[Contribution of urology in the interdisciplinary treatment concept of fertility disordered males].
The most important disturbances of male infertility are described in detail. The varicocele is in 30 to 40% the main cause of subfertility. 106 out of 125 patients are operated because of unability to conceive a child. Postoperatively, the results show a significant improvement of the sperm density, total sperm count, sperm morphology and the initial and late forward progression. 26% of the couples were achieve pregnancies. In obstructive azoospermia microsurgical repair is the preferable method. The obstruction, whether developmental or acquired, is most frequently at the epididymal junction. Vasography is performed intraoperative immediately before the planned reconstruction to demonstrate the block. In only 5 of 12 patients microsurgical repair was possible. The other patients had developmental abnormalities or scarring and long-distant obstruction. The diagnostic and therapeutic procedures in erectile impotence are described, 5 patients are operated by implantation of a penile prosthesis. The most important step in prophylaxis of infertility is the treatment of cryptorchidism. The therapy should be closed at the end of the second year of life. The role of testicular autotransplantation in selected cases is discussed. Because of more recent data suggest that a male factor is present in or contribute to as many as 50 per cent of the infertility problems and the urologist has the best training and expertise to examine and to diagnose disorders of the male reproductive tract, he should be at the forefront of treatment of these problems.
Lenk
S
S
Oesterwitz
H
H
Engel
S
S
Zimmermann
H B
HB
Fahlenkamp
D
D
Kunz
B
B
D003251:Constriction, Pathologic / Q000601:surgery; D003456:Cryptorchidism / Q000601:surgery; D007172:Erectile Dysfunction / Q000601:surgery; D005500:Follow-Up Studies; D005832:Genital Diseases, Male / Q000601:surgery*; D006801:Humans; D007248:Infertility, Male / Q000601:surgery*; D008297:Male; D008866:Microsurgery; D009845:Oligospermia / Q000601:surgery; D010348:Patient Care Team; D013086:Spermatic Cord Torsion / Q000601:surgery; D014646:Varicocele / Q000601:surgery
Beitrag der Urologie im interdisziplinären Behandlungskonzept fertilitätsgestörter Männer.