Caring for men’s health and promoting social harmony The name Andrology originates from the combination of the Greek words andros and logy, meaning the science of men. As an emerging discipline, the International Society of Andrology (ISA) was formally established in 1981 and regularly holds large-scale international conferences on andrology. In the 1990s, the male branch of the European Association of Urology was founded in Germany and could train as a qualified male surgeon in 2-3 years. The development of male medicine in China also dates back to the 1980s, but the development of the last 20 years has made significant progress in male medicine. Men, as the pillar of the family and the backbone of social development, are under pressure from all sides of the family and society. With this comes an increasing incidence of male diseases, and the deterioration of psychological states and diseases often alternate. In recent years, as social forces continue to inject themselves into the field of male science, the original lack of unity has added a bit of noise to the situation. However, once a male illness occurs, men’s unique self-esteem and strength often prevent them from being seen and treated in a timely manner, or seeking more private help. This is often not the case, and the treatment is not as effective as it should be, given the large amount of medical costs. As a fledgling specialty, the number of outpatient visits to our male department has increased year by year in recent years. At present, the annual outpatient volume has already reached more than 10,000 people. However, how to maintain a standardized medical process in the chaotic field of male science, how to provide convenient medical services for the majority of men from a professional point of view has been the direction of male department efforts and maintain: a. Clinic hours I have male department outpatient clinics on Mondays, Tuesdays, Wednesdays and Fridays throughout the day to provide convenient access to the majority of male friends, while for each patient to do effective communication. A wide range of outpatient services 1, preconception testing: the World Health Organization (WHO) reported that in the past 20 years, the sperm concentration of men in some parts of the world has declined at an average rate of 2.6% per year, and the proportion of normal sperm and motility have declined by 0.7% and 0.3% per year, respectively. Reports indicate that the overall semen quality of men in China is declining at a rate of 1% per year. As people become more health conscious, the need for the health of the next generation has begun with pre-conception health care for both partners. Among them, the medical demand for pre-conception checkups and health care guidance for men is even more obvious. The male department conducts fertility assessments for each prospective husband, including medical history, male physical examination, relevant semen and endocrine examinations, etc. The department escorts the female partner to get pregnant and smoothly welcome the next generation. 2, infertility: WHO regulations, the couple did not use any contraceptive measures cohabitation life for more than 1 year, due to male factors caused by the female infertility, called male infertility. Male infertility is not an independent disease, but the result of one or many diseases and/or factors. In recent years, the incidence of male infertility has been increasing. With the rapid development of assisted reproductive medicine, there are many treatment options available to meet the fertility requirements of both couples. How to choose the best option for each couple itself is the key to solving the problem. The Department of Male Medicine at our hospital provides appropriate treatment plans for couples with male infertility from various perspectives, including age, medical history, fertility and etiology. 3, erectile dysfunction (ED), premature ejaculation (PE), prostatitis (CP): these types of male diseases can become unspeakable for male patients. Often male patients who seek private help find that the investment in medical expenses does not yield good results. Our male department looks for risk factors associated with these diseases from a medical history, relevant professional assessment scales, and an etiological perspective. For example, diabetes, hypertension, reproductive tract infections, metabolic syndrome, and history of specific medications. In addition, we will combine relevant tests to distinguish organic and psychogenic factors and apply medications appropriately, and relieve men’s mental anxiety from a psychological perspective. Combined with sexual concentration training, behavioral therapy, cognitive therapy, biofeedback therapy and other ways to improve or reverse the vicious cycle of psychological disease from the psychological and behavioral levels. It is worth noting that erectile dysfunction is known as an early warning sign of cardiovascular disease, when suffering from ED at the same time need to beware of the possibility of the development of cardiovascular disease. So it is essential to get professional help and treatment early. 