Hossein Sadeghi-Nejad

Hossein Sadeghi-Nejad
Rutgers New Jersey Medical School | UMDNJ · Department of Urology

About

162
Publications
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Publications

Publications (162)
Article
Introduction Despite direct access to clinicians through the electronic health record, patients are increasingly turning to the internet for information related to their health, especially with sensitive urologic conditions such as Peyronie’s disease (PD). Large language model (LLM) chatbots are a form of artificial intelligence that rely on user p...
Article
Introduction Prior consensus meetings have addressed the relationship between phosphodiesterase type 5 (PDE5) inhibition and cardiac health. Given significant accumulation of new data in the past decade, a fourth consensus conference on this topic was convened in Pasadena, California, on March 10 and 11, 2023. Objectives Our meeting aimed to updat...
Article
Background Variations in climate have been associated with a greater risk of surgical site infections, urinary tract infections, and changes in the skin microbiome; however, limited data exist on the impact of climate on inflatable penile prosthesis (IPP) infections. Aim We sought to evaluate the impact of climate on the risk of IPP infections in...
Article
Introduction Intracavernosal injection (ICI) therapy for erectile dysfunction (ED) carries a risk of corporal fibrosis, potentially making placement of an inflatable penile prosthesis more difficult. Prostate cancer treatment may also induce corporal fibrosis. Objective To assess whether a history of ICI or prostate cancer treatment is associated...
Article
Purpose The purpose of this white paper is to educate health care professionals about the evolution of telemedicine (TM) and to propose a hybrid model that leverages the strengths of traditional in-person medicine as well as virtual medicine while maximizing the safety and quality of men’s sexual health care. Literature Search Strategy A literatur...
Article
Full-text available
Introduction Intracavernosal injection (ICI) therapy for erectile dysfunction (ED) carries a risk of corporal fibrosis, potentially making placement of an inflatable penile prosthesis more difficult. Prostate cancer treatment may also induce corporal fibrosis. Objective To assess whether a history of ICI or prostate cancer treatment is associated...
Article
Full-text available
Introduction Variations in climate have been associated with greater risk of surgical site infections, urinary tract infections, and changes in the skin microbiome. Although the pathogenic organisms for inflatable penile prosthesis (IPP) infections are commonly skin flora, limited data exists on the impact of climate on IPP infections. Objective W...
Article
Full-text available
Introduction Radiation therapy (RT) can predispose the onset of corporal fibrosis and microvasculopathy. The impact of RT on intra-operative complications is not well described in the literature. Objective In this study, we assess intra-operative and post-operative outcomes among patients with or without prior history of RT following primary Infla...
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Background In 1999, 1 year after the approval of the first oral phosphodiesterase type 5 (PDE5) inhibitor for the treatment of erectile dysfunction (ED), the first Princeton Consensus Conference was held to address the clinical management of men with ED who also had cardiovascular disease. These issues were readdressed in the second and third confe...
Article
Objective: To assess the difference in outcomes between single dilation (SingD) and sequential dilation (SeqD) in primary penile implantation, hypothesizing that patients who undergo sequential dilation had higher rates of non-infectious complications. Methods: We performed a multicenter, retrospective study of men undergoing primary IPP placeme...
Article
Background: Corporal fibrosis is known to result from prolonged priapism; however, the impact of the timing of penile prosthesis placement after priapism on complication rates is poorly understood. Aim: We sought to evaluate the impact of timing of inflatable penile prosthesis (IPP) placement on complications in men with a history of ischemic pr...
Article
Full-text available
Introduction Inflatable penile prosthesis (IPP) insertion is recommended for the treatment of patients with Peyronie’s Disease (PD) and significant erectile dysfunction (ED). Adjunctive procedures such as modeling, plication, or incision/excision and grafting can be used when there is residual curvature after IPP placement. Objective To evaluate t...
Article
Introduction The effect of the SARS-CoV-2 infection and vaccine on male fertility has been a cause of controversy. Studies have found that while active or recovering COVID-19 disease can be associated with decreased sperm counts and quality, the COVID vaccine is not. Despite evidence about the lack of association between the COVID-19 vaccine and ma...
