Andrology and Sexual Medicine

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Andrology & Sexual Medicine is a comprehensive source for urologists, andrologists, sexologists and general practitioners. It contains general and up-to-date information about almost all topics within andrology and sexual medicine, and is a unique source that can be used for both exams and general daily practice. Easily accessible to clinicians and researchers and specialists, it tackles the controversial and complex topics of andrology and sexual medicine for urologists.

Author(s): Selcuk Sarikaya, Giorgio Ivan Russo, David Ralph
Series: Management of Urology
Edition: 1
Publisher: Springer
Year: 2022

Language: English
Tags: Andrology; Sexual Medicine; Urology

Contents
1: Introduction, Epidemiology and Etiology of Sexual Dysfunctions in Men and Women
Sexual Dysfunctions in the Biopsychosocial Context
Epidemiology of Women’s Sexual Dysfunctions
Epidemiology of Men’s Sexual Dysfunctions
Medical Approach to the Etiology of Sexual Dysfunctions
Specific Etiological Factors in Women
Specific Etiological Factors in Men
Psychosocial Approach to the Etiology of Sexual Dysfunctions
Specific Etiological Factors in Women
Specific Etiological Factors in Men
Combining the Medical and Psychosocial Factors Toward a Comprehensive Approach to Sexual Dysfunction
Final Remarks
References
2: Diagnosis of Male Sexual Dysfunction
Setting the Scene
Sexual History Taking
The Bio-Psychosocial Approach
Individual
Relational
Family History
Sociocultural Context
Physical Examination
The Role of the Physical Examination
General Health Assessment
Genital Exam
Laboratory Tests and Specialized Tests
Summary
References
3: Erectile Dysfunction: From Diagnosis to Treatment
Introduction, Etiology and Epidemiology
Penile Anatomy
Physiology of Erection
Pathophysiology of Erectile Dysfunction
Diagnosis
Medical and Sexual History
Questionnaires and Diagnostic Tools
Physical Examination
Basic Laboratory Tests
Specific Diagnostic Tests
Treatment
Initial Approach, Lifestyle Modification and Psychological Therapy
Oral Phosphodiesterase Type 5 Inhibitors (PDE5i)
Vacuum Erection Devices (VED)
Extracorporeal Shock Wave Therapy (ESWT)
Stem Cell Therapy (SCT) and Platelet-Rich Plasma Injection (PRP)
Intracavernosal Injections (ICI)
Intrauretral Agents
Penile Prosthesis Implantation (PPI)
Vascular Surgery
Other Options
References
4: Ejaculation and Orgasmic Disorders
Ejaculation Disorders
Premature Ejaculation
Definition
Epidemiology
Pathophysiology, Aetiology, and Risk Factors
Classification
Diagnosis
History
Physical Examination
Stopwatch Assessment of Ejaculatory Latency (IELT)
PE Assessment Questionnaires
Psychiatric Evaluation
Treatment
Psychological Approach
Behavioral Strategies
Pharmacological Treatment
On-Demand Treatment Options
Topical Anesthetics
On-Demand Dapoxetine Treatment
Off-Label Treatments
Daily Treatment of SSRIs and Clomipramine
PDE5Is
On-Demand Tramadol Treatment
Emerging Treatment Options for PE
