Andrology (Penile Implant, Varicocele, Erectile Dysfunction)

This is the commonest mistake. A newly developed and progressively worsening erection problem can be the first sign of cardiovascular disease or diabetes, because the vessels in the penis are narrower than those supplying the heart and can show narrowing first. Assessment should therefore come before a prescription. That assessment is not there to delay you; it is there so that something more important is not missed.

Sudden severe testicular pain, particularly in a younger man, may be testicular torsion and requires intervention within hours. An erection lasting more than four hours that will not subside and is painful is also an emergency, and waiting can cause permanent damage. A painless firm lump in a testicle should also be assessed without delay.

Yes, and that is your right rather than a favour. You may ask who has access to your file, where records are kept, what name accommodation is booked under and what appears on the invoice. If you are asked for photographs or a testimonial you may refuse, and that will not affect your treatment.

Both partners. This is a couple's issue, and stopping the investigation as soon as something is found in the man is a common error. Ovulation, tubal status and female age bear directly on the outcome, and the expected benefit of treating the man cannot be judged properly without that information.

One test is not enough. Semen results are affected by febrile illness, significant stress, some medications and the conditions in which the sample was produced. The test is usually repeated after an interval. Do not make decisions on a single abnormal result.

No. In appropriately selected men it can improve semen parameters, but not every man improves, and not every couple in whom it improves goes on to conceive. Be cautious of anyone who promises a definite outcome.

Yes, and it should be treated as one. It should not be proposed before reversible options — tablets, injections, a vacuum device — have been tried. Natural erections do not return after an implant. An approach that proposes an implant without first asking what you have tried is not assessing you.

Here, managing expectations matters more than the technique. The claims you find online are frequently unrealistic. In some men the issue is not the measurement but the perception of it, and in that case surgery does not produce satisfaction. This is discussed openly at assessment.

Testosterone should not be given without a demonstrated deficiency. There is also an important point: testosterone treatment can suppress sperm production. If you plan to father children, this needs separate consideration — otherwise you may worsen a different problem while treating one.

No. Your medical information is not shared with anyone, including those closest to you, without your consent. You decide who is informed. If you travel with a companion, you also decide which parts of the consultation they attend. Saying so at the start is easier than explaining it at an awkward moment.

Any semen analyses, hormone results, blood sugar and cholesterol values, a complete list of your medication, your other medical conditions and records of any previous procedures. With these, which step you are at can be assessed before you travel.