The andrological examination
WHO IS THE ANDROLOGIST SPECIALIST?
The andrologist is the specialist who deals with typical male health problems and can be considered the counterpart of the gynaecologist in the field of female health.
The andrology specialist can be either an endocrinologist, in which case he/she deals more with the medical aspects of andrology, or a urologist, in which case he/she deals more with the surgical aspects of the branch.
WHY AN ANDROLOGICAL EXAMINATION?
The andrological examination is a common specialist examination, assessing male health in its totality and complexity, while focusing specifically on the male genital and reproductive system. The andrologist's focus is on disorders of the male genital system, both pertaining to dysfunctions and malformations, including infections, tumours and other conditions.
WHEN IS AN ANDROLOGICAL EXAMINATION NECESSARY?
An andrological examination should certainly be carried out whenever there is suspicion of pathologies of the male genital and reproductive system to verify their actual existence and to undertake any specific treatment.
However, on the other hand, an andrological examination should also be scheduled routinely, even without specific pathologies, at different stages of a male's life.
WHY IS IT IMPORTANT?
An andrological check in childhood allows to ascertain the normal development of the external genitalia, in particular the size and conformation of the penis as well as the regular position of the testicles in the scrotal sac and their palpatory integrity in relation to the prepubertal period.
A second important moment of evaluation is the pubertal development period to verify the correct start of the pubertal process and its completion with the achievement of a typical adult testicular volume. In this age group it is also important to meet with the andrologist for education on the testicular self-examination, an easy to perform, completely painless procedure that allows the early identification of any irregularities of the scrotal organs, including testicular lumps.
Moreover, the interview with the andrologist can be useful to answer the questions of the teenager who often does not know whom to ask about genitals and sexuality and who often turns to his peers or to the web, perhaps collecting inaccurate and misleading information. The andrologist will also teach/recommend any virtuous behaviour he or she should adopt in their approach to sexual life to avoid contracting sexually transmitted diseases potentially harmful to the genital health and future fertility.
Andrological evaluation is certainly also useful in adulthood and old age for the assessment of risks related to these specific ages or in relation to fertility in the young adult male. The andrologist can, once again, recommend correct behaviour to promote/preserve male health and counteract risk factors (smoking, obesity, abuse of anabolic substances, drug abuse, excessive alcohol consumption, and so on).
WHAT PATHOLOGIES AND PROBLEMS DOES THE ANDROLOGIST DIAGNOSE?
As mentioned above, the andrologist deals with male health in its complexity and comprehensiveness. In particular, the andrologist will diagnose, treat and monitor the following male health conditions over time:
- alterations in genital and/or pubertal development;
- shortness of the frenulum;
- erectile dysfunction;
- sexual desire disorders;
- ejaculation disorders (early or late);
- preputial phimosis/paraphimosis;
- "plastic 'penile induratio' or La Peyronie's disease;
- infections of the male genital organs;
- male infertility;
- prostatic hypertrophy;
- testicular infections/inflammations;
- infection/inflammation of the epididymis;
- micropenis;
- curved penis;
- prostatitis;
- testicular tumours;
- varicocele.
HOW DOES THE ANDROLOGICAL EXAMINATION TAKE PLACE?
The andrological examination is carried out according to the normal procedures of a specialist examination.
The first part of the examination, or anamnesis, consists of an interview with the patient in order to find out the reason for the visit and to acquire valuable data on his or her previous history, with particular attention to concomitant pathologies, his family history, his lifestyle habits, any current therapies, and his sexual health.
This is followed by the physical examination, which consists of the classic medical examination in which the general info is assessed, including weight, height, waist circumference, any malformations and also the degree of virilisation, with reference to specific tables.
The andrologist will then focus on an objective examination of the genitals assessing the size, shape and development of the penis, testicles, epididymis and vas deferens. In some cases, according to the andrologist's judgement and more frequently as the patient gets older, the prostate gland may also need to be evaluated by digital rectal examination. This manoeuvre, which lasts only a few seconds, does not cause pain but only a slight sensation of discomfort which is easily tolerated.
The examination then continues with a review of any blood or instrumental tests brought to the patient's attention. If the patient has not undergone any in-depth diagnostic tests, or if the andrologist considers it useful to request specific diagnostic tests or additional investigations to those already performed, he will prescribe them.
The andrologist may also request, as part of a multidisciplinary assessment, the evaluation of other specialists (e.g., dietician, cardiologist, geneticist, urologist, endocrinologist, diabetologist, paediatrician, psychosexologist, surgeon, and so on).
The examination will end with the report by the specialist and any therapeutic prescriptions that are explained to the patient.
REPRODUCTIVE AND PUBERTAL DEVELOPMENT DISORDERS AT AUXOLOGICO
The Auxologico Reproductive and Pubertal Development Disorders Centre has a highly specialised team that can accommodate and satisfy all diagnostic and therapeutic requests relating to pathologies of pubertal development, sexual health and reproduction in both males and females.
UROLOGY AND ANDROLOGY AT AUXOLOGICO
The clinical and surgical activities of Urology and Andrology at Auxologico aim to offer the best diagnostic and therapeutic standards of urological and andrological diseases with the creation of programmes dedicated to individual and specific clinical conditions and patient pathologies.
Outpatient activities are carried out at all Auxologico sites, where all the diagnostic imaging equipment (traditional radiology, magnetic resonance imaging, CT scans and ultrasound scans) needed for the correct diagnostic assessment is also available.
And there is also, unique for Italy, a Urogenetics Service dedicated to the prevention of prostate cancer in individuals with a family history of this disease.
Finally, innovative diagnostic tests are performed, such as RM fusion prostate biopsy and the examination of circulating tumour cells in the blood.
The Uro technologies Centre also carries out surgery using advanced, minimally invasive technologies and procedures, which have unquestionable advantages such as reducing invasiveness and pain, shortening convalescence times, and guaranteeing superior results to traditional surgery.
Surgery is carried out at the Capitanio Hospital, in the centre of Milan, with an attentive assistance of patients in the pre- and post-operative phases and dedicated rehabilitation programmes.