Oral Pharmacological Agents
DA-8031
On-Demand Clomipramine
GSK958108
Modafinil
Alpha (α) Blockers
Oxytocin Receptor Antagonist
Penile Nerve Resection and Pudendal Neuromodulation
Glans Penis Hyaluronic Acid Injection
Botulinum Toxin-A Injection
Neuromuscular Electrical Stimulation
Transcutaneous Posterior Tibial Nerve Stimulation
Future Treatment
Delayed Ejaculation
Definition
Epidemiology
Pathophysiology, Etiology, and Risk Factors
Classification
Diagnosis
Treatment
Pharmacotherapy
Penile Vibrator Stimulation
Psychotherapy
Anejaculation
Definition
Epidemiology
Pathophysiology, Etiology, and Risk Factor
Classification
Diagnosis
Treatment
Painful Ejaculation
Definition
Epidemiology
Pathophysiology, Etiology, and Risk Factors
Diagnosis
Treatment
Retrograde Ejaculation
Definition
Epidemiology
Pathophysiology, Etiology, and Risk Factors
Diagnosis
Treatment
Pharmacological Treatment
Surgical Treatment
Approach to Infertility
Centrifugation and Resuspension
Hotchkiss (or Modified Hotchkiss) Method
Ejaculation on a Full Bladder
Hemospermia
Definition
Epidemiology
Pathophysiology, Etiology, and Risk Factors
Diagnosis
Treatment
Orgasmic Disorders
Anorgasmia
Definition
Epidemiology
Pathophysiology, Etiology and Risk Factors
Classification
Diagnosis
Treatment
Psychosexual Counseling
Pharmacotherapy
Other Treatment Methods
Postorgasmic Illness Syndrome (POIS)
References
5: Andrologic Emergencies
Introduction
Ischemic Priapism
Definition and Epidemiology
Etiology
Diagnosis
Treatment
Auxiliary Strategies
Corporal Blood Aspiration
Intracavernous Injection of Sympathomimetic Drugs
Penile Shunt Surgery
Penile Prosthesis Implantation
Penile Mondor’s Disease
Definition and Epidemiology
Etiology
Diagnosis
Treatment
Paraphimosis
Definition and Epidemiology
Etiology
Diagnosis
Treatment
Non-surgical Reduction of Paraphimosis
Surgical Reduction of Paraphimosis
Blunt Penile Trauma
Penile Fracture
Definition and Epidemiology
Etiology
Diagnosis
Treatment
Strangulation Injuries of the Penis
Definition and Epidemiology
Diagnosis
Treatment
Blunt Penile Contusion
Penetrating Penile Trauma
Penetrating Wounds
Definition and Epidemiology
Diagnosis
Treatment
Penile Amputation
Definition and Epidemiology
Treatment
Testicular Torsion
Intravaginal Torsion
Extravaginal Torsion
Clinical Presentation and Diagnosis
Treatment
Fournier’s Gangrene
Epidemiology and Risk Factors
Clinical Presentation and Diagnosis
Treatment
References
6: Peyronie’s Disease and Penile Curvature
Introduction
Epidemiology
Penile Anatomy And Peyronie’s Disease
Etiology
Pathogenesis
Course of Disease
Clinical Aspects
Diagnosis
Oral Treatment
Potaba
Vitamin E
Colchicine
Tamoxifen
Carnitine
Pentoxifylline
PDE-5 Inhibitors
Intralesional Injection Therapies
Verapamil
Interferon α-2B
Hyaluronic Acid
Clostridium Collagenase
Other Treatments
Penile Traction and Vacuum Devices
Shockwave Therapy
Laser, Radiation and Iontophoresis Therapy
Combination Therapy
Surgical Treatment
How to Select the Right Surgical Procedure for the Individual Patient?
