Ranjith Ramasamy

• Doctor of Medicine
• Consultant Urologist at Jumeirah American Clinic

Introduction: Erectile dysfunction (ED) pathophysiology involves complex interactions between vasculogenic, hormonal, and neurological mechanisms, with endothelial dysfunction and oxidative stress playing crucial roles. There is growing interest in intravenous (IV) peptides and amino acids as potential therapeutic options for ED treatment. Areas...

Purpose: This narrative review aims to provide the most updated knowledge regarding the treatment of adverse effects secondary to testosterone replacement therapy (TRT), such as gynecomastia, cardiovascular and hematologic risks, prostate health risk, and liver dysfunction risks. Materials and Methods: An extensive literature review was conducted,...

Background Reproductive health technology has evolved significantly since the introduction of in vitro fertilization in 1978, enhancing the possibility of conceiving children at later stages in life. Despite these advancements, there remains a critical gap in fertility knowledge among young adults, as demonstrated by recent studies. This gap is com...

Introduction This video aims to present an in-depth, step-by-step tutorial on microsurgical reconstruction for obstructive azoospermia, featuring a distinctive case involving anastomosis from vas deferens to rete testis. The video endeavors to disseminate expertise, methodologies, and perspectives that can be advantageous to individuals grappling w...

Introduction Peyronie’s Disease (PD) is a medical condition characterized by localized inflammation in the penile tunica albuginea, leading to the formation of fibrotic plaques. These plaques cause penile curvature and painful erections, significantly impacting the quality of life for affected individuals. Current therapeutic options for PD are lim...

Background Varicocele, a common vascular abnormality surrounding the testis, is known to be associated with impaired semen parameters and male infertility in adults. However, its impact on the adolescent and young adult (AYA) population is less well known. Objectives The study aimed to assess the improvement in sperm parameters following varicocel...

We evaluated depression-related health care resource utilization and antidepressant prescription medication utilization among commercially insured men in the United States who underwent inflatable penile prosthesis (IPP) implantation between January 1, 2007 and December 31, 2020, and who received a depression diagnosis in the year preceding the IPP...

Purpose: There is a lack of pooled data exploring the time and rates for human chorionic gonadotropin (hCG) monotherapy vs. combination therapies (hCG+human menopausal gonadotropin or recombinant human follicle-stimulating hormone) to restore spermatogenesis in azoospermic men with congenital hypogonadotropic hypogonadism (CHH). We aimed to invest...

Purpose: Intracavernosal injections are used to treat erectile dysfunction. Patient compliance with intracavernosal injections is required for success, though factors influencing compliance are unknown. This study aimed to identify factors that influence compliance with intracavernosal injections among men with erectile dysfunction. Materials and...

The SARS-CoV-2 coronavirus (COVID-19) pandemic has had widespread implications on various aspects of life; however, there is a paucity of longitudinal data regarding its impact on sexual behavior. To assess the impact of the COVID-19 pandemic on changes in frequency of sexual activity and partner dynamics in the United States, we utilized data from...

Introduction Testosterone deficiency is a clinical disorder due to either failure of the testes to produce testosterone or failure of the hypothalamus or pituitary to produce sufficient gonadotropins. Previous formulations of oral testosterone therapy, particularly methyltestosterone, have been associated with adverse liver effects. Many different...

We describe the development of an elastomer-molded vas model as a microsurgical training tool, particularly for vasectomy reversals. This microsurgical training tool is formed by molding polydimethylsiloxane into a vas deferens shape with a patent lumen through the use of a 3D printed mold and simple monofilament wires. The expanded use of our vas...

Objective To describe the evidence of Platelet Rich Plasma (PRP), Stem cells therapy (SCT) and Extracorporeal shockwave therapy (ESWL) for the treatment of Peyronies disease (PD), including information from the main urological society guidelines. Materials and Methods A literature review of PubMed articles published between 2000 and 2023 was condu...

Introduction Obstructive azoospermia occurs when there is a blockage in the male reproductive tract, leading to a complete absence of sperm in the ejaculate. It constitutes around 40% of all cases of azoospermia (¹1. Ghieh F, Mitchell V, Mandon-Pepin B, Vialard F. Genetic defects in human azoospermia. Basic Clin Androl. 2019;29:4. doi: 10.1186/s126...

Background The effects of bariatric surgery on testosterone levels in men with obesity and hypogonadism have not been thoroughly explored yet. Objectives To investigate the possible effects of bariatric surgery on T levels in obese hypogonadal men by comparing T levels before and after surgery using a comprehensive claims database. Materials and...

