IJIR: Your Sexual Medicine Journal https://doi.org/10.1038/s41443-020-0280-2 CORRESPONDENCE The Italian andrology patient is changing. Broader cultural knowledge is needed! Guglielmo Mantica 1 ● Aldo Franco De Rose 1 ● Francesca Ambrosini 1 ● Fabrizio Gallo 2 ● Franco Gaboardi 3 ● Felice Durand 1 ● André Van der Merwe 4 ● Carlo Terrone 1 Received: 6 January 2020 / Accepted: 6 April 2020 © The Author(s), under exclusive licence to Springer Nature Limited 2020 To the Editor: The inexorable process of globalization has been taking place for decades and is slowly changing the European demography. In particular, the last two decades have been characterized by a critical migratory flow of people mainly coming from Africa and moving towards Europe. Many countries such as Italy and Germany count hundreds of thousands of migrants crossing their borders every year in search of better opportunities and a new life [1]. Migrations are a natural process of human history and are known to influence the epidemiology of certain diseases both in the migrant groups and in nations receiving them [2]. For this reason and given the important globalization phenomenon that has been taking place in recent years, migratory medicine is emerging and growing in importance [3]. However, although most migrant populations generally consist of relatively young age groups, there are no studies focused on the andrological field. In this light, this study aimed to evaluate the impact of migration on the andrology clinics (ACs) of Italian insti- tutions in order to provide better information to clinicians aimed to improve healthcare. A retrospective review of all visits to the urology and andrology outpatient clinics between January and June 2019 was performed at three Italian tertiary centers of different major cities. The total number of patients, epidemiological characteristics, and diseases of the not-European Union born (NE) patients were recorded both for those who were referred to the AC and for those who were referred to the urology outpatient clinic (UC). The causes for referral to the AC of the NE patients were evaluated and compared with those of the European Union born (EU) patients. A descriptive statistical analysis was performed. Variables are presented as median (1st–3rd interquartile range) and or as a percentage (%). The statistical analysis of nominal variables was done using the Chi-Square test and for nonparametric variables using the Mann–Whitney test. The level of sig- nificance was set at p < 0.05. A total of 8425 visits were made to the three centers, of which 7998 were urological and 427 andrological. In the UC group, the sample consisted of 379 (4.74%) NE patients out of 7998 patients, while in the AC group, there were 74 (17.3%) out of 427 (p < 0.0001). Within the AC group, the median age of NE patients (40; 34–48) was significantly lower than that of European patients (44; 33–54) (p < 0.0009). Overall, the reason for referral among AC group patients did not differ significantly between NE and Eur- opean born patients (Table 1)(p = 0.45). However, and considering the limitations of the small sample, about 45% of EU patients attended the andrological examination for Peyronie’s disease, compared with about 36% of NE patients (p = 0.13). Similarly, about 22% of the NE patients (and in particular the 25% of the African group) referred to the AC for infertility, against 14% of EU patients (p = 0.1) (Table 1). The identikit of the migrant is generally that of a young person eager to improve his life and who is young enough to sustain a demanding journey. In our opinion, young age is most likely the main reason for this significant difference in terms of access to the AC compared with the UC. NE patients did not show any difference in terms of the type of disease compared to locals. However, this does not mean that the andrologist should not pay more attention to these patients and trends. * Guglielmo Mantica guglielmo.mantica@gmail.com 1 Department of Urology—Policlinico San Martino Hospital, University of Genova, Genova, Italy 2 Department of Urology, San Paolo Hospital, Savona, Italy 3 Department of Urology—San Raffaele Turro Hospital, San Raffaele University, Milan, Italy 4 Department of Urology, Stellenbosch University and Tygerberg Academic Hospital, Cape Town, South Africa 1234567890();,: 1234567890();,: