Medical Specialists

Urology (yū-RŎL-ŏ-jē) is the study of the male and female urinary systems and the male reproductive system.^[1] A urologist (yū-RŌL-ŏ-jĭst) is a physician who specializes in the diagnosis and treatments of disorders of the urinary and reproductive systems.

Diagnostic Testing

Semen Analysis

A semen analysis (SĒ-mĕn ă-NĂL-ĭ-sĭs) evaluates the volume and quality of a man’s sperm. It is one of the first tests performed when a couple experiences infertility. It is also performed to determine if a vasectomy was successful. Semen analysis involves collecting a semen sample and evaluating it in a lab.^[2]

When used as a fertility test in men, a semen analysis evaluates the following^[3]:

• pH level: Whether semen is too acidic, which can affect sperm health.
• Semen volume: Amount of semen in the sample (in millimeters).
• Sperm concentration: Number of sperm per millimeter of semen.
• Sperm morphology: Size and shape of the sperm.
• Sperm motility: Ability of the sperm to swim toward an egg.
• Time to liquefaction: How quickly semen changes from a sticky substance to a liquid.
• Vitality: Percent of live sperm in the sample.
• White blood cells: A sign of infection or inflammation.

Procedures

Circumcision

Circumcision (sĭr-kŭm-SIZH-ŭn) is the surgical removal of the foreskin (prepuce), a fold of skin covering the tip of the penis. It is a common procedure for newborn boys in certain parts of the world, including the United States. For some families, circumcision is a religious ritual or family tradition.^[4]

Newborn circumcision is typically done in the hospital nursery by a pediatrician within a few days after birth. The penis and surrounding area are cleansed, and an anesthetic is injected into the base of the penis or applied to the penis as a cream. A special clamp or plastic ring is attached to the penis, and the foreskin will be removed. Afterward, the penis is covered with an ointment and wrapped loosely with gauze. The procedure generally takes about ten minutes.^[5]

Circumcision is also used to treat men with phimosis (fī-MŌ-sĭs), a tightness of the prepuce (foreskin) that prevents its retraction over the penis. It may be congenital or the result of balanitis. Balanitis (băl-ă-NĪ-tĭs) is a common condition that causes an inflammation of the glans penis (i.e., the head of the penis). It can be caused by fungi, yeast, bacteria, or viruses, including those that cause sexually transmitted infections (STI), but balanitis is not considered an STI.^[6]

Hydrocelectomy

Hydrocelectomy (hī-drō-sē-LĔK-tō-mē) is the surgical removal of a fluid-filled sac around the testicle that is causing scrotal swelling (i.e., a hydrocele).

Vasectomy

A vasectomy (vă-SEK-tŏ-mē) is a surgical procedure that prevents sperm from leaving the body, providing permanent birth control, referred to as sterilization (ster-ĭ-lĭ-ZĀ-shŏn). The procedure closes off the ends of the vas deferens, the tubes that carry sperm. Semen samples are routinely checked after a vasectomy to confirm a successful procedure. Vasectomy is safe and effective for preventing pregnancy, but it doesn’t protect against sexually transmitted infections.^[7]

There are two types of vasectomies. One is an incision vasectomy, and the other is a no-scalpel vasectomy. The incision vasectomy requires two small incisions, whereas the no-scalpel vasectomy requires only one small puncture. Both are done in doctors’ offices or outpatient surgery centers and use local anesthesia to numb the scrotum. Both types of vasectomies divide and close off the ends of the vas deferens, preventing sperm from getting through. The vas deferens is divided and tied, clipped, or cauterized (using an electrical current to close the incision).^[8]