Urology – Andrology

Dr Josep Viladoms is a urologist who trained at Fundación Puigvert in Barcelona, with subsequent studies in the US (Emory Clinic in Atlanta and New York-Presbyterian/Weill Cornell Medical Center). In particular, he focuses on:


Phimosis is the difficulty or impossibility of retracting the foreskin (the skin that covers the tip of the penis or glans).

If the foreskin applies too much pressure to the body of the penis when descending, it prevents the glans from being fully revealed, or if the foreskin struggles to cover the penis after it has descended, this could be a case of phimosis.

Circumcision consists of removing the excess foreskin through an operation performed under local anaesthesia on an outpatient basis.

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Impotence or erectile dysfunction

Sexual impotence or erectile dysfunction consists of the difficulty or impossibility of achieving and/or maintaining a stiff enough erection to achieve satisfactory intercourse for the man and his partner.

Erectile dysfunction is a very common problem: more than 2,000,000 Spanish men suffer from it, although it is also an issue whereby help is not frequently sought (<20%), due to a lack of awareness that solutions exist, embarrassment, etc. Most men will experience impotence at some point in their lives (52% of men between 40 and 70 years of age).

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Penile curvature

Penile curvature, also called disproportioned corpus cavernosum, can be congenital or caused by Peyronie’s disease.

It consists of an area of scarring in the corpus cavernosum that, as it is not elastic, causes a retraction or curvature that shortens the penis and hinders penetration.

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Premature ejaculation

Premature ejaculation (PE) is defined as an ejaculation that occurs earlier than desired, whether before or after penetration, causing anxiety to one or both members of the couple.

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Varicocele is the varicose dilation of the veins in the spermatic cord at scrotal level. It occurs in around 15% of the general population, between 35% and 40% of men with primary infertility (who have not become pregnant with their first child) and between 70% and 80% of men with secondary infertility (who have been able to get pregnant once, but are now unable).

It is much more common on the left side (90%). The incidence in adolescents is 15% and is extremely rare in preadolescents. Varicocele frequently occurs in the case of a smaller, softer testicle.

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Vasovasostomy is an operation that rejoins the vas deferens that was cut and obstructed during the vasectomy to achieve the free flow of sperm that allows pregnancy through sexual intercourse. It must be performed by an expert andrological microsurgeon

It is performed under local anaesthetic and takes between 1.5 to 3 hours. In approximately 90% of cases, it results in sperm appearing in the semen, which allows for pregnancy to occur through sexual intercourse.

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