Men's Health and Fertility
The OHSU Men’s Health Team has extensive experience and fellowship training in all areas of sexual and reproductive medicine. As a premier high-volume center in the Northwest offering these services, we receive extensive referrals for even the most challenging of cases.
Some of the most common concerns that bring patients to our clinic include:
- The National Institute of Health estimates that one in 5 men over the age of 65 experiences erectile dysfunction, or ED, which occurs when a man cannot obtain or keep an erection satisfactory for sexual intercourse. While occasional erection trouble may not necessarily raise concern, ongoing erectile dysfunction can cause significant personal distress and strain relationships. Uncertainty about the cause behind erectile dysfunction or apprehension about possible treatment may prevent some from seeking help, but our understanding of the physiologic causes of ED has made significant advancements in recent years, and many successful treatments are now commonly employed with great success.
- Many of the pioneering medical and surgical protocols utilized in the treatment of erectile dysfunction were first implemented here at OHSU, establishing the exemplary program that flourishes today. We serve as a major referral and high volume center for patients around the Pacific Northwest, and boast some of the top surgeons in the nation with the most training and experience in treating erectile dysfunction.
- Low testosterone, also called hypogonadism, is increasingly common and can cause a variety of issues affecting energy, mood, libido, bone and blood health, and more. It can be caused by several factors, and identifying and treating those causes is critical. Our providers have advanced training in all available forms of testosterone and associated hormone therapies, and can build a treatment plan that fits your goals, lifestyle, and physiology.
- While infertility was previously considered to most often be woman’s problem, we now know that a male factor is present in about half of the 15% of all couples who struggle with infertility. A 2002 National Survey of Family Growth found that 7.5% of sexually active young adult men had seen a fertility doctor at some point, and 18% of these men were subsequently diagnosed with an infertility disorder. Male infertility can be caused by many different factors affecting the sperm or semen, including varicoceles, medical conditions like diabetes or obesity, trauma and spinal cord injury, exposure to radiation or chemotherapy, and others.
- OHSU’s Department of Urology is the only health center in the state of Oregon to offer advanced male factor fertility diagnosis and treatment. We serve as the primary referral and high-volume center for complex male infertility cases in the Pacific Northwest. Coupled with our services in advanced fertility testing, our providers are uniquely experienced in procedural treatments for male infertility, including microsurgical varicocele ligations, testicular sperm extraction (TESE), and micro-TESE.
- The surgical gold standard in care for erectile dysfunction, placement of a penile prosthesis can be a life-changing and empowering experience. Our surgeons specialize in placing these devices, and can help you decide if this surgery is right for you, and if so, what model or style would work best for you. Our team has experience with the most challenging prosthetic revision cases, and are glad to help you if you have a device that is not working properly or had to have a prior device removed.
- Recognized as an increasingly common issue, Peyronie’s disease involves the buildup of scar tissue in the penis which causes a curve, bend, or other change in the shape. OHSU offers all of the proven therapies for this condition, including medical therapy, collagenase injections, and surgical procedures. We understand that this condition can have a huge impact on sexual health, relationships, and self-image, and are committed to providing discreet and cutting-edge care.
- Vasectomy, the blocking of both sperm tubes in the scrotum, is a safe and effective long-term option to prevent pregnancy. Having performed thousands of vasectomies, and trained many of the providers across the Pacific Northwest, OHSU is proud to continue empowering men to take responsibility for their family planning.
- While a vasectomy is generally considered a permanent procedure, circumstances can lead some couples to pursue a reversal to re-establish fertility. Sometimes vasectomy reversal can be indicated for treatment of testicular pain associated with vasectomy. For men who are pursuing a vasectomy reversal, the success rates are 95 to 98% for returning sperm to the ejaculate at our institution.
- The OHSU Department of Urology has been instrumental in the development and implementation of vasectomy reversals. Dr. Eugene Fuchs is responsible for pioneering the mini-incision vasectomy reversal approach, first performed here at OHSU in 1978. We also participated in the initial Vasovasostomy Study Section, the most frequently cited reference for statistics regarding the procedure. Thirty-five years later, we now serve as one of the highest volume vasectomy reversal centers in the nation, having performed over 7,000 to date, and we serve as a primary referral center in the Pacific Northwest for complex or repeat reversals. This training and technical excellence was passed by Dr. Fuchs to Dr. Jason Hedges, and then Dr. Jasper Bash, who now lead the program.
