By John P Mulhall
Clinical Care Pathways in Andrology provides a invaluable source for figuring out medical decision-making within the context of the most important male reproductive and sexual problems for which sufferers in general search overview and remedy. stipulations which are much less famous yet could be significantly bothersome to sufferers, resembling penile sensory loss, also are awarded. in keeping with medical proof and specialist consensus, useful medical care pathways are featured for every situation. each one scientific care pathway involves an set of rules that delineates the general constitution of decision-making for every situation, describes preliminary medical displays, and publications the reader via diagnostic checking out and remedy. moreover, the quantity beneficial properties annotations that strengthen key andrological ideas and supply causes for every step in prognosis and administration.
Designed for readability and straightforwardness of use, Clinical Care Pathways in Andrology is a pragmatic and priceless reference for urologists, fundamental care physicians, and citizens who're no longer distinctiveness educated in andrology.
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Extra info for Clinical Care Pathways in Andrology
The “climactic pleasure experienced during sexual activity” will go a long way towards simplifying the diagnosis and management. Men can easily have anejaculation and still be perfectly orgasmic. However, men who say they ejaculate and have no orgasm usually have a psychological sexual problem. Asking whether the patient has the complete inability to achieve or has difficulty (delay) in achieving orgasm is important. The next step in history taking is defining whether the condition is life-long or acquired.
Non-obstructive azoospermia: a revolutionary surgical approach and results. Semin Reprod Med. 2009;27(2):165–70. Tanrikut C, Goldstein M. Obstructive azoospermia: a microsurgical success story. Semin Reprod Med. 2009;27(2):159–64. P. 1007/978-1-4614-6693-2_5, © Springer Science+Business Media New York 2014 31 32 5 Azoospermia: Surgical Sperm Retrieval Recent advances in techniques for surgical sperm retrieval and the advent of intracytoplasmic sperm injection (ICSI) allow for biological paternity in azoospermic men for whom the only available treatments a mere 20 years ago were use of donor sperm or adoption.
The classic approach in these cases has been performance of diagnostic testicular biopsy for direct histologic assessment of spermatogenesis and remains the gold standard for diagnostic evaluation. However, most experts (including the authors) advocate directly proceeding to exploratory surgery without performance of a separate testicular biopsy. The advantage of this approach is that it is both diagnostic and therapeutic, allowing for management of the patient with indeterminate azoospermia with a single procedure.
Clinical Care Pathways in Andrology by John P Mulhall