Surgical Techniques
Tunical Shortening Procedures
Tunical Lengthening Procedures
Penile Prothesis Implant
Adjuvant Procedures
Circumcision
Penile Cosmetic Surgeries
Surgical Technique
Postoperative Cares
Complications
Persistence and Recurrence of Curvature
Erectile Dysfunction
Glans Necrosis
Other Complications
Conclusion
References
7: Reconstructive Andrologic Surgery
Principles of Reconstructive Surgery
Hidradenitis Suppurativa
Fournier’s Gangrene
Genital Lymphoedema
Preputioplasty
Foreskin Restoration (Reversal of Circumcision)
Aesthetic Revision Surgery of the Male Genitalia
Penile Lengthening
Penile Girth Enhancement
Penoscrotal Transposition
Genital Foreign Body
Buried Penis
References
8: Transmasculine Gender Affirmation Surgery
Introduction
Definitions and Terminology
Genital Gender Affirmation Surgery
Penile Reconstruction
Phalloplasty: A Historical Overview
Contemporary Phalloplasty Techniques
Metoidioplasty
Penile Allotransplantation
Adjunctive Procedures
Staging of Surgery
Penile and Testicular Prosthesis Insertion
Non-genital Gender Affirmation Surgery
Chest Reconstruction
Other Non-genital Procedures
Vocal Cord Surgery
Facial Masculinisation Surgery
Summary
References
9: Transfeminine Gender Affirmation Surgery
Introduction
Perioperative Management
Preoperative Requirements and Criteria
Multidisciplinary Team
Criteria for Genital Reassignment Surgery
Fertility
Pre- and Postoperative Course
Counseling and Compliance Strategies
Perioperative Patient Management
Patient Self-Management, Follow Up and Cancer Screening
Patient Self-Management
Follow Up
Routine Check-Ups and Cancer Screening
Surgical Techniques for Male-to-Female Genital Reassignment
Basic Principles of Male-to-Female Genital Reassignment
Orchiectomy, Vagino-, Clitorido-, Labio- and Vulvoplasty- Techniques
Incision According to the Preferred Vaginoplasty Technique
Orchiectomy
Perineal Dissection and Urethral Preparation
Creation of the Neoglans and Dissection of the Neurovascular Bundle
Creation of the Neovaginal Cavity
Vaginoplasty
Penoscrotal Inversionplasty (PI)
Vascularised Bowel: Segment Vaginoplasty (Ileum/Sigma)
Clitoridoplasty, Labioplasty and Vulvoplasty
Complications and Outcomes
Complications
Rectal Complications
Urethral Complications
Neovulvar Complications
Neovaginal Complications
Outcomes
Conclusion
References
10: Penile Rehabilitation: Current Challenges and Future Perspectives
Introduction
Pathophysiology
Factors Influencing the Likelihood to Recover Erectile Function
Rationale of Penile Rehabilitation
Penile Rehabilitation Protocols and Their Tailoring to the Patient
The Importance of Preoperative Counseling
Timing to Start Penile Rehabilitation
Phosphodiesterase Type 5 Inhibitors
Intracavernosal Injections
Intraurethral Alprostadil
Vacuum Erection Device
Novel Penile Rehabilitation Options
Low Intensity Extracorporeal Shock Wave Therapy
Stem Cells
Sexual Rehabilitation Beside Penile Rehabilitation
Non-penetrative Intercourse
Ejaculatory Complaints
Penile Morphometric Changes
Psychological Factors
Penile Rehabilitation After Surgery Other Than Radical Prostatectomy
Radical Cystoprostatectomy
Rectal Surgery
Conclusions
References
11: Pathophysiology and Clinical Aspects of Sexual Dysfunction in Women
Pathophysiology and Clinical Aspects of Sexual Dysfunction in Women
Female Pelvic Anatomy
Physiology of Female Sexual Response
Sexual Dysfunction and Hormonal Influences
Diagnosis
Treatment
References
12: Sexual Arousal and Sexual Pain Disorders in Women
Sexual Arousal
Sexual Arousal as an Emotion
Disgust, and Its Relevance to Sex and Sexual Problems
The Reciprocal Dynamics Between Sexual Arousal and Disgust
