Respected friends: Male common medical problems because they are related to personal privacy, and male semen and sexual function examination and treatment costs are high and not reimbursed by medical insurance, the treatment course is long, often need to be combined with physical therapy such as vacuum negative pressure, extracorporeal shock wave treatment, which requires long-term regular follow-up, and even the need for surgical treatment. Therefore, in order to facilitate the consultation and save your time, we hope to read the following points before the consultation: 1, male infertility or pre-fertility examination, it is recommended that abstinence (no intercourse, masturbation, dream emission and other seminal emission phenomenon occurs) 4 to 5 days (often patients mistakenly believe that the longer the better, although abstinence 2 to 7 days can also be examined, but to ensure the comparability of each result, we require more stringent) to check, while a week No colds, fever, late nights, drunkenness, etc. within a week. If the semen quality is not good, we need to arrange another re-examination within 2 weeks. 2. Routine semen analysis (CASA) can only provide about 70% to 90% of the information related to fertility. Even if the CASA result is completely normal, it does not mean that the fertility is completely normal, and for those who have been infertile for a long time but have normal CASA results, further examination of anti-sperm antibodies (ASAb), sperm morphology (malformation rate), sperm hypotonic swelling test (HOS), sperm acrosome enzyme For abnormal CASA results, in addition to further examination of sperm and seminal plasma, scrotal + transrectal ultrasound, sex hormone test, peripheral blood chromosome karyotype, and Y chromosome microdeletion test are recommended if necessary. If necessary, scrotal + transrectal ultrasound, sex hormone test, peripheral blood karyotype, Y chromosome microdeletion test, etc. In case of recurrent miscarriage (more than 2 spontaneous miscarriages/abortions), the male partner is recommended to check ABO+Rh blood group, G6PD+digest, routine semen analysis (CASA), sperm morphological examination (abnormality rate), sperm DNA fragmentation rate (SDFI), peripheral blood chromosome karyotype, and infectious disease examination. 3. Please understand that different tests will have different time limits (laboratory varies from hospital to hospital), and the time required to issue the test report varies greatly (90 minutes to 15 working days). Our male laboratory requires that: semen routine analysis (CASA) and anti-sperm antibody test can be performed before 11:00 a.m. Monday to Friday, before 4:30 p.m. Monday to Friday, and before 10:30 a.m. on Saturdays at the male laboratory window on the third floor of the outpatient clinic, and all semen can be collected directly by masturbation (no condom can be passed, no semen can be missed), and the report will be issued 90 minutes after the test is sent. Other semen and seminal plasma examinations are recommended to be performed together with CASA from Monday to Friday morning, with reports issued the next day for sperm morphology, sperm acrosomal enzymes and seminal plasma zinc; about 5 working days for seminal plasma neutral a-glucosidase, seminal plasma fructose and seminal leukocyte peroxidase; about 15 working days for sperm DNA fragmentation rate; semen-cervical mucus interaction ( post-coital test) needs to be performed after synchronous consultation with the female partner. 4. Make sure to provide true information and medical history. Do not talk about the diagnosis, but inform the consulting physician of your distress, how long it lasts, what accompanying conditions, what treatment you have undergone, what effect you have had, and provide the corresponding examination report. It is best for both men and women to come at the same time, with separate consultations if necessary. The vast majority of male surgeries can be done under local anesthesia without hospitalization, but preoperative examination and preparation are as essential as inpatient surgery. At present, the local anesthesia procedures routinely performed in our department include: circumcision, testicular biopsy, vasectomy, penile orthopedic surgery, deep dorsal vein encapsulation, testicular sheath reversal, microscopic spermatic vein ligation, and microscopic vasectomy/vasectomy reconstruction. Depending on the type of surgery and intraoperative conditions, it will be decided whether the postoperative period requires overnight observation in the outpatient holding area. 5. Patients with azoospermia should be examined at least three times (all centrifugal sediment smears did not find sperm), preferably at different hospitals to confirm the diagnosis. It should be differentiated from orgasmic disorder, non-ejaculation, retrograde ejaculation, dry ejaculation, etc. Blood needs to be drawn for sex hormones, peripheral blood karyotype, Y chromosome microdeletion; while semen should be examined for spermatogenic cell staining, seminal plasma fructose, seminal plasma neutral a-glycosidase; ultrasound scrotum + transrectal to understand testes, epididymis, vas deferens, seminiferous veins, ejaculatory ducts, prostate and seminal vesicles. Initially determine whether it is obstructive azoospermia (OA) or non-obstructive azoospermia (NOA), and if necessary, perform minimally invasive testicular biopsy to understand the exact spermatogenic capacity of the testes. 6, male sexual function assessment or disability forensic appraisal, need to conduct nocturnal penile erectometry (NPT) examination to understand the erectile hardness, swelling circumference, duration of the penis under adequate sleep state, so as to determine whether there is organic erectile dysfunction, because nocturnal erectometry (NPT) examination requires 2 to 3 consecutive nights (11:00 pm to 7:00 am the next day) to monitor penile erection under sleep state, need Do not sleep during the day on the day of the NPT examination, and it is best to participate in light to moderate exercise to help the quality of sleep at night and improve the quality of the examination. 7.Penile vascular ultrasound + cavernous vasoactive drug injection test can clarify the classification of vascular erectile dysfunction (arterial or venous), an appointment is required. The basic procedure of the examination is to perform ultrasound + Doppler contrast examination of the penile cavernous vascular system before and after cavernous injection of vascular drugs to understand the hemodynamic changes, especially the results after injection-induced erection. After drug-induced erection of the penile corpus cavernosum, the penis cannot leave the hospital if it does not weaken. Persistent erection (no weakness for more than 4 hours) after going home requires emergency return to the hospital to avoid permanent penile non-erection.