# The Evolving Role of Artificial Intelligence in Andrological Surgery: Current Landscape and Future Direction

## TL;DR

Artificial intelligence is transforming andrological surgery by improving diagnosis, surgical planning, and patient care, but more research and ethical guidelines are needed.

## Contribution

This review synthesizes current AI applications in andrological surgery and highlights future directions for precision medicine and ethical integration.

## Key findings

- AI models improve risk prediction and diagnosis of erectile dysfunction and support individualized surgical candidate selection.
- AI-driven tools enhance microsurgery through visualization and decision support, and monitor postoperative recovery and quality of life.
- Standardized datasets and ethical frameworks are crucial for the safe integration of AI into andrological care.

## Abstract

Background: With the rapid advancement of artificial intelligence (AI), its applications in andrology are expanding across diagnostic assessment, preoperative planning, intraoperative assistance, and postoperative management. This narrative review aims to synthesize current evidence regarding AI applications across the spectrum of andrological surgery. Methods: A comprehensive literature search was conducted using the PubMed, Scopus and Web of Science databases to identify relevant studies published between January 2020 and October 2025. The search strategy utilized combinations of keywords including “artificial intelligence,” “andrology,” “erectile dysfunction,” “male infertility,” “microsurgery,” and “robotic-assisted surgery.” Original research and review articles published in English were selected based on their clinical relevance to surgical practice. Results: AI has shown promise in the evaluation and management of erectile dysfunction (ED), male infertility-related microsurgery, and complex reconstructive procedures. AI-based models can improve risk prediction and diagnosis of ED, standardize semen analysis, support individualized selection of surgical candidates for varicocele repair and other interventions, and augment microsurgery through enhanced visualization and decision support. In the postoperative phase, AI-driven tools are being explored for complication prediction, functional recovery monitoring, and long-term quality-of-life follow-up, enabling more patient-centered, continuous care. Conclusions: AI holds significant promise for advancing precision medicine in andrological surgery by enhancing objective assessment and intraoperative guidance. However, large-scale, standardized datasets and rigorous multi-institutional validation are needed. Establishing robust ethical and legal frameworks will be essential to ensure the safe and effective integration of AI into routine andrological care.