Martin M Miner

Martin M Miner
Brown University · Division of Urology

MD

About

176
Publications
16,942
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4,388
Citations
Citations since 2017
7 Research Items
2125 Citations
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Introduction
Martin M Miner currently works at the Division of Urology, Brown University. Martin does research in Andrology, Cardiology and Urology. Their current project is 'Testosterone' and cardiometabolic health and safety.

Publications

Publications (176)
Article
Full-text available
Introduction: Cligosiban is an orally administered oxytocin receptor antagonist being developed to treat premature ejaculation (PE). Aim: To determine the safety and efficacy of cligosiban capsules (dose range 400-800 mg) to improve intravaginal ejaculation latency time (IELT) and patient-reported outcomes in men with severe lifelong PE. Method...
Article
Full-text available
Introduction: Cligosiban is an orally administered, centrally penetrant oxytocin receptor antagonist being developed to treat premature ejaculation (PE). Aim: To determine the efficacy of 3 dose levels of cligosiban caplets to prolong intravaginal ejaculation latency time (IELT) and improve patient-reported outcomes in men with lifelong PE. Met...
Article
In this review, we focus on current trends in the management of male lower urinary tract symptoms (LUTS), defined here as LUTS, namely, storage, voiding, and post-micturition symptoms presumed secondary to benign prostatic hyperplasia (BPH), and discuss possible novel approaches toward better care. According to results of a PubMed database search c...
Article
Full-text available
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
A variety of methods for testosterone replacement therapy (TRT) exist, and the major potential risks of TRT have been well established. The risk of developing polycythemia secondary to exogenous testosterone (T) has been reported to range from 0.4% to 40%. Implantable T pellets have been used since 1972, and secondary polycythemia has been reported...
Chapter
This chapter discusses the latest evidence for the metabolic investigation of erectile dysfunction as it relates to cardiometabolic risk and visceral adiposity, the key component of metabolic syndrome. The authors illustrate this concept with a clinical example from their own practice, and the metabolic investigation of ED as it relates to the etio...
Article
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
Background: The association between subclinical cardiovascular disease and subsequent development of erectile dysfunction (ED) remains poorly described. Hypothesis: Among multiple subclinical atherosclerosis and vascular dysfunction measurements, coronary artery calcium (CAC) score best predicts ED. Methods: After excluding participants taking...
Chapter
Over one-third of men over the age of 45 years in the United States have defined testosterone deficiency based upon decreased serum testosterone levels and related symptoms. This clinical entity has been associated with specific sexual signs and symptoms including decreased libido, erectile dysfunction, and loss of spontaneous erections. It is also...
Article
Objective: To analyze the proportion of men taking tadalafil 5mg once-daily who reach a combined improvement (henceforth known as a combined responder) in symptoms of both erectile dysfunction (ED) and lower urinary tract symptoms associated with benign prostatic hyperplasia (LUTS/BPH). Materials and methods: Data from men aged ≥45 years randomi...
Article
Little is known about how total testosterone and estradiol-17β influence lower urinary tract symptoms (LUTS) in men with benign prostatic hypertrophy (BPH). We analyzed data from a subset of men aged ≥18 years randomized to tadalafil 5 mg once-daily or placebo who had ≥6 month history of LUTS and an International Prostate Symptom Score (IPSS)≥13 en...
Article
Full-text available
Identification of vasculogenic erectile dysfunction (ED) should be used to focus preventive efforts on reducing the risk of future cardiovascular events. For younger men 40 to 60 years old believed to have predominantly vasculogenic ED, we recommend an algorithm for further assessment of cardiovascular disease modified from the 2013 American Colleg...
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...
Article
Cardiovascular disease and erectile dysfunction are commonly encountered disorders in men of advancing age that share a common pathophysiologic pathway with endothelial dysfunction. Metabolic syndrome and its various components play pivotal roles in the development of both cardiovascular disease and erectile dysfunction. The evaluation and manageme...
Article
Full-text available
The role of testosterone in the cardiovascular (CV) health of men is controversial. Data suggest that both the condition and treatment of clinical hypogonadism is associated with decreased CV mortality; however, two recent studies suggest that hypogonadal subjects treated with testosterone replacement therapy have a higher incidence of new CV event...
Article
An erection is a mechanical event dependent primarily on corporeal vascular dynamics wherein arterial inflow and storage of blood within the corpora is greater than the egress of blood from the corpora. The most common cause of erectile dysfunction (ED) is the inability of the corporal tissue to store the blood within the corporal sinusoids once in...