- Several manuscripts have been published illustrating the practices and findings among this large set of patients that underwent vasectomy reversal at OHSU. Some of the results of our findings can be found in:
- 1. Relating economic conditions to vasectomy and vasectomy reversal frequencies: a multi-institutional study Sharma V, Zargaroff S, Sheth KR, Le BV, Dupree JM, Sandlow JI, Polackwich AS, Hedges JC, Fuchs EF, Goldstein M, Brannigan RE. J Urol. 2014 Jun;191(6)
- 2. Impact of Gross and Microscopic Vasal Fluid During Vasectomy Reversal on Pregnancy.Ostrowski KA, Polackwich AS, Conlin MJ, Hedges JC, Fuchs EF.J Urol. 2015 Jan 13.
- 3. Higher outcomes of vasectomy reversal in men with the same female partner as before vasectomy Ostrowski KA, Polackwich AS, Kent J, Conlin MJ, Hedges JC, Fuchs EF J Urol. 2015 Jan;193(1):245-7
- Varicocele refers to an abnormal dilation of the veins that let blood exit the testicles. It is common, but can lead to discomfort and impede the proper functioning of the testicles. Historically there have been many ways to treat them, and OHSU providers have advanced training and experience in the gold standard surgical treatment: the minimally-invasive subinguinal microscope-assisted varicocelectomy.
Some of the treatments that our Fellowship-trained team offers include:
- Medical treatment of ED (medications, injections, etc)
- Penile Implant Surgery
- Penile Rehabilitation after prostate surgery
- Testicular Implant Surgery
- Complex Penile Reconstruction
- Xiaflex Injections
- Vasectomy
- Microsurgical Vasectomy Reversal
- Microsurgical Varicocelectomy
- Sperm Extraction
- Testosterone Replacement Therapy
Dr. Jason Hedges, M.D., Ph.D. specializes in men's sexual health, and has particular interest in vasectomy, vasectomy reversal, erectile dysfunction, Peyronie's disease, male infertility, prosthetic urology, and penile implants. He has advanced fellowship training in Andrology from Northwestern University, as well as a Ph.D. in Cell & Molecular Biology. He is committed to making men's sexual health care easily accessible, efficient, and effective.
Dr. John Barry, M.D. has been a faculty member in Urology at OHSU since 1973, and has made significant contributions to the understanding and treatment of a wide variety of urologic conditions. With extensive training and experience in the field of men’s health. Dr. Barry particularly specializes in erectile dysfunction, and is highly knowledgeable about its many diagnoses and treatments.
Dr. Jasper Bash, M.D., specializes in the medical and surgical optimization of Men’s Health, including treatment for infertility, erectile dysfunction, Peyronie’s disease, male hormone management, and complex prosthetics. He completed medical school and residency at OHSU, where he returned as faculty after advanced training at UCLA’s Male Reproductive Medicine and Surgery Fellowship. Dr. Bash enjoys bringing transparent communication and a comprehensive approach to his patient care here in the beautiful Pacific Northwest.
Lauren Lamina, DNP, APRN, FNP is a Nurse Practitioner with her Doctorate in Nursing Practice. She has been practicing Men's Health and Urology at OHSU since 2021. She has extensive experience and training in testosterone replacement therapy, erectile dysfunction, ejaculatory dysfunction and pituitary abnormalities.
She received her undergraduate degree in Arkansas and her Master's and Doctorate degrees from Rocky Mountain University of Health Professions in Provo, Utah.
She specializes in Men's urological health including low testosterone, erectile dysfunction, and ejaculatory dysfunction. She enjoys keeping up to date with industry organizations and professional societies to advocate for patients and the advancement of advanced practice providers in Men's Health.
She is from Kansas, originally and landed in Portland in 2016. Her professional background consists of experience in intensive care, emergency, post-surgical, and cardiac care. In her spare time, Lauren enjoys baking, home DIY, and sports.