4, late-onset hypogonadism (male menopause): male menopause is a related disease corresponding to female menopause, mainly due to age-related hypogonadism or insensitivity to sex hormones caused. It is often not taken seriously and recognized by the majority of men. However, many middle-aged men may find that their spirits are not as good as before, their limbs are slightly muscle weak, they are prone to fever and sweating, and they have osteoporosis and other symptoms and changes, which may be related to male hypogonadism. It is recommended that the relevant items be examined and treated. 5, pubertal growth retardation: puberty is the fastest growing period of male growth, however, some parents found that also at the end of puberty or after still stay at the level of development before puberty. The signs such as the lack of prominent laryngeal nodes and hair, the lack of development of secondary sexual characteristics, and possibly olfactory impairment, or even the development of male breast or testicles that are very small and hard, may all be signs of delayed male puberty. Most of the causes are primary hypogonadism, congenital chromosomal abnormalities, and misalignment. For example, Turner syndrome, kallmann syndrome, Klinefelter’s sign and HH sign in males. Relevant tests are needed to evaluate and determine the etiology. We will also provide treatment and guidance to patients and their families upon request. A significant portion of male diseases are triggered by psychological factors. It is a challenge for clinicians to deal with male physical and mental diseases and reverse the alternating deterioration of physical and psychological states. In the male department, we apply psychological counseling techniques to relieve men’s psychological anxiety in response to psychogenic-related disorders. In addition to the consultation and counseling for men, we also selectively counsel both men and women together or individually for men and then women, and communicate with them about the differences in sexual life and issues related to men and women. The psychological relief men get in the clinic is brought to their daily lives by their wives in a coherent manner, combining behavioral therapy and cognitive therapy to reduce stress for men in all aspects. Fourth, a wealth of examination items semen examination as a routine male examination items, has been carried out by major medical institutions. However, it is difficult to keep up with the latest WHO Manual of Laboratory Tests for Human Semen and Sperm-Cervical Mucus Interaction (hereinafter referred to as WHO Manual) because of the variety of examination methods and approaches used. It is difficult to meet the clinical needs with a single semen examination method. In our outpatient male examination, the routine semen test uses Computer-aided sperm analysis (CASA) and adds the tests of seminal plasma acid phosphatase, seminal plasma α-glucosidase, seminal plasma fructose (quantitative), seminal plasma trace elements, reproductive tract mycoplasma, chlamydia, gonococcus (PCR), etc. in conjunction with the WHO Manual. Together with tests for male sex hormones such as follicular estrogen, luteinizing hormone, prolactin, estradiol, and testosterone, they can provide a better assessment of male fertility. Three of these tests for seminal plasma enzymes can provide information on the secretory capacity of the male accessory gonads (prostate, seminal vesicles, epididymis), which may be associated with semen insolubility, weak spermatozoa, and abnormal spermatozoa. Seminal plasma trace elements are important antioxidant factors in the reproductive tract, and when the antioxidant capacity falls below oxidative levels it can affect sperm production, maturation and the integrity of sperm DNA to varying degrees, and may even affect the process of embryo development. For couples with a history of miscarriage, we have conducted a sperm DNA fragmentation test, which has been shown in recent national and international literature to be significantly associated with embryonic arrest and spontaneous miscarriage in the female partner. In addition, we have recently successfully carried out ultrasound examination of the male reproductive system and Doppler ultrasound testing of the male penile blood flow to better serve our male patients! V. Precautions for semen examination 1. The quality of male semen fluctuates greatly, and WHO recommends two to three times to help obtain reliable data. 2. The specimen collection time should be abstinence for at least two days and a maximum of seven days. The number of days of abstinence should be as constant as possible if a review is needed. 3.Sperm collection should be performed by masturbation. Please urinate and wash your hands and urine before collection, and wash your genitals the night before collection. 4. Please be as fully excited as possible and drain the semen to avoid missing the collection. If the semen is not completely drained or there is any omission, please inform the male doctor or the laboratory doctor in time to avoid affecting the accuracy of the report. 5.If the sperm is collected outside the hospital (daily condom collection is prohibited), please send it to the laboratory within half an hour. The sample should be kept in an environment of 20-37℃ on the way to the laboratory. As a young specialty, the male department will still continue to base on its work and make its contribution to the health of more male compatriots based on the prevention of disease development and professional standards.