Urology, Andrology

The increasing importance of the male factor in couples’ infertility has made male examination inevitable at the beginning of a diagnosis. It is necessary to make an appointment (by telephone, e-mail or personally) for an examination of ejaculate or to make an appointment for a subsequent ambulatory consultation and examination.

Diagnostics

Laboratory – sperm collection and examination

Prior to planned sperm collection it is necessary to follow the instructions :

• 2 – 4 days of sexual abstinence
• the procedure is described in detail in the manual placed in the collection room
• during collection, video-stimulation is available
• we respect patients’ privacy and natural shyness.
• A properly trained team is available to assist reaching maximum success of treatment.

Ambulance - examination

• Maedical history, physical, ultrasound and hormonal examination
• evaluation of ejaculate examination
• examination and standardization of sperm donors, regular verification of donors

Treatment

Ambulance

Treatment of inflammatory and hormonal causes of male factor infertility. If any preparation is necessary, the patient is instructed during the preceding visit.

Surgical - MESA

(microsurgical epididymal sperm aspiration), TESE (testicular sperm extraction)

Examination preparation is subject to verbal and written instructions that are communicated to patients during diagnosis at an ambulatory examination or during treatment. Surgery takes place, with exceptions, under the following circumstances:ambulatory – the patient is released approximately 3 hours after the surgery to home aftercare, a check-up in the Pronatal Sanatorium the following day is necessary, the surgeon is available on telephone 24 hours. The patient receives the surgeon´s telephone number before leaving the clinic.

General anaesthesia Necessary documentation prior to the surgery:

• Genetic examination
• Pre-operation examination (not older than 30 days)
• Accepted and signed informed consent
• Accepted and signed instructions prior to anaesthesia
• Reservation of overnight stay (in Prague for out-of-town patients), SP reception can assist in finding accommodation in SP vicinity.

MUDr.Vladimir Sobotka is responsible for the urologic ambulance of the Pronatal Sanatorium, which offers full diagnosis and therapy of male factor infertility. Urologic and andrologic problems that are not related to fertility are resolved in co-operation with the andrologic ambulance of the Teaching Hospital at Královské Vinohrady.

The urologic ambulance of the Pronatal Sanatorium closely collaborates with a paediatric endocrinologist at the Motol Teaching Hospital and Endocrinology institution on efficient cooperation between both workplaces in the field of paraplegic patients, on treatment of neurologically disabled males and on resolving procedures, which enable reproduction of patients suffering from severe hormonal disorders. The SP team’s objective is also successful cooperation with an oncologist throughout freezing of male gametes prior to treatment.