Infertility in Males — It’s Not Just the Woman

Male and female couple at a doctor's desk, holding hands and discussing Infertility in Males.

By Dr. Lawrence Goldstone, M.D., F.A.C.S.

Infertility is defined as a couples inability to conceive after one year of appropriately timed and unprotected intercourse. It can affect 15% of couples. Typically thought to be a woman’s problem, infertility in males is actually the primary factor in 20-30% of cases, and is a contributor as a combined couples problem an additional 20-30% of the time.

The evaluation of infertility in males is a relatively simple and straightforward process. It begins with a thorough history, focusing on sexual history, the timing of intercourse, and the use of lubricants. A past history of prior surgeries in the pelvis or reproductive tract will be noted, as well as a history of pain, swelling, or infections in that area.

Medicines and lifestyle choices will be carefully reviewed. Smoking (both tobacco and marijuana) and alcohol can affect sperm health. Testosterone supplements and anabolic steroid usage are an increasingly common cause of male factor infertility. Stress, obesity, and even prolonged heat exposure to the genital area may adversely affect sperm quality.

A physical exam with attention to testicular size and quality will be performed. The presence or absence of the vas deferens(the tube that carries sperm from the testicle) can easily be addressed. Your physician will also check for vein swellings in the scrotum called varicoceles that can impact sperm counts and function.

A semen analysis will be arranged if not already performed. This gives valuable information about semen volume, sperm quantity, and quality. Laboratory testing can provide important clues to hormonal imbalances and chromosomal abnormalities that may affect reproductive health. Ultrasound examinations of the genital tract may occasionally be arranged. In summary, the evaluation is relatively quick and simple and can often be accomplished after only one or two office visits.

Treatment of infertility in males will, of course, depend on the underlying factors. It may be as simple as lifestyle modifications and timing and frequency of intercourse. Medications may be used, particularly for hormonal imbalances. Minor surgeries to correct varicoceles can often be helpful. There are even procedures to retrieve sperm from men who were previously thought to be completely sterile and without hope.

In summary, male factor infertility is a common problem and the physicians at Georgia Urology are well-focused on its improvement. Click here to schedule an appointment with us today if you want to discuss further. 

Georgia Urology Adopts Groundbreaking Enlarged Prostate Surgery

Male doctor checking another male patient by pressing into his side as he lays down, checking for enlarged prostate to see if the groundbreaking enlarged prostate surgery is necessary.

Georgia Urology’s Dr. Brent Sharpe counts himself fortunate to not only witness revolutionary breakthroughs in his field, but to be a purveyor himself.

When treating patients for benign prostate hyperplasia (BPH), otherwise known as prostate enlargement, Dr. Sharpe can now offer the option of the groundbreaking enlarged prostate surgery Aquablation TURP, a game-changing urological procedure. Georgia Urology is the first practice in three surrounding states to perform the surgery.

BPH is a very common condition in which the prostate grows and obstructs the flow of urine. Its effects on the urinary system include decreased flow, difficulty starting the flow, starting and stopping during urination, frequency, urgency, and commonly getting up at night to use the bathroom.

Aquablation TURP by Procept BioRobotics utilizes the clarity of real-time multidimensional imaging, the accuracy of an autonomous robot, and the power of a heat-free water jet to produce a more reliable and predictable surgery. The use of real-time ultrasound permits for key structures to be identified to allow for normal sexual function and continence, as well as to determine the exact size and shape of the prostate.

The automatic robotic device allows for faster and more predictable removal of tissue. In fact, operative times may be reduced as much as 50 percent. Finally, by not using heat energy during the procedure there is a reduction in the typical complications associated with standard TURP.

“It’s really revolutionizing robotic surgery for men with benign prostate hyperplasia,” Dr. Sharpe says, “ which may make other forms of transurethral surgery obsolete.”

After suffering from an enlarged prostate for approximately 12 years, Roger Lance of Buford, Georgia opted for Aquablation TURP and walked away astonished by the results.

Lance says the high-pressure saline stream basically obliterated the obstruction quickly and efficiently. The surgery itself only required an overnight hospital stay. After a one- to two-week recovery period, Lance says he regained bladder control, and things improved greatly.

“I haven’t been able to go to the bathroom like this since I was a teenager,” Lance says. “It’s just amazing how much it changed everything.”

Millard Hixson of Toccoa, Georgia echoes the same sentiment. With an enlarged prostate four times larger than normal, Dr. Sharpe suggested they take action. Hixson chose Aquablation TURP.

“I couldn’t imagine the procedure going as good as it did,” he says. “It’s made a big difference. I don’t get up at night anymore, and I’m able to sleep a lot better. I didn’t realize how much continuous sleep night was important. Now I can sleep for seven to eight hours straight. I have a lot more energy now.”

According to Dr. Sharpe, providing this type of relief and lifestyle change to patients via groundbreaking technology remains one of the most rewarding aspects of his career as a urological surgeon.

