Andrology
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Urethral Stricture

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Urethral Stricture

T

he Urinary system is constituted by the kidneys, ureters and the urethra. The urethra is a tube structure through which the urine expels abroad.

Urethral stricture is a condition which basically consists of a narrowing of the urethra.

This can be caused by injury, instrumentation, infection, and certain non-infectious forms of urethritis.

Currently, it is considered that urethral strictures develop secondarily to a process of scarring or fibrosis of the urethral mucosa and/or periurethral tissues, so any process that conditions a trauma can propitiate a urethral stricture.

So, here´s a brief explanation of 3 treatment options:

  • Urethral dilatations:
    The first treatment described for this pathology is periodic urethral dilation, which is recommended in stenoses smaller than 2 cm. A complication rate or failure rate has been reported with this treatment in 32% of patients. Some authors consider it as a non-curative therapy, so it has been replaced by balloon dilatations, stents, and direct visual internal urethrotomy (DVIU).

  • Internal urethrotomy:
    It has become the most used technique compared to urethroplasty, since it is considered a simple, safe procedure, with a short and simple convalescence time to perform despite having a risk of recurrence during the first 6 months of a 50%. The objective of this technique is to allow reepithelialization before the scar is faced again, with which the urethral scar would be remodeled to an open position.

  • Urethroplasty:
    The technique consists of opening the urethra at the level of the penis or perineum, with excision of the segment that presents the stenosis. Depending on the location and length of the stenosis, the reconstruction can be performed in a single time or it may be necessary to leave the urethra open to facilitate its regeneration, proceeding to the final reconstruction in a second time.

Frequently Asked Questions

Urethral stricture is a condition which basically consists of a narrowing of the urethra.

There are a 3 alternative treatment options. you can find an explanation of these 3 options down below:

Urethral dilatations:

The first treatment described for this pathology is periodic urethral dilation, which is recommended in stenoses smaller than 2 cm. A complication rate or failure rate has been reported with this treatment in 32% of patients. Some authors consider it as a non-curative therapy, so it has been replaced by balloon dilatations, stents, and direct visual internal urethrotomy (DVIU).

Internal urethrotomy:
It has become the most used technique compared to urethroplasty, since it is considered a simple, safe procedure, with a short and simple convalescence time to perform despite having a risk of recurrence during the first 6 months of a 50%. The objective of this technique is to allow reepithelialization before the scar is faced again, with which the urethral scar would be remodeled to an open position.

Urethroplasty:
The technique consists of opening the urethra at the level of the penis or perineum, with excision of the segment that presents the stenosis. Depending on the location and length of the stenosis, the reconstruction can be performed in a single time or it may be necessary to leave the urethra open to facilitate its regeneration, proceeding to the final reconstruction in a second time.

Andrology
AndrologybyTHS Hospital

Male Subfertility

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Male Subfertility

S

ubfertility is a medical term that refers to a form of diminished fertility which implies an extended period of undesirable non-conception.

Infertility is defined as the inability to achieve a spontaneous pregnancy after one year of sexual intercourse without the use of contraceptive methods. Approximately 15% of couples consult for this reason. The male factor is the only responsible in 20% of cases, and contributes to the infertility of the couple 50% of the time. When faced with a male factor, a quantitative or qualitative alteration of one or more seminal parameters will always be observed.

Male subfertility or infertility can be caused by a variety of conditions. Some of them can be identified and treated, such as hypogonadotrophic hypogonadism; others are diagnosed, but do not have a specific treatment, such as genetic alterations or testicular atrophy. In 30-40% of patients with spermiogram alterations, physical examination and laboratory tests fail to objectify a specific cause of infertility, classifying these patients as carriers of an idiopathic male infertility. The different sperm retrieval techniques, which extract gametes from different regions of the male reproductive system, have achieved that couples with severe male factor without specific treatment can achieve pregnancies and offspring. Carrying out a complete study of these patients will allow the specialist:

  • Treat correctable alterations.
  • Identify the conditions without specific treatment, to offer assisted reproduction techniques using the patient’s sperm.
  • Identify the conditions where it will be impossible to recover viable male gametes, being able to offer techniques of assisted reproduction with donor sperm or adoption.
  • Recognize serious illnesses that may be manifesting as infertility.
  • Diagnose genetic alterations that may affect the health or reproductive potential of the offspring.

At Harley Street Hospital, we have the best doctors to treat this condition. Book a consultation to get a specialist´s opinion.

Andrology
AndrologybyTHS Hospital

Premature Ejaculation

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Premature Ejaculation

D

uring the evolution of human sexuality, the ability to control the time of ejaculation has been one of the most important characteristics of the sexual health of couples. For this reason, the lack of control in ejaculation has a profound psychological base effect and its treatment must be carried out through a psychological therapy to the man or the couple. The ejaculatory alterations, especially premature ejaculation is one of the most common complications of adult men and men with premature ejaculation report low levels of sexual satisfaction compared to men with normal ejaculation.
Premature ejaculation, or lack of control of ejaculation, is the inability to exercise voluntary control over the ejaculatory reflex so that once a man reaches a certain level of sexual arousal he ejaculates automatically and quickly after or even before vaginal penetration. Because intravaginal ejaculation in patients with premature ejaculation usually occurs, it is rarely a cause of infertility.
If this is the case, ejaculation happens before vaginal penetration, couples can perform some assisted reproduction procedure for solving the problem of infertility.

Treatment

Currently, there are protocols to treat premature ejaculation that last between 8 and 12 weeks, going to consultation normally once a week or every 15 days depending on the case.
The used therapies are those that have empirical support derived of fields like sexual medicine and experimental psychology and they are internationally accepted techniques that are part of the consensus guidelines of the International Society for Sexual Medicine for the treatment of premature ejaculation.
These protocols can be applied individually or to the couple, and are adaptable to each case, they include the latest advances in sexual medicine at the pharmacological and psychological levels.

The treatment´s main goal is that the patient reaches the control over his ejaculation, by doing so he can lead a satisfactory sexual life.

At Harley Street Hospital, we have some of the best doctors that can treat premature ejaculation. Book your consultation now to get a specialist opinion.

 

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