Santiago Brugo Olmedo M.D.
Medical Director
Seremas Medicine for men and women
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Andrology


SPECIALTIES | Basic Steps

Basic steps for the potentially sterile man's exams

Andrology is a medical discipline devoted to the study of men’s fertility and sexuality disorders. In other words, it takes care of male reproductive health.

Doctors started to work in this field of medicine in the ‘50s, and Argentina was one of the pioneer countries, as the first andrologists internationally well-known were born and formed in this country, like Roberto Manzini, M.D.

Sterility, sexual dysfunction and aging male are three of the basic aspects that an andrologist treats.

SEREMAS Andrology department is in charge of the study and treatment of those men’s disorders.

This department interacts directly with the female department, in order to achieve integral and personalized assistance to both members of the couple who consult because of sterility or sexual dysfunction.

Starting with a detailed medical history, complete reports about the patient’s state will be required.

Using the most modern laboratory facilities in the country, in terms of computerized semen analysis, spermatic functional tests, hormonal and immunologic analysis. This all places SEREMAS at the best level of service assistance.

SEREMAS surgical area, in Andrology field, offers the highest andrologic macro and microsurgery technology; including spermatozoa retrieval from the epididymis or from testis in order to perform Assisted Reproduction; varicocele surgery through videolaparoscopy, etc.

Besides, SEREMAS has the necessary technology to collaborate on the cases of ejaculation disorders, for instance spinal cord disabled patients with ejaculatory inability, through electrostimulation, which resulted in the first pregnancies and births in the country.

Availability of ICSI in SEREMAS provides solution to the cases of more severe male sterility.

In SEREMAS we also count on the possibility of treating the cases of sexual dysfunction with advanced diagnostic methodology and with a specially trained Psychology team.

SEREMAS offers these patients all the auxiliary diagnostic methods: hormone measurement, ultrasound with Doppler, study of night penial tumescence and cavernosometry.

Thanks to correct diagnosis and proper treatment, rehabilitation of these patients is possible, with the following achievement of a normal sexual life.

What is premature ejaculation?

Men can suffer from disorders in their sexuality in three main areas:

1. Decrease in desire or libido
2. Penial erection failure or impotence
3. Ejaculation problems

Premature ejaculation is defined as persistent or recurrent ejaculation with minimal previous stimulation, during or soon after penetration and before the person wants it to occur. In a study carried out on a representative sample of the United States population, it was estimated that premature ejaculation affects 29% of men.
The fact of ejaculating too soon implies a problem neither for every man nor for all their partners. Some men simply accept their lack of control and in the same way; many women tolerate their partners’ premature ejaculation and enjoy other aspects of their relationship. Flexible couples adapt to their premature sexual pattern in different ways: the woman learns how to reach her orgasm faster, or she gets it through manual or oral stimulation before or after coitus.

In the case of young men it is habitual that they try to compensate it with reiteration of intercourse. However, in many cases it can lead to severe conflicts in the couples that wish to get their orgasm through coitus. The man may feel guilty, which generates anxiety about his performance, lack of self-confidence in front of their partners and low self-esteem. In some men it may generate rejection to starting new sexual ties and generate conflict in the search of a partner for fear of failure and shame.

As far as the moment of this dysfunction is concerned, it can be primary when it affects the man since the beginning of his sexual activity. There might be here a previous background of fear of failure, avoidance of actions that trigger sexual excitement, and decrease in sexual activity frequency. Secondary premature ejaculation is the one which appears in men who have previously had satisfactory ejaculatory control. It is interesting to know some aspects which make part of the man’s sexual response. There are several physiological steps which integrate the sexual act: erection, semen emission, ejaculation and orgasm. Erection implies neurovascular mechanisms which allow tumescence and corpora cavernosa rigidity. Semen emission is the result of genital glands activity such as the prostate gland and seminal vesicles. Ejaculation is the act through which emitted semen which is accumulated under pressure goes back down the urethra and is released by contraction of specific muscles. This is provoked by tactile stimulation which comes from the genital area and which reaches brain centres from where ejaculatory response is produced, and that is executed through nerves which get to the muscles mentioned before. Finally, orgasm is a pleasant sensation which is produced in the brain because of integration of stimuli coming from the nervous system.

The specialist handles clinical and diagnostic elements to evaluate this dysfunction, whenever it appears alone or related to erectile dysfunction. Currently, the discovery of new medication which allows helping to control progressively the ducts and centers that regulate ejaculation have remarkably improved the treatment of this dysfunction. Specialists coincide in pointing out that pharmacological treatment must be accompanied by sexologic counseling for the couple in order to optimize therapeutic results.

Treating premature ejaculation means improving sexual life quality.

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SEREMASArenales 1954, 1st floor
Buenos Aires City
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