Pediatric andrology: bridging pediatric urology and reproductive medicine.

PURPOSE OF REVIEW: Andrological disorders, including male infertility, hypogonadism, and sexual dysfunction, are often managed in adulthood despite their origins in early life. This review proposes the emerging concept of 'pediatric andrology', which integrates pediatric urology, endocrinology, and reproductive medicine, and aims to highlight its clinical significance from a life-course perspective.

RECENT FINDINGS: Growing evidence suggests that common andrological conditions such as varicocele, cryptorchidism, and Klinefelter syndrome originate in childhood and have long-term implications for fertility and hormonal function. Advances in microsurgical techniques and assisted reproductive technologies, including microdissection testicular sperm extraction (micro-TESE), have improved reproductive outcomes even in severe cases. In parallel, recent guidelines emphasize the importance of early diagnosis, appropriate timing of intervention, and structured transition to adult care. However, controversies remain regarding optimal management strategies, timing of surgical intervention, and fertility preservation, particularly in adolescents. Environmental and lifestyle factors may also contribute to future reproductive health, although evidence is still evolving.

SUMMARY: Pediatric andrology represents a novel interdisciplinary field that bridges pediatric urology and adult reproductive medicine. A life-course approach is essential to better understand the pathophysiology of andrological disorders and to optimize long-term outcomes. Establishing structured transition care and promoting collaboration across specialties will be critical for advancing this field and improving male reproductive health.