Article
Introduction The American Urological Association (AUA) recommendations on antibiotic prophylaxis in penile implant surgery are based on low quality evidence and expert opinion. Recent evidence suggests the recommended regimens may be suboptimal. Objective To determine if the AUA recommended antibiotic regimen (vancomycin + gentamicin) for primary...
Article
Introduction Inflatable penile prosthesis (IPP) can be used in both acute and delayed management of priapism-induced erectile dysfunction. Prolonged priapism may result in corporal fibrosis that makes IPP placement more difficult. The current literature on IPP placement in men with a history of priapism is limited to small series and often single-c...
Article
Introduction Predictors of intraoperative corporal perforation and delayed cylinder complications in inflatable penile prosthesis (IPP) placement have not been well-delineated in the literature. Inflatable penile prosthesis (IPP) can offer high satisfaction rates of patients, but this procedure is not without complications that can be encountered i...
Article
Introduction Inflatable penile prosthesis (IPP) placement is associated with high postoperative patient satisfaction. Patients often express concerns about postoperative penile length. There is scant evidence in the literature of clinical and surgical factors that predict IPP length. Objective To evaluate predictors of cylinder length for men unde...
Article
Introduction In primary implant patients without significant corporal fibrosis, penile implant surgical technique varies in implementation of either single dilation (SingD) or sequential dilation (SeqD). Vigorous debate exists regarding both methods, but there is no robust evidence supporting one technique over the other in the literature. Objecti...
Article
Introduction Low testosterone is a common finding in aging men. Symptoms of low testosterone include fatigue, loss of libido, depression, and erectile dysfunction, among others. American Urologic Association (AUA) guideline approved treatments for low testosterone include testosterone replacement therapy (TRT) either intranasally, intramuscularly,...
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Purpose of Review This paper aims to survey current literature on urologic graduate medical education focusing on surgical autonomy. Recent Findings Affording appropriate levels of surgical autonomy has a key role in the education of urologic trainees and perceived preparedness for independent practice. Recent studies in surgical resident autonomy...
Article
Purpose: To determine if the AUA recommended prophylaxis (vancomycin + gentamicin alone) for primary inflatable penile prosthesis (IPP) surgery is associated with a higher infection risk than non-standard regimens. Materials and methods: We performed a multicenter, retrospective study of patients undergoing primary IPP surgery. Patients were div...
Article
Full-text available
Purpose: The prevalence of erectile dysfunction (ED) and the utilization of inflatable penile prosthesis (IPP) among prostate cancer patients are understudied. The aim of the study was to examine the relationships between ED, prostate cancer treatment type and IPP implantation in a national cohort. Materials and Methods: We identified a retrospecti...
Article
Objective : To examine stakeholder perspectives regarding the lack of in-person externships and transition to a virtual urology residency interview format. The unprecedented disruption from the COVID-19 pandemic forced an abrupt pivot to a “virtual” Urology Match for the 2021 cycle. We aim for our study to inform ongoing deliberations on the future...
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Defining the risks associated with diabetes mellitus in patients undergoing penile prosthesis implantation remains controversial. Our study aims to assess whether preoperative hemoglobin a1c and preoperative blood glucose levels are associated with an increased risk for postoperative infection in diabetic men. We performed a retrospective review of...
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Full-text available
Introduction YouTube is an unregulated platform that patients are using to learn about treatment options. Aim To assess the reliability of YouTube videos (YTVs) related to male hypogonadism and testosterone therapy. Methods Searching on YouTube by relevance and view count, we analyzed the top 10 videos (80 videos total) for the following search t...
Article
Introduction YouTube is the most used social media website, and there is a growing body of literature examining the reliability of healthcare information on this platform. Patients seeking men’s health information may be more likely to use YouTube owing to the sensitivity of these issues. Objectives The objective of this study is to review the lit...
Article
Full-text available
Purpose: We examined whether patients are appropriately screened for previous prolonged erections or priapism and counseled about trazodone complications, specifically prolonged erections and priapism, prior to trazodone treatment. Materials and methods: We identified patients under the age of 50 on trazodone as of February 27, 2019 at the VA Ne...
