the scrotum. Many men worry about the pain that may be involved with a vasectomy, but pain is minimal. There may be some pain during and following the operation, but ice packs, athletic support and mild medication should help.

In the weeks following the procedure, you can gradually become more active. After one week, you can have sex, but be sure to continue using birth control until you have taken a semen test to check for sperm.

Usually, the procedure does not result in any problems, and when problems do arise, they are minimal. For example, the incision may become infected, causing swelling and bleeding. If infection occurs, you may be prescribed an antibiotic.

A condition known as “congestive epididymitis,” characterized by a painful lump on the scrotum, develops in some men following a vasectomy. This usually goes away on its own and can be relieved with aspirin or Tylenol.

Infertility

Infertility

Conceiving a child is something that most of us take for granted. But almost one in five couples has difficultly conceiving within one year of unprotected sexual intercourse. The issue is due to female infertility about 40 percent of the time and male infertility about 40 percent of the time. The remaining 20 percent of the time, issues with both partners likely contribute to the infertility.

Education/General Information

The most common cause of male infertility is the inability to produce fully functional sperm. Male infertility may also be caused by abnormalities in the testes or other areas of the male reproductive tract, as well as by immune system defects. Fortunately, many diagnostic tests are available to help determine the causes of male infertility. An initial screening of the male partner should be performed whenever a couple complains of infertility.

Your doctor will examine you for factors that may lead to infertility, including possible structural defects in the reproductive system, hormonal deficiencies, illness or even trauma that might be impairing your fertility. The most common possible causes are:

  • Varicocele, a condition in which the veins surrounding the testicles become swollen and dilated, reducing sperm count
    • Infection of the prostate or epididymis
    • Hormonal problems
    • Genetic abnormalities that affect chromosomes and DNA strands
    • Blockage of sperm flow
    • Medication and treatment side effects
  • Diagnosis

    Diagnosis for male fertility begins with a medical history and physical exam. Your doctor will check your testicles, scrotum and prostate for obvious problems. Blood tests may also be done to evaluate hormone levels.

    A semen analysis is used to evaluate the quality and quantity of your sperm. This helps detect factors that might impair the sperm’s ability to travel to the fallopian tubes or penetrate the egg’s protective covering. The semen analysis reveals sperm motility, sperm count and sperm shape.

    Depending on the results of your physical exam and semen analysis, your doctor may perform other tests, including:

    • Ultrasound to examine the state of the seminal vesicles
    • Antibody testing to determine whether the man or woman produces antibodies to sperm that may destroy or immobilize them

    Treatment

    Factors that decrease male fertility may be treatable with medication, hormones or surgery. The treatment depends on what is causing the fertility problem and may include the following:

    • Treating infection in any part of the reproductive tract with antibiotics
    • Improving sperm concentration through sperm washing
    • Treating sperm antibodies
    • Correcting hormonal problems through hormone therapy
    • Varicoceles surgery
    • Reversing vasectomy
    • Clearing duct obstructions
    • Treating ejaculation problems
    • Timing intercourse during the “fertile window”

    If these techniques fail, your doctor may recommend assisted reproductive options, such as intrauterine insemination (IUI), in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI).

    Diet and lifestyle changes may also improve fertility. These changes include:

    • Stop smoking
    • Reduce alcohol and drug use
    • Avoid excessive heat for optimal sperm production
    • Improve your diet
    • Exercise regularly
    • Limit caffeine
    • Avoid environmental hazards, such as pesticides or solvents

    Circumcision

    Circumcision

    Circumcision is the surgical removal of the foreskin from the head of the penis.  Although a majority of males are circumcised at birth, it is not uncommon to be circumcised later in life. At Arkansas Urology, we perform adult circumcisions and childhood re-circumcisions.

    Adult Circumcision
    Adult circumcision is performed less often than infant circumcision. In most cases, it is performed to treat a medical condition or urological emergency, including:

    • Paraphimosis: the retracted foreskin can’t return to it’s normal position
    • Phimosis: the foreskin is too tight to retract from the head of the penis
    • Recurrent inflammation of the foreskin

    The risks associated with adult circumcision include

    • Pain
    • Risk of bleeding and infection at the site of the circumcision
    • Irritation
    • Increased inflammation

    Childhood Re-circumcision
    In some cases, male infants and children require re-circumcision due to complications that arise following the initial circumcision. In some cases, the foreskin may re-adhere to the head of the penis. This can cause problems with urination or lead to infection. A re-circumcision may also be necessary if too much or too little skin is initially removed. Keep in mind that your child may have to wait until at least the age of 6 months to undergo a re-circumcision. The reason for this delay is the need for general anesthesia. By 6 months of age, infants are healthy and strong enough to tolerate general anesthesia.

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