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Urology · Andrology

Andrology

Erectile dysfunction, male infertility, penile conditions and reconstructive surgery. Private clinic, consultation conducted personally by Dr. Calarco.

Condition Andrological conditions (ED, infertility, penile curvature, reconstructive surgery)
Techniques Medical · Surgical · Rehabilitative
Hospital stay Day surgery (penile prosthesis, varicocelectomy)
Anaesthesia Spinal or local (depending on procedure)
Follow-up Check-up at 4 weeks; personalised rehabilitative follow-up

Andrology and men's health

Andrological conditions (ED, infertility, penile curvature, reconstructive surgery)

Treatment options

I.

Erectile Dysfunction

ED

ED affects approximately 50% of men between ages 40 and 70. Causes are often vascular, neurological or psychogenic, and in most cases effective treatments exist.

  • Complete aetiological assessment (hormonal, vascular)
  • Dynamic penile colour Doppler ultrasound
  • Personalised pharmacological therapy
  • Penile prosthesis implant (refractory cases)

Indicato per: ED of vascular, neurological or psychogenic origin

II.

Male Infertility

In one third of couples struggling to conceive, the cause is male. A comprehensive andrological assessment identifies and often corrects the problem.

  • Semen analysis and culture
  • Hormone levels (FSH, LH, testosterone)
  • Microsurgical varicocelectomy
  • TESE/microTESE for azoospermia

Indicato per: Male infertility with correctable factor

III.

Reconstructive Surgery

Correction of congenital or acquired penile deformities, trauma or infection sequelae, and prosthetic surgery for erectile rehabilitation after prostatectomy.

  • Penile curvature correction (Peyronie's disease)
  • Adult hypospadias surgery
  • Penile prosthesis implant (hydraulic/semi-rigid)
  • Post-prostatectomy erectile rehabilitation

Indicato per: Deformities, traumatic sequelae, refractory to medical therapy

Clinical pathway

  1. 01
    First andrological visit

    Full medical history, physical examination, possible dynamic penile Doppler. Duration: 45–60 min. Personal consultation, no assistants present.

  2. 02
    Couple assessment

    When indicated, a joint consultation with the partner is available to address the problem together.

  3. 03
    Integrated pathway

    Collaboration with sex therapists, endocrinologists and ART centres for cases requiring a multidisciplinary approach.

  4. 04
    Treatment

    Medical, surgical or rehabilitative depending on diagnosis. Day surgery where indicated.

  5. 05
    Follow-up

    Check-up at 4 weeks. Post-operative erectile rehabilitation programme if required.

Frequently asked questions

Is erectile dysfunction always treatable?
In most cases an effective treatment exists: oral medication, local therapies or, if these do not work, a penile prosthesis implant, which the literature reports with high satisfaction levels. The choice depends on the cause and is discussed at the consultation.
Does varicocele always cause infertility?
Not necessarily. Varicocele is present in 15% of men but causes infertility in only some. Semen analysis determines whether surgical correction is indicated.
Can erectile function be recovered after prostatectomy?
Yes, especially in younger patients (<65) with bilateral nerve-sparing technique. Erectile rehabilitation with PDE5-inhibitors begins in the early post-operative weeks. Results depend on age, pre-operative function and surgical quality.
Is bladder neck hypertrophy the same as chronic prostatitis?
No. Chronic prostatitis is an inflammatory/infectious problem of the prostate; bladder neck hypertrophy or sclerosis is a mechanical obstruction of the passage between the bladder and the urethra. Symptoms can look similar, but the cause and treatment are different.
Does bladder neck surgery always cause retrograde ejaculation?
No. With traditional bladder neck incision or resection, retrograde ejaculation is a frequent effect. The ZANCLE technique was designed to reduce this risk: in the published studies, in selected patients, antegrade ejaculation was preserved. The result in the individual patient cannot be guaranteed.
Do the results of bladder neck surgery last over time?
In the published studies on the ZANCLE technique the improvement in urinary flow was maintained up to 24 months, the latest follow-up reported (Surgeries 2026). Data over longer periods are not yet published; regular check-ups are recommended.

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