Article
Full-text available
Erectile dysfunction (ED) is a form of sexual dysfunction that is estimated to affect > 30% of men between the ages of 40 and 70. As a result of an improved understanding about the pathophysiology of ED and improved treatment options, an increasing number of men are presenting for evaluation than several decades ago. In fact, many of these men are...
Article
Full-text available
Two recent studies raised new concerns regarding cardiovascular (CV) risks with testosterone (T) therapy. This article reviews those studies as well as the extensive literature on T and CV risks. A MEDLINE search was performed for the years 1940 to August 2014 using the following key words: testosterone, androgens, human, male, cardiovascular, stro...
Article
The primary care provider is in an optimal position to identify and care for the patient affected by prostate-related lower urinary tract symptoms (LUTS). This assessment can be readily accomplished with a good history and only a few simple, in-office tests. Unfortunately, the modern provider may believe that they do not have the experience, comfor...
Article
Testosterone deficiency (TD) afflicts approximately 30% of men ages 40-79 years, with an increase in prevalence strongly associated with aging and common medical conditions including obesity, diabetes, and hypertension. There appears to be a strong relationship between TD and metabolic syndrome, though the relationship is not certain to be causal....
Article
In the primary care office the evaluation of prostate related lower urinary tract symptoms (BPH-LUTS) in the male can be confusing. Are the symptoms, in fact, from the prostate or is there another etiology such as the bladder or medical conditions causing or contributing to the problems? If the cause is the prostate, how does the physician choose f...
Article
Patients with urologic conditions may present to a primary care physician (PCP) in the emergency department or in the PCP's office. Some conditions are true emergencies that require immediate surgical intervention. Others may require medical treatment or possibly simply reassuring the patient that there is no serious medical problem. Sometimes the...
Article
The evaluation and treatment of overactive bladder (OAB) starts in the primary care office and can be accomplished efficiently, effectively and, most importantly, safely. With appropriate knowledge of the disease and an understanding of what to look for the primary care physician (PCP) can readily make the empiric diagnosis and initiate treatment....
Article
An association between erectile dysfunction (ED) and cardiovascular disease has long been recognized, and studies suggest that ED is an independent marker of cardiovascular disease risk and even further, a marker for the burden of both obstructive and non-obstructive coronary artery disease. Therefore, the primary care physician (PCP) must assess t...
Article
A variety of methods for testosterone replacement therapy (TRT) exist, and the major potential risks of TRT have been well established. The risk of developing polycythemia secondary to exogenous testosterone (T) has been reported to range from 0.4% to 40%. Implantable T pellets have been used since 1972, and secondary polycythemia has been reported...
Article
Full-text available
Objective Low testosterone levels and increased aortic stiffness are predictors of cardiovascular events. The influence of androgen level on the age- and blood pressure-related increase in aortic stiffness is unknown. Methods From January 2007 to June 2011 we enrolled 455 consecutive men with no evidence of cardiovascular disease from a large coho...
Article
We investigate the impact of dutasteride on prostate specific antigen (PSA) and prostate volume in men receiving testosterone (T) therapy. Twenty-three men on stable dose T therapy were randomised to receive either dutasteride or placebo for 12 months. Serum levels of PSA, T and dihydrotestosterone (DHT) and responses to the International Index of...
Article
This resource provides an evidence-based perspective on the health problems that affect men and the ways in which such problems may be prevented or treated utilizing a broad range of approaches. It covers how integrative treatments are becoming more popular with men whose healthcare providers understand that most of the leading causes of morbidity...
Article
This chapter discusses the latest evidence for the metabolic investigation of erectile dysfunction as it relates to cardiometabolic risk and visceral adiposity, the key component of metabolic syndrome. The author illustrates this concept as it relates to the etiology of ED and cardiovascular risk stratification utilizing the latest guidelines of ca...
Article
Objective: Peyronie's disease (PD) is a progressive fibrotic disorder of the penis that is characterized by formation of collagen plaques on the tunica albuginea of the penis that may result in penile deformity, pain (typically early in the disease course), and often occurs in conjunction with erectile dysfunction. This review's purpose is to rais...
Article
The primary care provider is in an optimal position to identify and care for the patient affected by prostate-related lower urinary tract symptoms (BPH-LUTS). This assessment can be readily accomplished with a good history and only a few simple, in-office tests. In some instances, the primary care provider may believe that they do not have the expe...
