Expertise & Special Interests
Male Infertility
Causes of male infertility include varicoceles, testicular production problems, genetic, hormonal, environmental, or lifestyle factors. Additionally, one out of every eight couples struggles with infertility, and half of all infertile couples have a contributing male factor. In successfully treating male infertility, the goals involved include identifying serious or life-threatening medical problems, diagnosing the underlying cause, correcting and / or improving medical issues potentially impairing sperm production using a combination of lifestyle modifications, medical therapy, including prescriptions, and surgery. These goals optimize sperm health and improve outcomes for natural conception and / or assisted reproduction, including IVF and IUI.
Sperm Retrieval
Sperm retrieval is a medical procedure used to extract sperm from men who cannot produce any sperm in their ejaculate (azoospermia). Many factors are considered to determine the appropriate technique to use for sperm retrieval, primarily the patient’s underlying condition as well preferred approach will guide our decision. Some of the procedures that can be performed include TESA, TESE, and microTESE (mTESE). Fortunately, all of these procedures are minimally invasive.
Vasectomy Reversal
Vasectomy reversal is a procedure performed to restore fertility in a man who previously had a vasectomy. During the procedure, the tubes of the vas deferens are reconnected, to allow for the possibility of natural conception. Unlike the original vasectomy, the reversal is a more complex procedure that requires an operating microscope and sutures the size of an eyelash. The surgeon will first identify the site of the vasectomy and cut the vas deferens, checking for the presence of sperm in the fluid from this cut end. If sperm is present, the severed ends of the vas deferens can be resewn back together, known as vasovasostomy.
Varicoceles
Varicoceles are abnormally dilated veins in the scrotum, which are common and found in up to 15% percent of all men. They typically first appear during adolescence and are found on the left side. While most men are asymptomatic from their varicoceles, a small minority may report a dull aching discomfort or a dragging sensation in the scrotum. Varicoceles are one of the leading causes of male-factor infertility, and about 20% of men with infertility issues have them.
Vasectomy
A vasectomy is a permanent birth control method that involves cutting the tubes (vas deferens) responsible for carrying sperm, ensuring that they cannot be released during ejaculation. The rate of vasectomy failure is 1/2000, making it the most effective birth control possible. It is recommended that men only undergo this procedure if they are certain they do not want children.
Recurrent Pregnancy Loss / IVF failure
Couples may face difficulties with maintaining a pregnancy even if they don't have trouble getting pregnant. The American Society of Reproductive Medicine defines recurrent pregnancy loss as experiencing two or more failed pregnancies. The chance of losing a pregnancy after it has been clinically recognized is about 15-25%.
Testicular Pain
The spermatic cord is a bundle of vessels, nerves and ducts that runs to and from the testicles, contained in a thin sheath of connective tissue resembling a cord. The nerves in the cord transmit pain signals to the testicles. The most direct treatment for testicular pain is by a spermatic cord block. We use a combination of steroid and numbing medication, injected into the spermatic cord to target the offending nerves.
Low Testosterone
Low testosterone, or Low-T, is a condition in which a man’s body has lower than normal levels of the hormone testosterone. Testosterone is an essential hormone that plays a vital role in male sexual development and fertility. Low-T can be caused by various factors, including aging, obesity, side effects of certain medications, metabolic syndrome, testes injury or infection, congenital conditions, chemotherapy or radiation treatments, issues with the pituitary gland, or autoimmune diseases.
Common symptoms of low-T include decreased sexual desire, erectile dysfunction, loss of body or facial hair, constant fatigue, decreased amounts of lean muscle mass, signs of depression, or weight gain. It also has been found to be a risk factor for cardiovascular disease.
Erectile Dysfunction (ED)
Erectile Dysfunction (ED) is a prevalent issue that impacts many men but often goes unspoken. It is characterized by the inability to achieve or sustain an erection adequate for intercourse. ED can affect up to 50% of men by age 50.
The good news is that ED is not an inevitable part of aging and there are several proven, effective therapies available to men of all ages. It is important to seek out a men's health expert for a comprehensive evaluation and a personalized treatment plan that fits your individual needs and lifestyle.
Peyronie’s Disease /
Penile Curvature
Peyronie’s disease is a condition that causes the penis to bend or become disfigured due to scar tissue in the tunica albuginea (fibrous layer within the penis). The exact cause of the disease is unknown. Research shows a prevalence of Peyronie’s disease close to 8%, with 1 in every 11 men suffering from the condition.
Men with diabetes, a history of trauma to the penis, low testosterone, and those with a history of radical prostatectomy for prostate cancer are at risk of developing Peyronie’s disease. Symptoms may include a bend or curve in the penis, hardness or lump in the penis, narrowing or shortening in the shaft of the penis, painful erection, pain during sexual intercourse, and erectile dysfunction.
Penile Rehabilitation After Cancer Treatments
Following a prostatectomy, erectile dysfunction is a common problem that can take 1-2 years to recover from. To help with this, penile rehabilitation is a comprehensive treatment plan that we encourage you to begin even before your surgery.
Penile Doppler Ultrasound
Penile Doppler Ultrasound is a diagnostic procedure that evaluates blood flow to your penis. This procedure is an important part in the diagnostic workup of erectile dysfunction as it allows for simultaneous assessment of blood flow in real-time. It can also help identify men with severe venocclusive dysfunction who may require surgical intervention.
Oncofertility
One of the most distressing outcomes of successful cancer treatment is the possibility of infertility, which can impact future quality of life and lead to psychological distress. This issue affects cancer survivors of all ages. Despite improvements in cancer survival rates among young people, the reproductive consequences are often overlooked and unaccounted for.
Orgasm and Ejaculatory Dysfunction
Ejaculation and orgasm are separate bodily functions, each controlled by the nervous system. Disorders of these functions can be complex.
Premature ejaculation is a condition where there is poor control over ejaculation, resulting in a short time between arousal and ejaculation. This condition can be present from birth or acquired later in life.
Penile Implant / Prosthesis
A penile implant, also known as a penile prosthesis, is a surgical treatment option for men with erectile dysfunction. It is considered minimally invasive when performed by a qualified surgeon. The penile implant is known to be the most satisfying treatment option for both the patient and their partner, when non-surgical remedies have been found to be ineffective in curing the underlying issue.
There are two types of penile implants: malleable (bendable) or inflatable. The inflatable penile implant consists of three components: two inflatable cylinders, a reservoir, and a pump, all of which are concealed within the body.
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