Sexual function

Question 1

Vasectomy

Answer 1

Bilateral surgical ligation or resection of ductus deferens for purpose of sterilization
-local anesthesia; outpatient procedure; takes 15 to 30 mins

Although meant to be permanent, reversals are common
-vasovasotomy or vasoepididymostomy

Question 2

After vasectomy

Answer 2

Ejaculate has similar look and feel; made of seminal and prostatic fluid

• alternate contraception required until no sperm in semen
• sperm cells are made but stored in epididymis and reabsorbed by body

Hormone production and ability to ejaculate/orgasm are unaffected

Psychological adjustment might be a thing

• some consider vasectomy as castration
• psychogenic ED
• increased sexual activity to prove masculinity

Question 3

Erectile disfunction

Answer 3

Inability to attain or maintain an erection that allows for satisfactory sexual activity; HCP should address

In US over 10 mil suffer –> more likely the older you get

50% men bt 40 and 70 have it to some degree

• young men: usually due to substance abuse, stress, anxiety
• mid age: chronic med conditions or treatments for the conditions

Question 4

Risk factors for ED

Answer 4

Common: diabetes, vascular disease, med side effects, result of surgery, trauma, chronic illness, stress, relationship issues, depression

Results from less blood to penis –> maybe associated with cardiovascular disease bc of similar risk factors of both

underlying cause for some men maybe physiologic age related changes

Question 5

ED clinical manifestation

Answer 5

Typical: self report

• may be occasional; continual with gradual onset or sudden
• Gradual = associated with physiologic factors
• sudden = associated with psychologic factors

Inability to perform sexually leads to distress in relationships and self-concept –> can lead to anger/anxiety/depression

Younger men may have diabetes, HTN, depression, or cholesterol abnormalities

Question 6

Infertility definition

Answer 6

Inability to conceive after 1 year of frequent, unprotected intercourse

• disorder of a couple; not one person
• both pp lshould be involved in determining the cause
• male related factors 20-30% (some ppl say 12%)

Question 7

Infertility
diagnostic studies
Cultural considerations

Answer 7

Studies

• semen analysis –> sperm concentration, motility, morphology
• hormone studies –> testosterone, LH, FSH

Cultural
-Fertility = masculinity

Both partners should have simultaneous evaluations to avoid delays in treatment