Article
The ability to attain and then maintain an erection is the result of a dynamic balance between arterial inflow and cavernosal outflow. Any imbalance that either decreases arterial inflow and/or increases cavernosal outflow may result in symptomatic erectile dysfunction (ED). Current data suggest that vasculogenic ED is of arterial origin and primar...
Article
Male rejuvenation, defined as a process in men to both limit the impact of aging on body image and experience greater virility, is growing among middle-aged and older men. While rejuvenation was primarily in the domain of the younger male athlete with the use of performance enhancing hormones or in the aging woman through the use of cosmetic surger...
Article
Erectile dysfunction (ED) and cardiovascular disease (CVD) share risk factors and frequently coexist, with endothelial dysfunction believed to be the pathophysiologic link. ED is common, affecting more than 70% of men with known CVD. In addition, clinical studies have demonstrated that ED in men with no known CVD often precedes a CVD event by 2-5 y...
Article
Full-text available
Background: Testosterone decline becomes more prevalent as men age and symptomatic testosterone deficiency is associated with potentially serious comorbidities. Despite limitations, registries can provide an opportunity to accumulate data regarding disease management in a typical patient population, including diagnosis, treatment, and outcomes. M...
Article
Full-text available
Background: Although hypogonadism is common in men with human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS), testosterone levels after testosterone replacement therapy (TRT) in this population have not been reported. Methods: The Testim Registry in the United States (TRiUS) was the first prospective, observational regist...
Article
Purpose: We established erectile dysfunction as an often neglected but valuable marker of cardiovascular risk, particularly in younger men and men with diabetes. We also reviewed evidence that lifestyle change, combined with informed prescribing of pharmacotherapies used to mitigate cardiovascular risk, can improve overall vascular health and sexu...
Article
Purpose: The role of endothelial function testing using peripheral artery tonometry (PAT) in the evaluation of ED is not well established. Endothelial dysfunction is expected to be more common in men presenting with general or vasculogenic ED, compared with men who develop ED after prostatectomy. This study evaluated whether PAT could help identif...
Article
Full-text available
Testosterone levels naturally decline with age in men, often resulting in testosterone deficiency (hypogonadism). However, few studies have examined hypogonadal characteristics and treatment in older (≥65 years) men. To compare data at baseline and after 12 months of testosterone replacement therapy (TRT) in hypogonadal men ≥65 vs <65 years old. Da...
Article
The Princeton Consensus (Expert Panel) Conference is a multispecialty collaborative tradition dedicated to optimizing sexual function and preserving cardiovascular health. The third Princeton Consensus met November 8 to 10, 2010, and had 2 primary objectives. The first objective focused on the evaluation and management of cardiovascular risk in men...
Article
Multiple published studies have established erectile dysfunction (ED) as an independent risk marker for cardiovascular disease (CVD). In fact, incident ED has a similar or greater predictive value for cardiovascular events than traditional risk factors including smoking, hyperlipidemia, and family history of myocardial infarction. Here, we review e...
Chapter
Historically, erectile dysfunction (ED), as all sexual dysfunctions, has been relegated to a lower priority in a busy primary care practice. However, it is becoming evident that ED will not only accompany disease states of high comorbidity, but also can serve as an early marker for some patients presenting without established cardiovascular disease...
Article
Full-text available
Among patients with hypogonadism-associated comorbidities, opioid users have the highest incidence of hypogonadism. Data from the Testim Registry in the United States were analyzed to determine the efficacy of testosterone replacement therapy in opioid users vs nonusers. Prospective, 12-month observational cohort registry. Hypogonadal men (N = 849)...
Article
Hypoactive sexual desire disorder (HSDD) is the most common female sexual dysfunction (FSD) and is thus frequently encountered in the primary care provider and OB/GYN practices. Causes of low sexual desire may be hormonal, neurologic, vascular, psychologic, or a result of illness/surgery or medications. The condition is often left untreated because...
Article
Female sexual function is dependent, in part, upon normal endothelial function within the genital arterial (hypogastric-cavernosal) vascular bed. The first two Princeton Consensus Conferences were focused on relationships between male sexual function and cardiovascular health, and development of contemporary clinical guidelines for dysfunction mana...
Article
An office evaluation of men's health in primary care requires a thorough understanding of the implications of male sexual dysfunctions, hypogonadism, and cardiometabolic risk stratification and aggressive risk management. The paradigm of the men's health office visit in primary care is the recognition and assessment of male sexual dysfunction, spec...
