Urologic Andrology Fellowship

Male Infertility – Complete evaluation and treatment of the infertile male

Microsurgery – vasectomy, vasectomy reversals, varicocele repair, MESA, micro-TESE, microsurgical spermatic cord denervation

Sperm retrieval techniques – All methods of sperm retrieval will be learned including microsurgical approaches to epididymal and testicular sperm extraction. This includes both office and operating room based procedures.

Advanced Diagnostic Ultrasound – scrotal, penile duplex, transrectal ultrasounds that pertain to the fertility and sexual medicine evaluation of the male

Andrology lab experience – Interpretation of the semen analysis and other advanced andrology tests

IVF/ICSI and Female Fact Infertility Evaluation– This is taught jointly with the Andrology laboratory staff and Reproductive Endocrinology group at Virginia Fertility & IVF. The Fellow will participate in and will have the opportunity to learn basic semen analysis evaluation, techniques of sperm cryopreservation, IVF-ICSI and the basics of the female infertility evaluation.

Erectile dysfunction – penile prosthesis implantation via both penoscrotal and infrapubic approaches, including complex revision and replacement procedures

Peyronie’s disease – penile prosthesis implantation, penile plication, incision/excision and grafting, complex penile reconstruction, Xiaflex injections

Surgical Management of male incontinence including artificial urinary sphincter placement and male slings

Benign scrotal disorders – hydrocele, spermatocele, testicular prosthesis insertion

Hypogonadism – Comprehensive evaluation and management of hypogonadism, including Testopel insertion

Ejaculatory dysfunction and orgasm – Management of common disorders of ejaculation including medical treatment and infertility assessment/management including sperm retrieval

Urethral stricture disease – Assessment and surgical management of urethral stricture disease

Buried penis – Assessment and surgical management of buried penis

Priapism/Penile fracture – Evaluation and management of Andrology specific urologic emergencies of priapism and penile fracture

Gender health – Comprehensive evaluation and surgical management of transgender health including orchiectomy, reproductive health, and fertility preservation

Updated Information on Penile Prosthesis: As of December 2024, Dr. Nicolas Ortiz‘s practice has been designated as a Center of Excellence for the Boston Scientific AMS 700 Penile Prosthesis. Dr. Ortiz is one of only two providers in the state of Virginia to receive this prestigious designation.

• The Fellow will serve as a Clinical Instructor in the Urology department and will have the same operative and teaching privileges and responsibilities as other Urology Faculty.
• The Fellow is responsible to coordinate their case participation with the residents at least 1 week in advance of scheduled cases. This should be included in the weekly departmental emails delineating resident/Fellow involvement.
• The Fellow is responsible for balancing their operative role with that of residents to ensure a collaborative and balanced experience.
• The Fellow is expected to manage patients seen in their clinic including peri-operative coordination, test result follow-up, Epic in-basket messages and phone calls. Patients managed by previous Fellows will be considered part of the current Fellows’ panel.
• The Fellow will assist with the management of Andrology faculty Epic in-basket management, patient phone calls and administrative tasks, in particular, when faculty are out of the office.
• The Fellow will assist on-call Andrology faculty with call responsibilities when requested.
• The Fellow will assist with coverage as a proctor for the annual resident in-service exam. The Fellow will also cover the primary resident pager the night before and during the in-service exam.
• The Fellow will take primary call during resident appreciation day (may be fall or spring depending on the year) and may be asked to assist with primary call on a limited basis when residents have visiting professorships or conference duties. This varies year to year with the Oncology fellow, when applicable.
• Primary resident pager coverage (see above) will be shared equally among all fellows in the department.
• The Fellow will serve as a faculty coverage for the Urology resident clinic as needed.

The Fellow will take Urology attending call at UVA Hospital. The call schedule is shared among the entire UVA Urology faculty, and is approximately 4 weeks per year. Call begins on Monday morning and lasts one week at a time. A call team will include a urology resident, a urology chief resident, and an attending or Fellow.

• As a Clinical Instructor, the Andrology Fellow will have the same clinical privileges as urology faculty and will participate in general urology cases and attending call.
• Subspecialty andrology cases will be observed by the Andrology faculty until the faculty are able to make an entrustment decision. A graded, mentorship approach will be utilized with the Fellow taking on different aspects of these procedures based on faculty entrustment decision-making.
• Moonlighting is permissible if approved by the Andrology faculty and must be in compliance with the Urology department and UVA moonlighting policies.

The Fellow will take Urology attending call at UVA Hospital. The call schedule is shared among the entire UVA Urology faculty, and is approximately 4 weeks per year. Call begins on Friday night and lasts one week at a time. A call team will include a urology resident, a urology chief resident, and an attending or Fellow.

Research time comprises approximately 10% of the Fellowship. Abundant clinical research opportunities are available. The Fellow may be involved with research already underway. New research topics and opportunities are mandatory for the Fellow to begin their own research. Clinical research pertains to shockwave therapy for erectile dysfunction, prosthetic surgery outcomes and a variety of infertility topics including development of a new diagnostic test for infertility. Fellow is expected to submit one or more abstracts to a national meeting. The Fellow will accompany the program faculty to subspecialty national meetings during the Fellowship. The Fellow is required to submit one original research paper in addition to submitting one or two review papers, commentaries or book chapters.

The Fellow will serve as teaching faculty to UVA medical students and Urology residents. The Fellow is expected to attend weekly urology conferences including grand rounds. The Fellow will attend IVF conferences if available. They will also participate in formal Andrology didactics throughout the year including resident in-service preparation, journal club, scheduled andrology conferences and surgical labs. They are also expected to be present and participate in all Urology department educational conferences on non-andrology topics.

The Fellow will be allotted the same vacation time as that for UVA Faculty.  Please see your UVA Health onboarding packet for this information. The Fellow will be permitted to take time prior to the written boards for studying which will not count towards vacation time, but should be approved by the Fellowship faculty. All vacation dates must be approved in advance by the Fellowship Director(s). Please note that any changes in clinic including moving of clinic dates or cancellations of clinic must be done at least 45 days in advance per the Urology Department policy. Any changes or cancellations of clinic must be approved by the Fellowship and Urology Director(s). Meghan Rover can assist with your travel reservations. Jessica Shifflett can ensure that your travel costs remain under those budgeted by the department (changes annually). Clinic and teaching activities are an important component of the fellowship and as, such, clinics or teaching responsibilities cannot be routinely rescheduled so that a Fellow can attend a case.

Prior to travel for vacation or conferences, it is the fellow’s responsibility to ensure that all their clinical or non-clinical assignments (such as resident clinic, call, etc.) have appropriate coverage.  Coverage arrangements must be communicated to the Fellowship Director(s).