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Complementary Exams

It is not just the spermogram and/or sperm function tests that should be requested in the investigation of male infertility or other issues related to the reproductive and sexual health of men. Periodic tests to screen for infections are extremely important for men's health.

In some cases, sexually transmitted infections (STIs) can be asymptomatic, that is, they do not show signs and symptoms in the infected individual, preventing him from seeking medical help and causing the disease to settle and progress to adjacent organs, such as the prostate. , epididymis and testes. Chronic infection is worrying, as it is often underdiagnosed and undertreated and can lead to male infertility. In cases of chronic epididymitis, prostatitis or orchitis, sperm are in an environment with high levels of free radicals and suffer from oxidative stress, with consequent damage to the plasma membrane and sperm DNA, important pathophysiological mechanisms for reducing the fertile potential.
Screening for STIs and other non-sexually transmitted infections is simple, inexpensive and should be performed annually or whenever the man notices something wrong.

See below the tests performed by Androscience that help in the diagnosis and treatment of reproductive tract infections.

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Our body is composed of thousands of cells that have constant metabolic activity that generate energy in order to maintain our vital functions preserved. Due to this metabolism, some byproducts toxic to cells are generated and need to be eliminated from the body. The organ responsible for eliminating such impurities is the kidney, which is in charge of continuously filtering the blood, in order to remove all foreign, toxic or excess substances. These substances are eliminated in the urine – biological fluid formed by the kidneys and excreted through the urinary tract, consisting mainly of water and metabolites such as urea, chlorine, sodium, among others. Urine is produced all the time and can serve as an important marker of renal and systemic health.

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Urine tests may indicate the presence of diseases in the renal and urinary system, such as infections, kidney failure and also systemic and metabolic diseases, such as diabetes. It is important that, along with urine tests, the physician requests additional tests, such as hormonal dosages and other substances (creatinine, urea, among others) that assess renal function so that it is possible to assess the patient jointly and correlating several parameters.

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There are two commonly ordered urine tests. Type I Urine and Uroculture. Type I Urine test assesses the presence and/or absence of various substances, such as glucose, ketone bodies, bilirubin, nitrite, proteins and also provides the pH value. In addition, it is possible to quantitatively assess the number of leukocytes, red blood cells, crystals, cylinders, among others. This test is usually performed with the first urine in the morning and the patient must undergo antisepsis of the hands and the intimate region so that the sample to be collected is not contaminated. Uroculture, on the other hand, is carried out with the aim of identifying possible pathogenic bacteria that can colonize the genitourinary tract and cause urinary tract infections (UTIs). As previously mentioned, at the time of collection, the patient must undergo rigorous hand and intimate antisepsis. The first stream of urine should be discarded, so that bacteria from the microbiota are not confused with bacteria causing infection. In cases of UTIs, this test is able to tell exactly which is the causative agent. It is important that the doctor also requests the performance of the Antibiotic Sensitivity Test (TSA) - it is he who will determine which antibiotic is most effective against the bacteria found in Uroculture.

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The pathogens that cause STIs have different tropism (preferring certain cells in the body) and therefore infect different regions of the body.

The urethra, the structure responsible (in men) for carrying urine and semen to the external environment, is frequently attacked by these agents, as it has a structure named fossa navicular that favors the proliferation of bacteria due to the characteristics of its cells.

Inflammation caused in the urethra is called urethritis and may or may not be accompanied by a discharge. The etiological agents most commonly found to cause urethritis are:

  • Enterobacteria (mainly in anal sex without using condoms);

  • Enterococcus spp;

  • Neisseria gonorrhea;

  • Chlamydia trachomatis;

  • Mycoplasma hominis;

  • Ureaplasma urealyticum;

  • Candida spp.

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When the urethra is inflamed and infected, it is called urethritis. Urethritis may or may not be accompanied by a discharge of secretion with or without a foul odor, a burning sensation, a desire to urinate frequently, among others. The microorganisms most commonly associated with causing urethritis are: 

  • Enterobacteria (mainly in the practice of anal sex without the use of condoms);

  • Enterococcusspp;

  • Neisseria gonorrheae;

  • Chlamydia trachomatis;

  • Mycoplasma hominis;

  • Ureaplasma urealyticum;   

  • candidatespp.

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Diagnosis is performed by collecting a sample of urethral secretion, performed by the doctor or nurse. The collected sample is sent to the laboratory, which performs conventional microbiological and molecular biology procedures to identify possible microbial pathogens causing urethritis and, consequently, epididymitis, prostatitis and orchitis. It is important that the doctor also order the Antibiotic Sensitivity Test (TSA) to determine the best antibiotic against the microorganism.

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There are microorganisms that normally inhabit the male urethra and even serve as protection against other agents. The microbiological analysis of the urethral secretion will tell if the bacteria present are from the microbiota or if they are pathogenic and what is the best medicine to fight it. Only the doctor will know how to interpret the result and determine the best course of action to be followed.

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