Article
Full-text available
To determine the effect of long-term testosterone replacement therapy (TRT) on depression symptoms in hypogonadal men. Data were from TRiUS, a multicenter, 12-month observational registry (N = 849) of hypogonadal men prescribed 1% testosterone gel. Measures including total testosterone (TT) were assessed at baseline and months 3, 6, and 12. Depress...
Article
Full-text available
Background: Recent evidence suggests that there may be a bidirectional, physiological link between hypogonadism and metabolic syndrome (MetS), and testosterone replacement therapy (TRT) has been shown to improve some symptoms of MetS in small patient populations. We examined the effect of 12 months of TRT on MetS components in a large cohort of hy...
Article
Full-text available
We measured prostate specific antigen after 12 months of testosterone replacement therapy in hypogonadal men. Data were collected from the TRiUS (Testim® Registry in the United States), an observational registry of hypogonadal men on testosterone replacement therapy (849). Participants were Testim naïve, had no prostate cancer and received 5 to 10...
Article
We examined the evaluation of and management for lower urinary tract symptoms/benign prostatic hyperplasia by physician specialty (urologist vs primary care physician). The BPH Registry and Patient Survey is a longitudinal, observational, disease registry cohort of patients enrolled from January 2004 to February 2005 in the United States. The surve...
Article
Full-text available
Up to 30% of erectile dysfunction (ED) patients treated with phosphodiesterase type 5 (PDE5) inhibitors do not show improved sexual function, which may be due in part to low serum testosterone. Hypogonadal patients already receiving testosterone replacement therapy (TRT) likewise can still suffer from symptoms of sexual dysfunction. In these patien...
Article
Testosterone deficiency (TD) afflicts approximately 30% of men aged 40-79 years, with an increase in prevalence strongly associated with aging and common medical conditions including obesity, diabetes, and hypertension. A strong relationship is noted between TD and metabolic syndrome, although the relationship is not certain to be causal. Repletion...
Article
Full-text available
Testosterone deficiency (TD) is prevalent among men seeking medical attention and may be associated with other comorbidities. The Testim(®) Registry in the United States (TRiUS), a large, multicenter, prospective, 12-month observational cohort registry, was established to quantify symptoms and comorbidities of hypogonadal men in real-world clinical...
Article
Erectile dysfunction (ED) is a marker of increased cardiovascular (CVS) risk and may indicate the need for aggressive evaluation for cardiovascular disease (CVD). In younger men with ED, the Framingham risk assessment has inadequate sensitivity. There is a need to develop a more sensitive risk-stratification protocol for this population. We sought...
Article
Hypogonadism (HG) is a clinical disorder consisting of reduced testosterone (T) levels and characteristic signs and symptoms of low T. Current instruments used to assess hypogonadal symptoms in men lack adequate measurement properties. To present data on the quantitative validation of a new self-report instrument (HG Screener) developed to identify...
Article
Evaluation of cardiometabolic risk has become vital in primary prevention of adverse vascular events (coronary artery disease, heart attack, stroke or congestive heart failure), particularly in younger middle-aged men (40-60 years old). To discern the prevalence of events in these men, clinicians often stratify cardiovascular risk and treat accordi...
Article
Full-text available
Results are reported from the first two adequate trials of the PDE-5 inhibitor vardenafil using a stopwatch to precisely measure erection duration in men with ED. Two randomized, multicenter, double-blind, placebo-controlled trials were conducted: a crossover 4-week treatment in men with ED (ENDURANCE) and a parallel group, 12-week treatment in men...
Article
Androgens not only play an important role in the development and function of the prostate but they are also intimately involved in the development and progression of prostate cancer (PCa). Within the prostate, testosterone is converted to the more potent androgen dihydrotestosterone (DHT) via the action of 5α-reductase enzymes. DHT is the primary p...
Article
Assess support for a recommendation to add screening for both erectile dysfunction (ED) and hypogonadism to the initial medical evaluation of young-to-middle aged (≥ 40 years of age) men in light of recent guidelines suggesting prostate-specific antigen screening occur at that age. A search of literature published from 1998 to 2009 was performed. S...
Article
Full-text available
Purpose: We measured prostate specific antigen after 12 months of testosterone replacement therapy in hypogonadal men. Materials and Methods: Data were collected from the TRiUS (Testim® Registry in the United States), an observational registry of hypogonadal men on testosterone replacement therapy (849). Participants were Testim naïve, had no prost...