“Every patient I’ve worked with has experienced a significant reduction in symptoms, and they’re extremely satisfied,” Dr. Sharpe says. “As a surgeon, you can’t hope for a better outcome than that.”

For more information, you can contact Dr. Sharpe at 678-205-8387 or click here to schedule an appointment.

Common Questions about Urinary Control after Prostate Surgery

Portrait of happy woman surgeon standing in operating room, ready to work on a patient, ready to discuss Urinary Control after Prostate Surgery.

Expert urologist Dr. John Stites, M.D., answers the most common questions about urinary control after prostate surgery below.

Is it common to have urinary control issues after prostate surgery?

Recovery of urinary control is one of the most common concerns for men undergoing treatment for benign and malignant prostate disorders. While most men experience significant improvement or resolution in urinary symptoms, they remain a common source of stress before and after surgery.

Why do men have problems with urinary control after prostate surgery?

It might seem counter-productive that men may have issues controlling their urination after prostate surgery, especially since many men undergo surgery to treat their urinary symptoms to begin with. The underlying causes of these symptoms aren’t limited to the prostate itself; often other structures such as the bladder or urethra can undergo changes after surgery.

For example, a man may undergo surgery to reduce obstruction from his prostate gland so that he may more easily pass urine. Before surgery, his bladder must push harder than usual to pass urine beyond his prostate gland. When this obstruction is surgically removed, however, the bladder must adjust to changes caused by surgery. An unusual urge to urinate with or without leakage may occur during this recovery.

What changes in my urinary control can I expect after prostate surgery?

Individual changes after surgery cannot always be predicted, but there are many tools to help us identify those at risk for urinary control issues after surgery. Before surgery is performed, testing may be needed to determine the functional and structural characteristics of the urinary tract. This information helps us identify men at risk for postoperative urinary control issues.

Who is at higher risk for problems with urinary control after prostate surgery?

More invasive procedures (such as radical prostatectomy for prostate cancer) carry a higher risk for urinary control issues postoperatively. Many factors can influence urinary control after surgery, including underlying medical conditions, medications, diet, and daily activity. Many of these factors are modifiable, and improvement is often achieved by a comprehensive and motivated approach.

It is important to ask your urologist about urinary control when considering prostate surgery, and to discuss pre-existing urinary control issues. Patient education and motivation are among the most important factors in improving urinary control after prostate surgery.

If you have any additional questions regarding urinary control after prostate surgery, click here to contact our expert team.

How to Prevent and Manage STDs

Urologist tells patient that they have STDs.

By Dr. Darrell J. Carmen, M.D., F.A.C.S.

Unfortunately, sexually transmitted diseases (STDs) are common.

Chlamydia is the most commonly reported STD in the U.S. It’s spread mostly by vaginal or anal sex, but you can get it through oral sex, too. Sometimes you’ll notice an odd discharge from your vagina or penis, or pain or burning when you urinate. But only about 25% of women and 50% of men get symptoms. Some other common STDs are gonorrhea, genital herpes, human papillomavirus (HPV), syphilis, trichomoniasis, and HIV/AIDS human immunodeficiency virus or acquired immunodeficiency syndrome.

Not all conditions that affect the sex organs are considered STDs, and some are not related to sex at all. Some are sexually-associated, meaning that they aren’t transmitted during sex, but occur as a result of it. A urinary tract infection can occur because of irritation from intercourse but is not an STD.

How to Prevent STDs

To prevent getting a sexually transmitted disease, always avoid sex with anyone who has genital sores, a rash, discharge, or other symptoms. The only time unprotected sex is safe is if you and your partner have sex only with each other, and if it’s been at least six months since you each tested negative for STDs. Otherwise, you should:

  • Use latex condoms every time you have sex. Condoms are not 100% effective at preventing disease or pregnancy. However, they are extremely effective if used properly.
  • If you use a lubricant, make sure it’s water-based.
  • Avoid sharing towels or underclothing.
  • Shower before and after intercourse.
  • Get a vaccination for hepatitis B. This is a series of three shots.
  • Get tested for HIV.
  • If you have a problem with drug or alcohol abuse, get help. People who are drunk or on drugs often fail to have safe sex.
  • Consider that not having sex is the only sure way to prevent STDs.

It was once thought that using condoms with nonoxynol-9 helped to prevent STDs by killing the organisms that can cause disease. Current research shows that doing so also irritates a woman’s vagina and cervix and may increase the risk of an STD infection. New recommendations are to avoid using condoms with nonoxynol-9.

How to Manage STDs

  • Stop having sex until you see a doctor and are treated. Most tests to diagnose STDs can be obtained from a voided urine or blood specimen. urethral swab not needed.
  • Follow your doctor’s instructions for treatment.
  • Use condoms whenever you have sex, especially with new partners.
  • Don’t resume having sex unless your doctor says it’s OK.
  • Return to your doctor to get rechecked.
  • Be sure your sex partner or partners also are treated.
  • Use latex condoms every time you have sex. If you use a lubricant, make sure it’s water-based.

If you have any more questions about STDs from our experts, click here to contact us today.