Article
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Background: Prior to the COVID-19 pandemic, urology was one of the specialties with the lowest rates of telemedicine and videoconferencing use. Common barriers to the implementation of telemedicine included a lack of technological literacy, concerns with reimbursement, and resistance to changes in the workplace. In response to the COVID-19 pandemi...
Article
Introduction Pharmacologically induced priapism is now the most common cause of priapism, with approximately 50% of drug-related priapism being attributed to antipsychotic usage. The majority of pharmacologic priapism is believed to result in ischemic priapism (low flow), which may lead to irreversible complications, such as erectile dysfunction. I...
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Full-text available
Background Modern-day penile prostheses use infection retardant coating to decrease rates of postoperative infection, subsequently reducing explantation and revision rates as well. The Coloplast Titan models are dipped into antimicrobial solutions right before implantation, and the components used for dipping can be tailored toward the patient. Ai...
Preprint
BACKGROUND Prior to the coronavirus disease 2019 (COVID-19) pandemic, urology was one of the specialties with the lowest rates of telemedicine and videoconferencing use. Common barriers to the implementation of telemedicine included a lack of technological literacy, concerns with reimbursement, and resistance to changes in the workplace. In respons...
Article
Purpose: American Urological Association (AUA) antibiotic prophylaxis recommendations may be insufficient for covering organisms commonly found in penile prosthesis infections. In this study we assess the difference between AUA recommended antibiotic prophylaxis and nonstandard prophylaxis in preventing device infections in penile prosthesis surge...
Article
Introduction Infection remains a prominent concern following penile implantation. Recognition of the risk factors for infection may help to guide surgeons toward reducing the risk of prosthetic contamination. Aim To gain a further understanding of infectious adverse events following penile prosthesis, we performed a systematic literature review....
Article
Introduction: Inadequate treatment of men with erectile dysfunction (ED) subjects them and their partners to lost quality of life, yet little is known about the cause and duration of symptoms that lead to penile prosthesis (PP) placement. Aim: We performed a systematic review addressing cause and duration of symptoms before implantation. Method...
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Full-text available
Background The influence of serious mental illness (SMI) on the treatment and survival of patients with high‐grade prostate cancer is not well understood. We compared the initial cancer treatment and cancer‐specific mortality of SEER‐Medicare patients with locoregional high‐grade (nonmetastatic) prostate cancer with and without preexisting SMI. Me...
Article
Background: Removal of the penile prosthesis reservoir can be technically challenging because of its difficult locations either deep in the pelvis or high in the abdominal wall. Aim: To describe a detailed surgical technique for reservoir removal through a penoscrotal approach. Methods: We describe our preferred method for removal of prostheti...
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Purpose: The purpose of this guideline is to provide a clinical strategy for the diagnosis and treatment of erectile dysfunction. Materials & methods: A systematic review of the literature using the Pubmed, Embase, and Cochrane databases (search dates 1/1/1965 to 7/29/17) was conducted to identify peer-reviewed publications relevant to the diagn...
Article
Introduction: There has been renewed interest in the use of subcutaneous testosterone pellets for the treatment of hypogonadism since the introduction of Testopel in 2008 by Slate Pharmaceuticals (Durham, NC, USA). Manufacturer guidelines recommend using two to six pellets; however, in the clinical setting, this is deemed insufficient. This has pr...
Article
Introduction: Despite recent advances in our knowledge and treatment strategies in Peyronie's Disease (PD), much remained unknown about this disease. Aim: To provide a clinical framework and key guideline statements to assist clinicians in an evidence-based management of PD. Methods: A systematic literature search was conducted to identify pub...
Article
Introduction Erectile dysfunction (ED) is a common disorder that has many potential etiologies, including hormonal imbalances, psychogenic factors, neurologic disorders, vascular insufficiency, and other risk factors. Cigarette smoking has been well established as a risk factor for cardiovascular disease and stroke, but the relation between smoking...
