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URORESIDENT.COM
  • Home
  • Daily Tasks
    • Dictations >
      • Circumcision
      • Cystoscopy >
        • Cysto-OR
        • Cysto, +/- RPG +/- stent >
          • Cysto w/ b/l RPG
          • Cysto, L RPG
          • Cysto, R RPG
          • Cysto, L stent w/o RPG
          • Cysto, L RPG, L Stent
          • Cysto, R Stent w/o RPG
          • Cysto, R RPG, R Stent
        • Cysto, bladder biopsy
        • Cysto and TRUS Prostate Biopsy (OR)
        • Cysto Botox (F)
        • Individual parts of cystos
      • Prostate Biopsy >
        • Cysto and TRUS Prostate Biopsy (OR)
        • TRUS Prostate Biopsy (OR)
        • TRUS Prostate Biopsy (office)
        • MRI Fusion TRUS Prostate Biopsy
      • Robot Left Radical Nephrectomy
      • TURBT (M)
      • Ureteroscopy >
        • L U-scope (flex), RPG, (F)
        • R U-scope (flex), RPG, (M)
        • L U-scope,semirigid laser, flex, RPG, stent removal, (F)
      • ESWL >
        • Left Proximal ESWL
        • Left Renal ESWL
        • Right Proximal ESWL
        • Right Renal ESWL
      • TURP
      • Vasectomy
    • Plans >
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      • NMIBC
      • Peyronie's Disease
      • Prostate Cancer
    • Medications >
      • Antibiotics >
        • Bactrim
        • Cephalosporins >
          • Keflex
        • Ciprofloxacin
        • Macrobid
        • Gentamicin
      • Medications and Dialysis
      • Anticoagulation and Antiplatelets
      • 5α-Reductase Inhibitors
      • PDE5i
      • Prostate Cancer Drugs >
        • Abiraterone
        • Androgen Receptor Blockers
        • Pembrolizumab
      • Anticholinergics & β-3 Agonists
      • Estrace
    • Patient Discussions >
      • Prostate Cancer
      • PSA Screening
      • Tobacco Cessation
    • Radiation Exposure
    • Medicolegal
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  • Subjects
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      • Neurogenic Bladder/Spinal Cord Injury
      • CKD/ESRD
      • Erectile Dysfunction >
        • IPP
      • Female Urology
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      • Overactive Bladder
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        • Studies
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Fertility

 ​FSH stimulates Sertoli cells to make sperm.  Spermatogenesis takes 74 days to complete, they are made in seminiferous tubules where testosterone is required in the lumen.   The little swimmers mature in the epididymis and are stored in the cauda.  A fever can disrupt spermatogenesis for 3 months.
Risk factors for infertility in females are:​​
  • age>35
  • PCOS
  • PID
  • h/o tubal ligation
  • endometriosis
​
Picture
 Risk factors for infertility in males are:
  • varicocele
  • h/o STD's
  • ​trauma to testicles
  • ejaculation disorders
  • endocrine disorders​
    1. thyroid (hypo= ^  in prolactin
    2. hypo/hypergonadotropic
  • prostatitis
  • ​radiation
  • ​h/o cryptoorchidism, testicular torsion
  • DM
  • h/o surgery
  • ​fever
  • mumps (after puberty)
  • liver disease
  • drugs​​ - chemotherapy, cimetidine, colchicine, sulfasalazine, allopurinol, spironolactone, TCA's, dilantin
​CF, kartagener's, Young syndrome, myotonic dystrophy, CBAVD, radiation, pesticides


​
Semen analysis and sperm tests
  • fructose - made by seminal vesicles, if absent = obstruction, agenesis ect. 
  • leukocytes - if  >1million=culture semen, urine, prostate secretions, swab urethra
  • vitality - trypan blue, osmotic, eosin

​
  • Clomiphene citrate blocks estradiol negative feedback at the level of the hypothalamus and pituitary gland 



POST VASECTOMY
Post vasectomy, sperm retrieval with IVF/ICSI is preferred to surgical reconstruction if (1) advanced female age; (2) female factors requiring IVF are present; (3) the chance for success with sperm retrieval/ICSI exceeds the chance for success with surgical treatment, or (4) sperm retrieval/ICSI is preferred by the couple for financial reasons."
Average time to conception after vasectomy reversal is 12mo

