ESGURS-ESAU23: Addressing the full spectrum of male fertility

“The focus of the EAU’s andro-urology section is mainly male reproductive health, whereas ESGURS is mainly focused upon genital reconstructive surgery including penile prosthetics, Peyronie’s disease, and gender surgery. Clearly there is an enormous overlap in diseases between these two areas.”

“We are pleased that ESGURS-ESAU23 will feature a faculty of world experts in both fields, and in fact they are in some cases represented on both boards. This will be a true collaborative meeting and we will focus on these areas of overlap.”

Prof. Minhas is an ESAU Board Member and a consultant urologist and lead andrologist at Imperial College London. He is also vice-chair of the EAU Guidelines panel on Sexual and Reproductive Health.

A field in development
Prof. Minhas characterises andro-urology as a subspecialty that is still developing scientifically and clinically, meaning that a lot of the knowledge is based on experience and insights of experts.

“Whilst the field has been established, andrology is still somewhat underdeveloped within urology. We’re not dealing with oncological topics, classically like prostate cancer, where there are some well-defined areas and protocols.”

“We do of course have the EAU Guidelines in male sexual reproductive health, which highlight many of these areas and give best evidence for best practice, many are unfortunately still underdeveloped. Therefore we rely on these world experts to share best knowledge and cutting-edge practice.”

“Specific areas that we will be covering in Florence, particularly in the ESAU scientific programme, include men’s health and the association of infertility with men’s health. We are trying to raise the profile of male infertility as a marker or sentinel of general men’s health.”

Hot topics
The scientific programme of ESGURS-ESAU23 is rapidly taking shape. Apart from the two Sections’ input, the meeting will also be combined with the ESU-ESAU-ESGURS Masterclass on Erectile restoration and Peyronie’s disease on 22-23 November.

The ESAU programme will feature state-of-the-art presentations, panel discussions and case-based discussions featuring experts from across the world, leaders in their respective fields. Prof. Minhas highlights the main topics that will be covered over two days:

“One major topic is testosterone as a source of youth and energy. Physiology will be covered, libido, erectile function and indications too. Testosterone itself has almost become a recreational drug around the world. It’s important to realise and understand the complications, risks and indications for this treatment. Part of this involves discussing the role of testosterone replacement therapy in men with PCa: a controversial area. We will be giving updates in terms of guidelines, when to start testosterone treatment, and its safety.”

“Another controversial area is the effects of antioxidants, especially in the development of drugs that might help fertility. We don’t have a good level of evidence yet, and there is much debate on the use of antioxidants. Patients might use them on an everyday basis particularly related to fertility. In many countries these are over-the-counter drugs, and they represent a billion-pound industry worldwide. We will discuss the current levels of evidence.”

“We will complement the surgical side of the meeting with further talks on Peyronie’s disease: the role of surgery, and best treatment in terms of grafting. Discussions on male infertility also cover surgical aspects like surgical sperm extraction.”

“Finally: is there a role of endogenous or endocrine disrupting chemicals in fertility? In particular we will discuss the role of environmental or industrial oestrogen chemicals that may impact on fertility. As you can see we are trying to cover a broad spectrum of andrology, including basic science.”

Also for the general urologist
Instead of discussing a hyper-specialised corner of urology, Prof. Minhas points out that general urologists can really gain from learning more about these current topics that affect a large number of their patients.

“Many urologists will see patients who are dealing with the effects of prostate cancer treatment, or the everyday male infertility patient. Therefore it’s important for urologists to understand the limitations of some of these treatments, as well as which investigations should be performed in these patients. Knowing what the current state-of-the-art treatment is helps urologists refer and treat their patients appropriately.”

“The whole concept of our meeting is a comprehensive overview of men’s health in general, which involves not only the medical side but the surgical side too. Having said that, we want to attract other specialities as well. We would like to work with the European Academy of Andrology, and also attract gynaecologists. There is of course an overlap between men and
women’s health, and related issues like gender surgery.”

“I hope collaboration between our two Sections will continue in terms of providing a regular educational forum that exposes trainees and young urologists to the whole spectrum of topics that they will encounter in their careers.”

Check out the ESGURS23-ESAU23 scientific programme, and register here.