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Full-text available
In August 2015, an expert colloquium commissioned by the Sexual Medicine Society of North America (SMSNA) convened in Washington, DC, to discuss the common clinical scenario of men who present with low testosterone (T) and associated signs and symptoms accompanied by low or normal gonadotropin levels. This syndrome is not classical primary (testicu...
Article
The traditional inflatable penile prosthesis (IPP) reservoir placement is below the transversalis fascia in the space of Retzius. In 2002, Dr. Steve Wilson described ectopic reservoir placement, thereby providing a safe and effective alternative for implant surgeons. This new approach obviated the need for a second incision and decreased operative...
Article
The purpose of this guideline is to provide a clinical framework for the diagnosis and treatment of Peyronie's disease (PD). A systematic review of the literature using the Pubmed, Embase, and Cochrane databases (search dates 1/1/1965 to 1/26/15) was conducted to identify peer-reviewed publications relevant to the diagnosis and treatment of PD. The...
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Full-text available
Scrotal pain is a common complaint in a urological practice. Its diagnosis can prove challenging in both acute and chronic forms and requires a thorough and complete history and physical examination. This article discusses the evaluation and management of several entities of scrotal pain, including testicular torsion, epididymitis, postvasectomy pa...
Article
Introduction Medical malpractice and prostate cancer screening are important issues in the current landscape of health care. We identified factors contributing to litigation in the diagnosis of prostate cancer. Methods We used the Westlaw® database to search for jury verdict reports using the term medical malpractice combined with prostate cancer...
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Full-text available
Purpose Although penile duplex Doppler ultrasonography (PDDU) is a common and integral procedure in a Peyronie's disease workup, the intracavernosal injection of vasoactive agents can carry a serious risk of priapism. Risk factors include young age, good baseline erectile function, and no coronary artery disease. In addition, patients with Peyronie...
Chapter
Sexually transmitted infections (STIs) are common, with known complications in pregnancy such as miscarriage, preterm labor, stillbirth, and neonatal complications. Pelvic inflammatory disease is associated with female tubal infertility. The effect of these infections on male fertility is less clear. When investigating fertility issues in couples,...
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Full-text available
In recent years, the life expectancy for those living with human immunodeficiency virus (HIV) with access to combined antiretroviral therapy (cART) has increased. As men live longer, the role testosterone plays in sexual function as well as in general well-being is becoming increasingly important. Here we discuss the available literature concerning...
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Full-text available
Introduction We reviewed retrospectively the use of penile prostheses, including the indications and complications of penile prosthesis surgery. Methods We identified publications and the reported advances in penile prosthesis surgery between 1987 and 2012 in Pub-Med, and published information from American Medical Systems, Inc. (Minnetonka, MN, U...
Article
The newest data related to the Human Immunodeficiency Virus (HIV) / Acquired Immune Disease Syndrome (AIDS) epidemic is primarily positive, but many areas of the world, especially Sub-Saharan Africa, remain disproportionately affected. Between 2005 and 2007, three large randomized trials evaluating circumcision for prevention of HIV acquisition in...
Article
Introduction The Sexual Medicine Society of North America (SMSNA) includes as its members the most experienced prosthetic surgeons in North America who implant inflatable penile prostheses (IPPs). Obliteration of the space of Retzius (SOR) resulting from robotic‐assisted laparoscopic prostatectomy (RALP) is a growing concern that has prompted many...
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Full-text available
Infertility affects about 8% to 12% of couples, with male infertility being responsible for about 30% of cases. Sexually transmitted infections (STIs) are known to cause complications of pregnancy and are associated with tubal infertility in females, but the association with male fertility is still controversial. The prevalence of curable STIs has...
Article
Introduction: Vacuum erection devices (VEDs) have been approved in the United States since 1982 and offer a viable alternative to oral phosphodiesterase type 5 inhibitors (PDE5i), injections and transurethral suppositories. Studies have demonstrated efficacy in erectile dysfunction (ED) associated with a variety of conditions. More recently, this...
Chapter
The broader availability of antiretroviral therapies and generally increased life expectancy for men and women living with the HIV have resulted in higher prevalence of complications related to the infection itself as well as those related to the therapies. This chapter reviews the prevalence of hypogonadism in HIV disease in men, the likely etiolo...