The proliferation of microplastics (MPs) represents a burgeoning environmental and health crisis. Measuring less than 5 mm in diameter, MPs have infiltrated atmospheric, freshwater, and terrestrial ecosystems, penetrating commonplace consumables like seafood, sea salt, and bottled beverages. Their size and surface area render them susceptible to ch...

Background: Daily (once a day [OaD]) tadalafil intake is a valuable option for men favoring spontaneous over scheduled sexual intercourse. Aim: The study sought to assess the rate of and the clinical factors associated with spontaneous, medication-free erectile function (EF) recovery after discontinuation of tadalafil 5 mg OaD in a cohort of you...

Purpose of Review This narrative review aims to outline the current available evidence, challenges, and future perspectives of Artificial Intelligence (AI) in the diagnosis and management of priapism, a condition marked by prolonged and often painful erections that presents unique diagnostic and therapeutic challenges. Recent Findings Recent advan...

Inflatable penile prosthesis (IPP) implantation is a surgical approach for the management of erectile dysfunction (ED). A feared complication is IPP infection, and increased operative time is a risk factor for infection. Exposure of an IPP implant to ambient air in the operating room (OR aerobiome) is thought to contribute to risk of infection from...

Purpose This video aims to present an in-depth, step-by-step tutorial on microsurgical reconstruction for obstructive azoospermia, featuring a distinctive case involving anastomosis from vas deferens to rete testis. The primary aim of this endeavor is to offer thorough and practical insights for healthcare professionals and researchers within the r...

Background and objective: No clear-cut markers for predicting positive sperm retrieval (+SR) at microdissection testicular sperm extraction (mTESE) have been identified thus far. Our aim was to conduct a systematic review and meta-analysis to evaluate the ability of follicle-stimulating hormone (FSH), inhibin B (InhB), and anti-Müllerian hormone (A...

Background Existing literature does not provide accurate epidemiological data regarding the true prevalence of men with non‐obstructive azoospermia (NOA) who would be eligible for hormonal optimization therapy, according to specific pre‐treatment criteria. Objectives To investigate the characteristics of those men with NOA who would qualify for th...

Bibliometric analyses serve to identify influential articles that have shaped medical practice and fostered new research ideas. Over the past decade, research in andrology has witnessed exponential growth, with an increasing number of academic publications, collaborations, and research innovations. However, there is a lack of literature that has id...

Purpose: This meta-analysis aimed to determine the efficacy and safety of antioxidant supplementation for treating erectile dysfunction (ED). Materials and methods: We systematically searched MEDLINE, Embase, and the Cochrane Library for double-blind, randomized, placebo-controlled trials of oral antioxidant supplementation in men with ED. Erect...

Introduction Sexual dysfunction is highly prevalent among men of reproductive age. Clinical practice guidelines have been established to assist providers in identification and education of patients who are at increased risk for infertility and sexual dysfunction with certain congenital and acquired urogenital disorders. The authors sought to review...

A subset of men with prostate cancer have elevated periprostatic androgens compared with levels in peripheral blood (termed the sneaky T phenomenon), which are associated with poor clinical outcomes after radical prostatectomy. These androgens are of testicular origin and reach the prostate, presumably through venous shunting. Varicocele physiology...

Penile prosthesis implantation (PP surgery) is a well-established solution for severe, medication-refractory erectile dysfunction (ED). Despite its effectiveness, limited data exists on patient characteristics influencing the timing of PP surgery after ED onset. We aimed to investigate predictors for early PP surgery and compare preoperative factor...

Testosterone deficiency is a prevalent condition that frequently affects individuals with end-stage renal disease (ESRD) and those who have undergone renal transplantation. While the etiology of this condition is complex, its implications in this population are far-reaching, impacting various domains such as endocrine profile, sexual and erectile f...

Objective: This retrospective study aimed to evaluate the effectiveness of low-dose prednisone as a rescue therapy for patients with deteriorating semen parameters following vasovasostomy. Materials and methods: Electronic medical records were queried at the University of Miami with documented CPT code 55400 (Bilateral Vasovasostomy) between Jan...

Introduction Erectile Dysfunction (ED) is a common challenge post Radical Prostatectomy (RALP), affecting men’s sexual health after undergoing definitive cancer therapy. Despite employing nerve-sparing techniques, ED remains a prevalent issue in this population. Studies indicate that approximately 70%–85% of men experience varying degrees of ED fol...

