Article Figures & Data
Figures
- Figure 1.
Discussion outline for male reproduction life plan. FSH, follicle stimulating hormone; HCG, human chorionic gonadotropin; TSH, thyroid stimulating hormone.
Tables
Cryptorchidism, testicular torsion, and trauma6 Postpubertal mumps orchitis7 Congenital adrenal hyperplasia Obesity8 Diabetes and poor glycemic control9 Erectile dysfunction10,11 Multiple sclerosis and spinal cord injury12 Hyper or hypothyroidism13 Varicocele14 Prostatitis, epididymitis, sexually transmitted diseases15 Malignancies (Hodgkin16 and testicular cancer17) and any endocrine or metabolic effects of cancer18 Inguinal hernia repairs 19 Scrotal or pelvic surgery Retroperitoneal surgery in the setting of testicular cancer 20 Incision of the bladder neck and transurethral resection of the prostate Medication Effect Exogenous testosterone Decreased spermatogenesis Androgen supplements Impaired HPG axis 5-α reductase inhibition ED, impaired sperm production22 α-blockers Retrograde ejaculation Cimetidine, spirinolactone, and ketoconazole Direct inhibition of androgen production Erythromycin, neomycin, tetracycline, nitrofurantoin, and gentamycin Direct impairment of sperm production Selective serotonin receptor inhibitors, monoamine oxidase inhibitors, lithium, and phenothiazines Decreased libido, ED, and alteration of the HPG axis23 Chemotherapeutic agents Direct impairment of spermatogensis Marijuana,24 cocaine,25 alcohol,26 and tobacco27 May impair the HPG axis, spermatogenesis, and erectile function ED, erectile dysfunction; HPG, hypothalamic-pituitary-gonadal.
Examination Possible Condition General Tall stature Kleinfleter syndrome Long arms Kleinfelter syndrome Absence of body hair Adrenal disease Hyperpigmentation Adrenal disease Obesity Impaired testosterone and high estrogen HEENT Bitemporal hemianopsia Pituitary adenoma Goiter Thyroid disease Anosmia Kallman syndrome Chest Gynecomastia Kleinfelter syndrome or HPG axis defect Buffalo hump Adrenal disease Respiratory rhales and crackles Cystic fibrosis or ciliac disease Abdomen Surgical scars in the pelvis Possible nerve damage or vasal damage Inguinal scars Vasal obstruction Striae Adrenal disease Truncal obesity Adrenal disease Hepatomegaly Liver disease Genitals Penile lesions Possible STD, which impacts fertility Inguinal adenopathy Possible infection or malignancy Impalpable vas deferens Possible CBAVD or cystic fibrosis Vas deferens nodularity Possible vasal obstruction Varicocele Impairs fertility Scrotal scars Possible testicular or vasal injury Epididymitis, prostatitis Active infection can impair fertility CBAVD, congenital absence of the vas deferens; HEENT, head, ears, eyes, nose, and throat; HPG, hypothalamic-pituitary-gonadal; STD, sexually transmitted disease.