Consequences of Having Sex in the Absence or Sufficiently High Sexual Arousal: Pain
Psychological Treatment for Inhibited Sexual Arousal
Psychosexual-Education Targeting Factors Identified as Contenders to Sexual Arousal with Focus on the Relationship
Disgust-Based Interventions for Enhancing Sexual Arousal
Conclusion
References
13: Female Genito-Pelvic Pain and Penetration Disorders
Vaginismus
Definitions
Historical Background
Prevalence
Etiology
Dyspareunia
Etiology
Pain Mechanism
Management
Grading
Cognitive and Behavioral Therapies (CBT)
Pelvic Floor Physiotherapy
Psychological Managements
Surgical Interventions
Pharmacological Agents
Botulinum Toxin Injections
References
14: Male Infertility
Epidemiology
Diagnostic Evaluation
Classification and Clinical Management
Non-obstructive Azoospermia (NOA)
Treatment
Obstructive Azoospermia (OA)
Treatment
Idiopathic Male Infertility and Oligo-Astheno-Terato-Zoospermia
Sperm Retrieval Techniques
References
15: Male Contraception
Introduction
Principles of the Male Reproductive Physiology
Current Pharmaceutical Approaches for Male Contraception
Testosterone Monotherapy
Combination of Androgens with GnRH Analogues
Combination of Androgens with Progestogens
Hormone-Based and Non-hormonal Experimental Regimens
Current Surgical Approaches for Male Contraception
Vas-Occlusive Methods
Reversible Inhibition of Sperm Under Guidance (RISUG) and Vasalgel
Percutaneous Intra-Vas Plugs
Vasectomy
Preoperative Counselling
Techniques
Postoperative Care and Follow-Up
Complications
Vasectomy Reversal
References
16: Male Hypogonadism
Testosterone
Testosterone in the Male Development
Testosterone in Adulthood
Hypogonadism
Primary (Hypergonadotropic) Hypogonadism
Diagnosis
Treatment
Congenital Forms
Congenital Anorchia
Cryptorchidism
Noonan-Syndrome (Ullrich-Noonan Syndrome)
Androgen Insensitivity Syndrome
Klinefelter Syndrome (KS)
The 46,XX Males
Acquired Forms
Surgical Castration
Infections
Chemo and Radiotherapy
Hypogonadisms Associated with Systemic Diseases
Secondary (Hypogonadotropic) Hypogonadism
Diagnosis
Treatment
Hyperprolactinaemia
Kallmann Syndrome
Anabolic Steroid Use
Late-Onset Hypogonadism
References
17: Sexually Transmitted Diseases (STDs)
Introduction
Epidemiology
Primary Prevention
Secondary Prevention
Bacterial Infections
Syphilis
Pathology
Epidemiology
Clinical Manifestations
Diagnosis
Treatment and Prevention
Bacterial Vaginosis (BV)
Pathology
Epidemiology
Clinical Manifestations
Diagnosis
Treatment and Prevention
Neisseria Gonorrhoeae
Pathology
Epidemiology
Clinical Manifestations
Diagnosis
Treatment and Prevention
Chancroid
Pathology
Epidemiology
Clinical Manifestations
Diagnosis
Treatment and Prevention
Lymphogranuloma Venereum (LGV)
Pathology
Epidemiology
Clinical Manifestations
Diagnosis
Treatment and Prevention
Donovanosis
Pathology
Epidemiology
Clinical Manifestations
Diagnosis
Treatment and Prevention
Pelvic Inflammatory Disease (PID)
Pathology
Epidemiology
Clinical Manifestations
Diagnosis
Treatment and Prevention
Viral Infections
Human Papilloma Virus (HPV)
Pathology
Epidemiology
Clinical Manifestations
Diagnosis
Treatment and Prevention
Herpes Simplex Virus (HSV)
Pathology
Epidemiology
Clinical Manifestations
Primary Genital Herpes
Initial Genital Herpes
Relapsing Genital Herpes
Atypical Genital Herpes
Asymptomatic Genital Herpes
Diagnosis
Treatment and Prevention
Human Immunodeficiency Virus (HIV)
Pathology
Epidemiology
Clinical Manifestations
Diagnosis
Treatment and Prevention
Hepatitis B Virus (HBV)
Pathology
Epidemiology
Clinical Manifestations
Diagnosis
Treatment and Prevention
Hepatitis C Virus (HCV)
Pathology
Epidemiology
