Male infertility and sexual dysfunction
Men’s health specialists in Duke’s nationally ranked urology program use a wide range of therapies to treat the medical and psychological causes of erectile dysfunction and infertility. We understand the impact sexual health has on your quality of life and help you find a solution that allows you to regain sexual function, a sense of well being, and peace of mind.
Expert care for male sexual problems
Erectile dysfunction is one of the most common sexual problems in men. Approximately 50 percent of men over age 50 have erectile dysfunction (ED), which may include impotence, decreased libido, low testosterone, and Peyronie’s Disease, which is a build-up of scar tissue in the penis that leads to curvature. Our men’s health specialists see a high volume of patients, and can choose from a wide range of treatment options to meet your needs. We work with you to determine which is best for you. Our goal is to provide you with the least invasive yet most effective treatment that reliably delivers a firm and solid erection that is adequate to have penetrating intercourse of adequate duration to satisfy both you and your partner.
Choose Duke for the treatment of sexual dysfunction because we offer:
- Comprehensive care. We offer a variety of resources to effectively treat the cause of your sexual dysfunction. We offer support as you manage the physical and psychological effects of this condition.
- Seamless referrals. If your sexual dysfunction or infertility is the result of an underlying health problem, you have easy access to our entire network of highly trained specialists including cardiology, sleep medicine, neurology and endocrinology.
- Skilled surgeons. Duke surgeons are ranked in the top one percent nationally for the number of penile implant procedures performed. Our experience treating high volumes of patients lets us take on more complicated patients, including people who require revision surgeries or who have complex anatomic irregularities.
- Infertility evaluation and treatment. Evaluating and correcting any contributing male factor simultaneously with the female evaluation can expedite the process of a successful pregnancy. With today's advancing technology, we are able to identify many causes of infertility that have previously been unexplained. We work with the Duke Fertility Center to offer all forms of infertility testing and assisted reproductive therapy.
- Access to novel treatments sooner. You may be eligible to participate in clinical trials that test new devices and treatments before they become widely available.
- Early support for cancer survivors. Our cancer survivorship program encourages a proactive approach to managing the sexual side effects of cancer treatment, and educates you about available treatment options before treatment begins.
- No-scapel vasctectomy. If you are interested in permanent male fertility control, our specially trained Duke Surgeons can perform the no-scalpel vasectomy. The procedures decreases pain and allows patients a quicker return to their normal activities.
MALE INFERTILITY AND SEXUAL DYSFUNCTION
Choosing the right treatment is based on a careful evaluation of your symptoms and medical condition. Various treatments are available to treat erectile dysfunction, low testosterone, infertility, and Peyonie's Disease. Options include:
If you do not have an underlying health problem or physical abnormality, your doctor may suggest an exercise regimen, dietary changes and relaxation techniques that can increase your interest or sexual desire. Smoking cessation is encouraged and current medications are evaluated to look for pharmacological causes of ED.
An option for all patients with sexual dysfunction and may be recommended as a first line of treatment for people suffering from depression or other mental illness.
May be prescribed to increase blood flow to the penis. Drugs may itaken orally, injected into the penis or administered via urethral suppository. Medications may also be prescribed to slow the progression of Peyronie's disease, improve erections, and decrease pain.
For men with low testosterone or low “T”, we offer a variety of options for testosterone supplementation, including topical gels, creams, injection therapy, patches and the newest delivery method, testosterone implants, which have been shown to decrease the risk of secondary hormone exposure for spouses and children.
Corrects extreme curvature by suturing or stitching one side of the penis in men with severe Peyronie’s Disease and erectile dysfunction.
A technique used in special circumstances to treat severe penile curvature. The penis is straightened by excising the plaque and placing a graft material over the defect. Occasionally, grafting may be combined with a penile implant.
If medications are not effective, mechanical devices may be used. The vacuum erection device or penis pump is a hollow tube with a hand- or battery-powered pump that is used to encourage blood flow to the penis in an effort to promote erection.
A safe, reliable and effective treatment for erectile dysfunction (ED) and Peyronie’s Disease. An inflatable prosthetic device inserted directly into the penis to provide an erection suitable for intercourse. This minimally invasive procedure is peformed through small incisions which minimizes blood loss and recovery time. We use a minimally invasive technique through a small incision which allows quicker return to normal activity.
Retrieves sperm from the reproductive tract. May be an alternative to vasectomy reversal.
Permanent male fertility control. The No-Scalpel vasectomy is performed with local anesthesia. It requires one single puncture to reach the vas, which is the tube that leads from the testicle. Cutting the vas stops sperm from leaving the testicle.
Your physician may recommend injectable medications into the Peyronie’s scar or traction devices to permit straightening without need for invasive surgery. Traction devices apply upward tension on the penis to stretch it and, over time, reduce curvature caused by Peyronie’s Disease.
MALE INFERTILITY AND SEXUAL DYSFUNCTION
We evaluate your medical history, listen carefully to your concerns and perform a comprehensive physical exam to determine whether your sexual dysfunction may be the result of an existing medical condition like high blood pressure or diabetes, lifestyle choices such as excessive alcohol consumption, an anatomic abnormality such as a varicocele, or an underlying genetic cause. Other tests may include:
- Erectile dysfunction tests may include hormonal evaluation, PSA, and possible cardiac profile testing to evaluate underlying health problems like diabetes, cancer, or heart disease.
- Genetic testing may be recommended to identify the presence of certain conditions that increase the risk of male factor infertility and erectile dysfunction.
Determines the presence and quality of sperm in the semen.
May be recommended to evaluate and view blood flow in your penile arteries. This non-invasive test needs to be performed with a flaccid and erect penis, which is accomplished using a tiny diabetic needle to inject a medication into the penis to cause erection.