Clinical Care Pathways in Andrology by John P Mulhall

By John P Mulhall

Clinical Care Pathways in Andrology provides a invaluable source for figuring out medical decision-making within the context of the main male reproductive and sexual issues for which sufferers mostly search assessment and remedy. stipulations which are much less famous yet should be critically bothersome to sufferers, reminiscent of penile sensory loss, also are awarded. in keeping with scientific facts and professional consensus, sensible scientific care pathways are featured for every . each one scientific care pathway includes an set of rules that delineates the final constitution of decision-making for every situation, describes preliminary medical shows, and courses the reader via diagnostic trying out and remedy. additionally, the quantity good points annotations that boost key andrological ideas and supply motives for every step in prognosis and administration.

Designed for readability and straightforwardness of use, Clinical Care Pathways in Andrology is a pragmatic and worthy reference for urologists, fundamental care physicians, and citizens who're no longer forte educated in andrology.

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Complete failure to achieve orgasm is known as anorgasmia, while complete inability to ejaculate is known as anejaculation (see Anejeculation algorithm). Delayed orgasm is one of the most poorly understood and pharmacologically recalcitrant sexual dysfunctions. ” There is no specific time frame, and as is the case with PE, time frame cannot be the sole factor defining the condition. As with PE, the condition can be lifelong (primary) or acquired (secondary). , with partner but not masturbation, or with one partner but not another).

In this condition, both sperm production and testosterone synthesis are insufficient due to inadequate stimulation of the testes by gonadotropins. This rare cause of NOA may be congenital (Kallman’s syndrome), acquired (pituitary tumor, surgery or infarct), or idiopathic. Genetic tests for hypogonadotropic hypogonadism are available but are not yet part of routine clinical practice. One important caveat to note is that laboratory evidence of hypogonadotropic hypogonadism in a man who is particularly muscular and androgenized should raise suspicion for anabolic steroid use with an anabolic compound that is not detectable on standard testosterone assays (nandrolone or stanozolol).

Assessment of penile vibratory stimulation as a management strategy in men with retarded orgasm. Urology. 2007;69(3):552–5. Rosen RC, Lane RM, Menza M. Effects of SSRIs on sexual function: a critical review. J Clin Psychopharmacol. 1999;19(1):67–85. Rowland D, McMahon CG, Abdo C, Chen J, Jannini E, Waldinger MD, et al. Disorders of orgasm and ejaculation in men. J Sex Med. 2010;7(4 Pt 2):1668–86. P. 1007/978-1-4614-6693-2_7, © Springer Science+Business Media New York 2014 41 42 7 Erectile Dysfunction: Initial Evaluation Erectile dysfunction (ED) is defined as the consistent inability to obtain and/or maintain an erection sufficient for satisfactory relations.

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