​

QUIZ

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  • Home
  • Daily Tasks
    • Dictations >
      • Circumcision
      • Cystoscopy >
        • Cysto-OR
        • Cysto, +/- RPG +/- stent >
          • Cysto w/ b/l RPG
          • Cysto, L RPG
          • Cysto, R RPG
          • Cysto, L stent w/o RPG
          • Cysto, L RPG, L Stent
          • Cysto, R Stent w/o RPG
          • Cysto, R RPG, R Stent
        • Cysto, bladder biopsy
        • Cysto and TRUS Prostate Biopsy (OR)
        • Cysto Botox (F)
        • Individual parts of cystos
      • Prostate Biopsy >
        • Cysto and TRUS Prostate Biopsy (OR)
        • TRUS Prostate Biopsy (OR)
        • TRUS Prostate Biopsy (office)
        • MRI Fusion TRUS Prostate Biopsy
      • Robot Left Radical Nephrectomy
      • TURBT (M)
      • Ureteroscopy >
        • L U-scope (flex), RPG, (F)
        • R U-scope (flex), RPG, (M)
        • L U-scope,semirigid laser, flex, RPG, stent removal, (F)
      • ESWL >
        • Left Proximal ESWL
        • Left Renal ESWL
        • Right Proximal ESWL
        • Right Renal ESWL
      • TURP
      • Vasectomy
    • Plans >
      • Erectile Dysfunction
      • NMIBC
      • Peyronie's Disease
      • Prostate Cancer
    • Medications >
      • Antibiotics >
        • Bactrim
        • Cephalosporins >
          • Keflex
        • Ciprofloxacin
        • Macrobid
        • Gentamicin
      • Medications and Dialysis
      • Anticoagulation and Antiplatelets
      • 5α-Reductase Inhibitors
      • PDE5i
      • Prostate Cancer Drugs >
        • Abiraterone
        • Androgen Receptor Blockers
        • Pembrolizumab
      • Anticholinergics & β-3 Agonists
      • Estrace
    • Patient Discussions >
      • Prostate Cancer
      • PSA Screening
      • Tobacco Cessation
    • Radiation Exposure
    • Medicolegal
    • Urology Jokes & Quotes
  • Subjects
    • Various Pathology >
      • Neurogenic Bladder/Spinal Cord Injury
      • CKD/ESRD
      • Erectile Dysfunction >
        • IPP
      • Female Urology
      • Hypogonadism
      • Imaging
      • Nocturia
      • Overactive Bladder
      • Trauma
      • Urine Retention
    • Urologic Malignancy >
      • Prostate Cancer >
        • Choosing Therapy
        • Imaging
        • Genomic Testing
        • Locally Advanced and BCR
        • Metastatic Prostate Cancer
        • ADT and Hormonal Therapy
        • Surgery
        • Radiation
        • Adjuvant & Salvage Therapy
        • Prostate Biopsy
        • Studies >
          • Landmark Studies
          • Research
      • Bladder Cancer >
        • MIBC
        • NMIBC >
          • Intravesical Therapy
        • Urine Markers
        • Chemotherapy
        • Metastatic Bladder Cancer
        • Immunotherapy
        • Cystectomy & PLND
        • Variant Histology
        • Trimodal Therapy
        • Post Cystectomy Care (ERAS)
        • Studies
      • Renal Cancer >
        • Work-up
        • Treatment
        • Surgery
        • Renal Cysts
        • Locally Advanced & Metastatic
        • RCC Surveillance
        • Calculators & Nomograms
        • Landmark Studies
        • Other Studies
      • Upper Tract UCC >
        • Laser Treatment >
          • Studies
        • UTUC Chemotherapy
        • Surgery
        • Landmark Studies
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      • TURP
      • Urolift
      • Surgical Therapies
      • IPSS
    • Fertility >
      • Imaging and Lab Tests
      • Work-up
      • Surgery
      • Infertility in Spinal Cord Injury
      • Study guide
      • Interventions
      • Studies
    • Infection >
      • Fournier's Gangrene
      • Orchitis
      • UTI
      • Recurrent UTI
    • Incontinence >
      • Artificial Urethral Sphincter
      • Neuromodulation
      • Slings
      • Urethral Bulking
    • Pediatric Urology >
      • Pediatric Infections
      • Pediatric Surgery
      • Pediatric Tumors
      • Pediatric Trauma
    • Reconstruction >
      • Ureteral Stricture
      • Urethral Stricture
      • Studies
    • Other Random Studies >
      • Blood Transfusions
      • Fistula
      • Other studies/notes
  • Procedures
    • Cystectomy
    • Incisions
    • Endoscopic >
      • Cystoscopy
      • Ureteroscopy
      • Ureteral Stenting
    • Female Surgery >
      • Interstim & PTNS
      • Midurethral Sling
      • Sacrocolpopexy
    • Nephrectomy
    • PCNL
    • Prostate Biopsy
    • Radical Prostatectomy
    • Suprapubic Tube (SPT)
    • Urethral Catheters
    • Urodynamics
    • Varicocelectomy
  • Videos
  • Journal Club
    • Top 1000 Urology Journal Articles
    • Top Urology Journal Articles by Decade
    • Landmark Authors
    • Bladder Cancer Journal Club >
      • Landmark Papers
    • Reconstructive Journal Club >
      • Landmark Papers
    • Upper Tract Urothelial Carcinoma