Men’s Health Specialist Training

The existence of the fellowship is to augment and support the Department of Andrology at Institute of Andrology and Sexual Health at Bhandari Hospital, Jaipur and Department of Andrology, RUDN University,Russia & URO PRO CLINIC, RUSSIA and Prof Ege Can Serefoglu, Istanbul, Turkey to advance the field of sexual health and infertility consistent with the goals of the above mentioned institutions and the strategic plan on the above mentioned institutions.

We see approximately ~1200 new patients yearly in our specialized center dedicated to reproductive health of men with infertility, sexual dysfunction, penile abnormalities, benign prostatic disease and testosterone deficiency syndrome. Our team includes andrologist, urologist, pelvic floor specialist, andrology lab technician with special expertise in male reproductive biology. We perform about 100-150 andrology surgeries annually and 200-300 day care procedures/therapies annually including pelvic floor dysfunctions.

Eligibility:

It is mandatory for the doctor to have a minimum of post graduation degree in surgery/dermatology or a specialization in Urology to be accepted in this program.

Description of Program:

General

Andrology Fellowship addressing male reproductive and pelvic sexual health to be based at Institute of Andrology and Sexual Health at Bhandari Hospital, Jaipur, India and RUDN University, Russia and Prof Ege Can Serefoglu, Istanbul, Turkey.

The modern management of male pelvic reproductive and sexual health requires an in depth knowledge not only of surgery but of imaging, biopsy techniques, pathology, endocrinology, radiology and basic science. The fellowship is designed to enhance the basic knowledge of the management of male pelvic sexual and reproductive health acquired by a medical doctor.

Objectives:

The Andrology fellowship will enable the resident to acquire an advanced body of knowledge and level of skill in the management of reproductive and sexual health diseases in order to assume a leadership role in teaching and research in the field. This will include:

• an understanding of the classification and evaluation of erectile dysfunction;
• knowledge of the indications, techniques, and complications of radiographic evaluation of the arterial supply of the penis;
• an understanding of the basic techniques of testicular biopsy, evaluation and tissue processing, recognition of basic testicular pathology, and knowledge of pathologic prognostic factors;
• the ability to counsel patients on treatment options for therapy for erectile dysfunction and reproductive health abnormalities;
• an evaluation of erectile dysfunction and reproductive dysfunction in an office based setting;
• an understanding of the indications, complications, techniques, and results and biology of erectile dysfunction treatments;
• an understanding, the indications, results and basic biology of localized and systemic treatment for reproductive dysfunction;
• an understanding of the biology, evaluation and treatment of local therapies to the penis and testis;

Fellows will be addressing outcome studies in infertility and sexual health.

In addition, individuals completing this training program will be able to:

• Evaluate the clinical literature and erectile dysfunction and reproductive health in a critical fashion and make contributions to the field.
• Teach the specialty of Andrology.
• Organize a multidisciplinary approach to erectile dysfunction and male infertility care.

Organization and Faculty

Program Directors – The program will be directed by Dr. Chirag Bhandari, Dr Yakov Mirkin and Dr Ege Can Serefoglu.

Supervision of the fellow in non-surgical disciplines will be the responsibility of the individual in that section designated as the leader in treatment efforts in imaging, pathology, and reproductive endocrinology.

Application and Selection Process

Written applications, including a copy of the candidate’s curriculum vitae and letters of recommendation will be solicited.

Appropriate candidates will be interviewed by Dr Chirag Bhandari.

Applicants will be selected by the faculty committee based on past record of achievement, recommendations, and interview process without regard to gender or race.

Evaluation

Fellows will be evaluated by participating faculty for each of the rotations in the program. In addition, an overall evaluation will be done by faculty to assess whether the fellow has met the goals for the curriculum and skills acquisition.

Fellowship Summary

The modern management of male reproductive and sexual health requires an in-depth knowledge not only of surgery but of imaging, biopsy techniques, pathology, endocrinology, radiology and basic science. The proposed fellowship is designed to enhance the basic knowledge of the management of male sexual health and reproductive health acquired by a surgeon particularly in the non-surgical disciplines through a combination of surgery cases, clinics, research and didactic education.

