Pediatric And Adolescent Andrology

This book addresses and summarizes the main andrological disorders (genital, reproductive or sexual diseases) that may originate in childhood or adolescence. Since many of the andrological diseases that occur in adulthood originate before the age of 18 and sometimes even during gestation, andrological evaluation is essential during childhood to highlight anomalies in the genital organs. During puberty, evaluation can help to monitor growth and secondary sex characteristics, and to assess e.g. the possible presence of an eunucoid habitus, gynecomastia, testicular hypotrophy or varicocele, a very common pathology in young people. During adolescence, the assessment of risk factors, such as those related to certain lifestyles, is of fundamental importance for primary prevention. Moreover, in late adolescence the focus shifts to preventing sexually transmitted infections, or to dealing with possible discomforts related to the sexual sphere. Finally, ensuring young people’s genital and sexual health also means protecting their fertility. Written by respected experts in the field, this book constitutes an innovative resource, combining updated, reliable and comprehensive information with agile consultation in order to provide a streamlined approach to the care of children and adolescents with such disorders.

The subject matter in this volume was derived from papers presented at the Pediatric Andrology session of the 1st Pan American Congress of Andrology held in Caracas, Venezuela in February 1979, as well as from selected additional manuscripts of interest in this field. Prior to this session, identification of a distinct discipline and specialty devoted to pediatric andrology had not occurred, nor had it been conceptualized. Pediatric andrology encompasses many different areas: disorders of sexual development, structural disease of the genital organs, normal and abnormal puberty, undescended testes, genital tumors, gonadal function and its relationship to growth, virilization, fertility and gender identity all represent areas of specific interest, to name but a few. Andrology itself is a unique field, bringing together clinicians and basic scientists with diverse back grounds. It should be noted that between one-half and three-quarters of the clinicians contributing to this issue conduct basic research as well. It has been this unique blend of basic research and clinical medicine which has done much to unravel many of these problems characteristic of this field.

Andrology is the medical specialty dealing with men,Äôs health and reproductive system, including the genital, hormonal, reproductive, sexual, as well as psychological aspects, from birth to adulthood. Regular andrological checkups are essential both to reveal possible problems and to receive thorough advice and information so as to ensure that sexual and reproductive functions are well preserved. Estimates report that about one in three males suffers from andrological diseases, their rates varying according to the age: 27,Äì30% of pediatric male subjects have reproductive and/or sexual conditions. In adulthood, 40% of men are affected by andrological diseases, in particular infertility and sexual problems. We studied medical literature about infertility, its prevention, and its treatment; our outcomes were to evaluate the role of research to prevent infertility especially in pediatric and adolescent age. The analysis of the data shows that in absolute numbers, the conditions directly associated with infertility are less studied than the treatment with medically assisted procreation. This research is intended as a warning to the countries worldwide: all those involved in the pediatric treatment area should be stimulated to act toward this goal, and each country should bear the responsibility of promoting and financing andrological screening campaigns.

This book combines concise descriptions of the various andrological surgical interventions in the adolescent and adult with detailed analysis of the pre- and postoperative psychosexual counseling of the patient and his family that is appropriate to each procedure. It offers a multidisciplinary approach to the candidate for andrological surgery that reflects the everyday experiences of an andro-sexology team. Each chapter focuses on a particular surgical procedure. Succinct description of the disease and its epidemiology, diagnosis, and treatment is followed by extensive discussion of all aspects of psychosexual relevance and the required counseling. Topics addressed include, for example, the impact of diagnosis, body image issues, fears relating to the surgical procedure and its outcome, the risk of excessive expectations and consequent disillusionment, relationship issues and communication problems, and the role of the sexologist. The analysis and guidance offered in this book will be of particular value to the less experienced andrologist and will assist in achieving postoperative patient satisfaction.

The study of pediatric and adolescent medicine is an essential part of medicine as children react to diseases differently than adults. As new viruses continue to emerge, and as procedures are updated and revised, there is a need for comprehensive resources on the new developments and emerging technologies in this field. As medical technologies and innovative practices spread in recent years, it is vital that medical professionals are knowledgeable on the developments in the pediatric field as well. The Research Anthology on Pediatric and Adolescent Medicine presents the developments, emerging technologies, and challenges in pediatric and adolescent medicine. It also explains adolescent health management and promotion as well as recent discoveries on childhood development. Covering topics such as media consumption, neuro-developmental disorders, and health promotion, this book is a critical resource for pediatricians, nurses, medical professionals, hospital administration, behavioral scientists, therapists, psychiatrists, medical students, researchers, and academicians.

A comprehensive and practice-oriented resource guide to currently available diagnostic and treatment options for male infertility disorders. Topics covered range from basic sperm biology and male reproductive endocrinology, to immunology, specialized sperm testing, and the genetic background to male infertility. The authors emphasize the investigation, diagnostic testing, and management of the infertile male, but also examine such timely issues as gender selection, HIV discordance couples, and posthumous reproduction. Other topics of interest include laboratory accreditation, vasectomy reversal, ethical and legal considerations of donor insemination, optimizing success in a donor insemination program, and strategic therapies for ejaculatory disorders and erectile dysfunction in infertile men.

Dr. Felice has put together clinical reviews articles that cover a broad scope of clinical issues that are common among sexually active adolescent patients. Some issues addressed include: HPV Vaccine Update; Treating Dysmenorrhea/Menorrhagia; New STD Guidelines; Emergency Contraception; Talking to Parents about Teen Sexuality; and Long-acting Reversible Contraception. Most pediatricians feel poorly equipped to address these problems. They are also complicated issues that give the average pediatric clinician pause and often take more time than usually scheduled in a busy practice. By providing practical updated information on these clinical problems, pediatric practitioners can become more comfortable in dealing with these topics. Although many clinicians are not involved with adolescents in the juvenile justice system, Dr. Felice included an article on this so that pediatricians can be more educated and sensitive to the needs of these young people. An article on human trafficking of teens in included with the hope bringing awareness of this issue. Articles in this issue were selected specifically because they directly affect primary pediatric care. For example, an article is included on how to help young people avoid being victims of partner violence rather than an article on sexual abuse and rape because adolescents would be treated in the emergency room and not the pediatrician’s office.

The teen pregnancy and birth rates have decreased in the US in the past 30 years due to factors such as the availability of more hormonal contraceptive options and delayed initiation of sexual intercourse. However, the US still has one of the highest teen pregnancy rates of industrialized countries. Moreover, disparities in teen pregnancy and birthrates still exist due mostly to social determinants of health. This all points to the increased need of pediatric providers to provide comprehensive reproductive health to all adolescents they care for. Part 2 of the Adolescent Health Collection provides many resources to help do this.

Covering basic science as well as clinical andrology, this book includes chapters on biology of reproduction, testicular function, sperm maturation and fertilization, endocrinology of the male, environmental factors, psychology, senescence, contraception; as well as chapters on the diagnosis and therapy of andrological diseases including: infertility, hypogonadism, assisted reproduction: ICSI and TESE, therapy with testosterone, erectile dysfunction.

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