Clinical Manifestations
Diagnosis
Treatment and Prevention
Funginal Infections
Candida Albicans
Pathology
Epidemiology
Clinical Manifestations
Diagnosis
Treatment and Prevention
Ectoparasitic Infections
Trichomoniasis
Pathology
Epidemiology
Clinical Manifestations
Diagnosis
Treatment and Prevention
Pediculosis Pubis
Pathology
Epidemiology
Clinical Manifestations
Diagnosis
Treatment and Prevention
Scabies
Pathology
Epidemiology
Clinical Manifestations
Diagnosis
Treatment and Prevention
References
18: Penile Cancer
Introduction
Primary Tumor Management
Penile Sparing Non-surgical Treatment
5-Fluoroacil (5-FU)
Imiquimod
Radiotherapy: External Beam Radiotherapy (EBRT), Surface Mold Brachytherapy and Interstitial Brachytherapy
Lasertherapy
Penile Sparing Surgical Treatment
Wide Local Excision and Circumcision
Glans Resurfacing and Split-Thickness Skin Graft (STSG)
Glansectomy
Non-penile Sparing Surgical Treatment
Partial Penectomy
Total Penectomy With Perineal Urethrostomy
Lymph Node Staging and Groin Management
Objective Examination: Clinical Staging at Lymph Node Palpation
Role of Imaging in Nodal Staging
Management in Case of Negative Inguinal Palpation (cN0)
Active Surveillance
Invasive Lymph Node Staging
Management in Case of Doubtful or Positive Inguinal Palpation (cN1 and cN2)
Radical Inguinal Lymphadenectomy (ILND)
ILND Step by Step Technique
Video Endoscopic Inguinal Lymphadenectomy (VEIL) Step by Step Technique
Pelvic Lymphadenectomy (PLND)
Management in Case of Clearly Positive Inguinal Palpation With Voluminous Fixed Lymphadenopathies (cN3)
Adjuvant Chemotherapy
Nodal Recurrence
Advanced Disease
Introduction
Locally Advanced Primary
Advanced Inguinal Disease and Pelvic Disease
Metastatic Disease
Quality of Life
Psychological
Voiding
Sexual Dysfunction
Lymphoedema
References
19: Association of Sexual Dysfunction and Neurological Disorders
Neural Control of Sexual Function
Dysfunction in Neurological Diseases
Neurological Diseases
Trauma
Spinal Cord Injury and Abnormalities
Multiple Sclerosis
Movement Disorders
Epilepsy
Stroke
Peripheral Nerve Impairment
Conclusion
References
20: Testosterone Replacement Therapy
Effects of TRT
Secondary Sexual Characteristics
Sexual Functions
Body Composition, Muscle Strength, and Physical Function
Well-Being, Depressive Symptoms and Cognition
Bone Mineral Density
TRT in the Late Onset Hypogonadism
Testosterone Formulations
Oral Formulations
Parenteral Testosterone Formulations
Transdermal Testosterone Formulations
Other Formulations
Monitoring
Contraindications of TRT
Prostate Cancer
Breast Cancer
Severe Lower Urinary Tract Symptoms
Erythrocytosis
Obstructive Sleep Apnea
Uncontrolled Heart Failure
Adverse Effects Associated with TRT
Prostate Cancer
Lower Urinary Tract Symptoms (LUTS)
Erythrocytosis
Cardiovascular Effects
Venous Thromboembolism
Reversible Infertility
Acne and Skin Irritation
References
21: Biochemical Analysis and Laboratory Tests in Andrology and Sexual Medicine
Manual Semen Analysis
Qualitative and Quantitative Test of Semen
Significance of Quality Control in an Andrology Laboratory
Endocrine Evaluation
A Sperm Concentration < 10 Million/mL
Erectile Dysfunction
Signs and Symptoms of Endocrinopathies or Hypogonadism
Hormonal Evaluation
Recommendations: Routine Measurement of TT
Measuring Serum TT Levels
Methods to Measure Serum TT
Total Testosterone (TT)
Free Testosterone (FT)
Recommendations: Laboratory Diagnosis of TD
TD: Medical Approach and Monitoring
TTh and Male Fertility
Alternatıves to TTH
Selective Estrogen Receptor Modulators (SERMs)
Adverse Events and Monitoring with TTH
Follow-Up and Monitoring
Other Hormones
References