Program Weighting:

Male Infertility/Sexual function: 25%, 75%,

Education Program:

PART 1- INSTITUTE OF ANDROLOGY AND SEXUAL HEALTH ~ 30 DAYS

Knowledge Base

• An evaluation and management of erectile function and dysfunction.
• Erectile dysfunction risk assessment.
• Male infertility risk assessment.
• Male infertility genetics.
• Screening and diagnostic radiographic and ultrasound techniques.
• Natural history and pathology of erectile dysfunction and male infertility.
• Selection of local therapy, contraindications and expected outcomes in treatment of erectile dysfunction.
• Selection of local therapy, contraindications for treatment of testicular failure and infertility.
• Consequences of systemic treatments on erectile function and testicular function.
• Effect of systemic chemotherapy and endocrine therapy on reproductive health and sexual health.
• Preoperative workup and postoperative management of surgical patients with sexual dysfunction.
• Preoperative workup and postoperative management of post surgery of testicular biopsy imaging techniques.
• Psychosocial and legal aspects of erectile dysfunction and reproductive health.
• Sexually Transmitted Diseases
• HIV PRE and POST Exposure prophylaxis

Skills

• Ultrasound and MR imaging of testicular and vasal abnormalities.
• Biopsy techniques of testis
• Percutaneous and open sperm retrieval techniques
• Management of varicocele techniques
• Microscopic interpretation of testicular pathology
• P shot
• Stem Cells for ED
• Shockwave Therapy
• Penile Enlargement Surgeries
• Laser and Magnetic Stimulation Therapy for ED/Male Infertility
• Cryosurgery for Premature Ejaculation
• Dorsal Nerve Resection for Premature Ejaculation
• Pelvic Floor Rehabilitation for Chronic Pelvic Pain Syndrome/PE/ED
• Intracavernosal Injection Therapy for ED

PART 2- RUDN University, RUSSIA~ 15 days

THEORETICAL MODULE

• ADVERTISING 3 hours
• CALL CENTER TEAM 1.5 hours
• RECEPTION TEAM 1.5 hours
• FIRST VISIT OF THE PATIENT 3 hours
• Conversation – how to get JTB from patient
• Evaluation (questionnaire, etc.)
• Biothesiometry
• Diagnostic IC injection
• Doppler US
• USI of the urinary system
• Uroflowmetry
• Blood test etc.
• End of the first visit
• ERECTILE DYSFUNCTION: PATHOGENESIS, DIAGNOSIS,

CONSERVATIVE AND SURGICAL TREATMENT

• Pathogenesis of ED
• How can we recognize Jobs-to-be-Done for our patient: questionnaire, interview
• Doppler ultrasound with intracavernous injection
• PDE-5 inhibitors: how can we keep our patients as ours
• Physiotherapy of ED: shock wave, magnetic chair, biofeedback, etc
• Intracavernous therapy
• Surgical treatment of ED 3 hours
• PREMATURE EJACULATION: PATHOGENESIS, DIAGNOSIS,

CONSERVATIVE AND SURGICAL TREATMENT

• Pathogenesis of PE
• How can we recognize Jobs-to-be-Done for our patient: questionnaire, interview
• Biothesiometry
• Bulbo-cavernous reflex evaluation
• Intracavernous injection test
• Anesthetic injection test
• Conservative therapy
• SDN
• Cryoablation of DN
• Radiofrequency neuromodulation of DN
• BOTOX
• HYPOGONADISM
• CPPS
• BENIGN PROSTATE HYPERPLASIA

PRACTICAL MODULE

• IMPLANTATION OF MALLEABLE PENILE PROSTHESIS
• IMPLANTATION OF 3-PIECES PENILE PROSTHESIS
• LIGATION OF DEEP DORSAL PENILE VEIN
• SELECTIVE DORSAL NEUROTOMY
• CRYOABLATION OF DORSAL PENILE NERVES
• RFA OF DORSAL PENILE NERVES

PART 3- DR EGE CAN SEREFOGLU~ 15 days

The fellow will be shadowing Prof Dr Ege Can Serefoglu in his private clinic in Istanbul, Turkey for a period of 15 days.

The candidate will be exposed to the following:

• Microscopic Varicocoelectomy
• mTESE
• Testicular FNAC/Biopsy
• PESA/ TESA
• Vasectomy
• Management of Prostatitis
• Semen Analysis and its interpretation
• Andrology Lab Setup
• Journal Writing for Andrology/ Sexual Medicine journals

It is mandatory to complete all the three modules of Andrology training in order to get the certification from the respective institutions.

PS: Please note that the accommodation and travel, visa charges in INDIA/RUSSIA/TURKEY will be borne by the candidate apart from the program fees.