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Andrologische Diagnostik bei Fertilitätsstörungen

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Die Urologie

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Zusammenfassung

Die Betreuung des ungewollt kinderlosen Paares erfordert eine enge interdisziplinäre Zusammenarbeit und korrekte Diagnosestellung bei Mann und Frau. In ca. der Hälfte der Fälle finden sich Fertilitätsstörungen auf Seiten des Mannes, für die verschiedenste anlagebedingte sowie erworbene Faktoren ursächlich sein können. Nach ihrer Lokalisation lassen sich Störungen der Hoden, der ableitenden Samenwege und der akzessorischen Drüsen, der Samendeposition, Störungen des übergeordneten Hypothalamus-Hypophysen-Systems sowie Androgenrezeptor- und Enzymdefekte unterscheiden. Für die Einschätzung der männlichen Fertilität ist die Untersuchung des Ejakulates von zentraler Bedeutung, die andrologische Diagnostik darf sich jedoch keinesfalls hierauf beschränken. Ausführliche Anamnese, körperliche Untersuchung und skrotale Sonografie sind unverzichtbare Bestandteile des Basisprogramms, Hormonanalysen und weitere Zusatzuntersuchungen, wie z. B. eine humangenetische Diagnostik, werden bei Bedarf ergänzt. Als invasive Untersuchungsmethode ist die Hodenbiopsie bis heute nicht durch andere Verfahren zu ersetzen, insbesondere bei der Differenzialdiagnostik der Azoospermie.

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Authors and Affiliations

  1. Sektion Konservative Andrologie, Klinik und Poliklinik für Urologie, Kinderurologie und Andrologie, Justus-Liebig-Universität Gießen, Universitätsklinikum Gießen und Marburg GmbH, Gießen, Deutschland

    Hans-Christian Schuppe

  2. Andrologicum München, München, Deutschland

    Frank-Michael Köhn

  3. Klinik und Poliklinik für Urologie, Kinderurologie und Andrologie, Justus-Liebig-Universität Gießen, Universitätsklinikum Gießen und Marburg GmbH, Gießen, Deutschland

    Adrian Pilatz, Wolfgang Weidner & Thorsten Diemer

  4. Institut für Veterinär-Anatomie, -Histologie und -Embryologie, Justus-Liebig-Universität Gießen, Universitätsklinikum Gießen und Marburg GmbH, Gießen, Deutschland

    Daniela Fietz

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  5. Wolfgang Weidner
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  6. Thorsten Diemer
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Correspondence to Hans-Christian Schuppe .

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  1. Klinik für Urologie, Universitätsklinikum Mannheim, Mannheim, Deutschland

    Maurice Stephan Michel

  2. Klinik für Urologie, Universitätsklinik Mannheim, Mainz, Deutschland

    Joachim W. Thüroff

  3. Abt. für Urologie, Universitätsklinikum Salzburg, Salzburg, Österreich

    Günter Janetschek

  4. Klinik und Poliklinik für Urologie, Univer Tech Univ Dresden, Dresden, Deutschland

    Manfred P. Wirth

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  1. Klinik für Urologie, Kliniken Maria Hilf GmbH, Mönchengladbach, Deutschland

    Herbert Sperling

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Schuppe, HC., Köhn, FM., Pilatz, A., Fietz, D., Weidner, W., Diemer, T. (2023). Andrologische Diagnostik bei Fertilitätsstörungen. In: Michel, M.S., W. Thüroff, J., Janetschek, G., Wirth, M.P. (eds) Die Urologie. Springer Reference Medizin. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-63400-4_154

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