Andrology is a branch of medicine that focuses on the study of male health, including the anatomy and physiology of the male body, disorders of the male reproductive system, and their treatment methods.
Andrologists diagnose and treat:
Inflammatory diseases and trauma of the urethra, prostate gland, seminal vesicles, scrotum, and external genitalia;
Tumors of the prostate and seminal vesicles;
Congestive diseases of the male genital organs;
Erectile dysfunction;
Causes of delayed sexual development and hypogonadism;
Male menopause (andropause).
They also provide sexual function correction in healthy men, not only treating diseases.
Among the most common andrological issues are male infertility and sexual dysfunction. Andrology also covers congenital and genetic anomalies in the development of the male genital organs such as:
Cryptorchidism (undescended testes),
Phimosis,
Hypospadias and Epispadias (where the urethral opening is located not at the tip of the penis, but along its shaft or base).
These conditions may contribute to infertility, reduced birth rates, and a decline in overall quality of life, sometimes even leading to divorce.
Azoospermia
Azoospermia is a condition in which sperm is absent in the ejaculate, often due to either:
Blocked sperm ducts, or
Impaired sperm production in the testes.
About 5% of men with infertility are diagnosed with azoospermia.
There are 2 types of Azoospermia:
Obstructive Azoospermia – Caused by a blockage in the spermatic ducts at any level. In such cases, hormone levels (FSH) are normal, and removing the obstruction can restore fertility.
Non-obstructive Azoospermia – Caused by hormonal dysfunction in the brain or testicular insensitivity to hormones. Here, FSH levels are usually elevated.
Genetic and hormonal testing is essential in the evaluation of azoospermia.
Sperm Retrieval Methods for Azoospermia
If no sperm is detected in the ejaculate, various microsurgical methods are used to retrieve sperm directly from the testes:
PESA (Percutaneous Epididymal Sperm Aspiration) – Sperm is aspirated using a needle directly from the testicle. If sufficient sperm is retrieved, the procedure is terminated.
MESA (Microsurgical Epididymal Sperm Aspiration) – A small incision is made to access the epididymis, and sperm is aspirated under a microscope from dilated ducts.
TESE (Testicular Sperm Extraction) – Biopsy method where tissue samples are taken from the testicles for sperm retrieval.
Micro-TESE (Microsurgical Testicular Sperm Extraction) – The most advanced method used worldwide for severe male infertility. Under 15–25x magnification, multiple samples (from at least 50 points) are taken from enlarged tubules and sent to the lab. If sperm is found, the procedure is completed.
The method of retrieval is selected by the urologist-andrologist based on the patient's individual condition.