A journey through urology and andrology
Professor Suks Minhas is a consultant urologist and head of specialty in urology at the Trust, and centre director of the European Academy of Andrology at Imperial College London. Here, he gives an insight into his areas of expertise and the ever-evolving landscape of male reproductive health.
Why urology and andrology?
Urology is a dynamic surgical speciality, covering the diagnosis and treatment of disorders of the kidneys, ureters, bladder, prostate and male reproductive organs. When I began my medical training, urology was still a branch of general surgery but was rapidly evolving into an independent, cutting-edge field. My passion for urology started during my time as a senior house officer, where I was drawn to its evidence-based approach and the balance of both open surgery and minimally invasive endoscopic techniques. The combination of technical precision and patient-centred care has made urology an incredibly rewarding speciality ever since.
My interest in andrology (men's health) was developed when I undertook a research degree in the pharmacology of smooth muscle. This experience provided me with an insight into a very underdeveloped speciality but with a significant disease burden. It was clear to me even then that there was a need to advance research, education, and patient care in this area – something that continues to drive my work today.
What are some of your areas of expertise?
My primary focus is on disorders of the male genital system, including penile cancer, testicular cancer, penile reconstruction, and penile prosthetics. Over the last two decades, I have developed a major interest in male infertility, leading a research portfolio based at Imperial College London.
I am passionate about the development of evidence-based guidelines, education, and training as I firmly believe that there should be standardisation of care for all patients. I also find it rewarding to mentor and train future generations of surgeons.
From a slightly more personal perspective, I have an interest in health inequalities. Growing up in a deprived immigrant community in South East London, I saw first-hand the barriers that people from ethnic minority backgrounds face when accessing healthcare. Whether it's stigma around men's health or a lack of information in certain communities, I feel a strong sense of responsibility to advocate for greater inclusivity and equitable access to care.
Professor Suks Minhas
"Growing up in a deprived immigrant community in South East London, I saw first-hand the barriers that people from ethnic minority backgrounds face when accessing healthcare."
How has the field of male reproductive health evolved since you began practicing?
It has rapidly expanded over the last 20 years. Historically, men were somewhat ostracised with fertility issues and in many instances referred for IVF treatments without appropriate investigation and evaluation. There have been many advances in this field and in our understanding of the environmental, genetic and lifestyle factors which can cause fertility problems in men.
We now know that male infertility is often linked to broader health risks, including cardiovascular disease, which makes early diagnosis and intervention even more critical.
There are also many correctable causes for male infertility and surgical techniques have allowed men to achieve paternity when previously they were unable to do so. I'm pleased that at Imperial College London we have been involved in the development of state-of-the-art techniques and diagnostics for treatment. In particular we have developed research demonstrating the role of sperm DNA fragmentation in predicting outcomes from ART and novel imaging modalitites to assess sperm production.
What are some of the most common causes of male infertility?
There are many causes of male infertility, ranging from hormonal imbalances to genetic abnormalities. Some of the most common conditions we see include men with no sperm, varicoceles (swollen veins in your scrotum), testis cancer and low testosterone. In many cases we can optimise fertility potential but also evaluate and optimise couples who may not be able to achieve pregnancy even with IVF treatments.
Professor Suks Minhas
"It is fantastic to see novel innovations such as artificial intelligence (AI) in medicine and its potential to change the landscape of diagnosis and treatment. I believe AI has the potential to transform diagnostics and improve outcomes in male fertility treatments such as IVF."
What have been some of your career highlights?
Receiving the British Association of Urological Surgeons Golden Telescope award and the St Peter's Medal have undoubtedly been two career highlights. However, one of my greatest personal career highlights remains the moment I became a doctor. As a first-generation immigrant, I had to work extremely hard and neither of my parents could speak English. When I received my acceptance into medical school, my parents were unbelievably proud.
How do you stay up to date with the latest research?
Despite my busy schedule, I genuinely enjoy learning and staying up to date with the latest research. I'm privileged to attend many national and international meetings and contribute to the development of clinical guidelines – both of which allow me to remain at the cutting edge of urological practice.
What role does technology play in advancing treatments for conditions like erectile dysfunction, testicular cancer or Peyronie’s disease?
It is fantastic to see novel innovations such as artificial intelligence (AI) in medicine and its potential to change the landscape of diagnosis and treatment. I believe AI has the potential to transform diagnostics and improve outcomes in male fertility treatments such as IVF.
However, men's health research remains comparatively underfunded compared to other research areas such as cancer, which means we're only just scratching the surface of what’s possible...