Introduction Erectile dysfunction (ED) is a common condition that affects millions worldwide. Patients and urologists alike are seeking alternative therapies that can provide long-lasting results in the treatment of ED. This review provides a comprehensive overview of restorative treatments available for ED, such as platelet-rich plasma, stem cell...

Introduction: Men seeking treatment for sexual dysfunction can experience embarrassment as a result of stigma. This research manuscript presents the findings of a survey conducted to investigate the influence of humor on prospective patients' preferences when selecting a specialist to address erectile dysfunction (ED). Methods: The respondents were...

Introduction Treatment methodology for erectile dysfunction can vary from surgeon to surgeon. The It MATTERS registry has been developed to align prospective, long-term, real-world outcomes with current clinical practice. It MATTERS is an immediate avenue (following market approval of a product) to collect and monitor real-world data on existing an...

Peyronie's Disease (PD) is characterized by fibrotic plaques in the penile tunica albuginea, causing curvature and painful erections. Current treatments have limited established efficacy. Platelet-Rich Plasma (PRP), known for modulating inflammation, offers a potential alternative. This randomized, placebo-controlled, crossover study at the Univers...

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...

Introduction In the present era, the extensive use of modern cell phones has raised the health risks associated with the radiofrequency-electromagnetic radiation (RF-EMR) they emit, which the human body can absorb. RF-EMR exposure can potentially harm the process of spermatogenesis by increasing oxidative stress, elevating mitochondrial reactive ox...

Introduction Xiaflex (Collagenase Clostridium Histolyticum) is an FDA-approved treatment for patients with Peyronie’s Disease. However, despite its approval and widespread implementation in clinical practice, there is concern that urologists in training are offered minimal exposure to its use. Objective Thus, the purpose of this study was to evalu...

Introduction With therapy advances, people with cystic fibrosis (CF) are living longer, healthier lives, and thus increasingly have general and CF-specific sexual and reproductive health (SRH) questions. The CF Foundation is supporting the Sexual Health, Reproduction, and Gender Research (SHARING) Working Group to identify knowledge gaps, research...

Introduction Health literacy plays a crucial role in enabling patients to understand and effectively use medical information. As technology rapidly advances, the significance of health literacy becomes even more pronounced, particularly in comprehending complex medical information. Artificial Intelligence (AI) platforms have garnered significant at...

Introduction The notion of a potential difference between men and women in post-coital time-to-sleep has received attention in mainstream media, perpetuating the stereotype that men fall asleep first (1-7). However, scientific literature on this topic is limited and inconclusive (8-10). It is imperative that we establish a clearer understanding of...

Introduction Therapeutic approaches focusing on tissue neovascularization play a crucial role in the development of treatments for erectile dysfunction (ED). Autologous Platelet-Rich Plasma (PRP) and Low-Intensity Shockwave Therapy (SWT) are two restorative therapies that potentially target underlying causes of ED. Pre-clinical evidence suggests th...

Introduction Elevated C-Reactive Protein (CRP) and testosterone deficiency are associated with advanced age and chronic inflammatory diseases, such as cancer, diabetes, and cardiovascular disease. Testosterone decreases inflammation through several mechanisms, and testosterone replacement therapy (TRT) has been shown to lower CRP levels in aging, h...

Introduction Inflatable penile prosthesis (IPP) is widely considered medically necessary and a definitive treatment to restore erectile function, yet employer benefit exclusion and lack of insurer coverage of IPP implantation among non-Medicare men may limit their access to the treatment that can negatively impact quality of life. While previous re...

Introduction The use of psychotropic medications has a notable effect on sexual well-being. Prolonged use is closely linked to dyspareunia, reduced sexual desire, hypogonadism, and erectile dysfunction. We hypothesized that there was an increase in the prescription rates of psychotropic medications among adolescent patients during the COVID-19 pand...

Introduction The use of inflatable penile prostheses (IPP) is a fundamental approach in managing erectile dysfunction that does not respond to medical management. Approximately 28,000 IPPs are implanted annually in the United States. Device infection, with an incidence up to 3%, is a particularly concerning complication as management generally nece...

Introduction Prior studies have shown underrepresentation of minority men in clinical trials. The NIH has issued a mandate to include minority groups in clinical trials, however, there is still significant underrepresentation in urological trials. Therapeutic interventions for erectile dysfunction (ED) have also demonstrated different patterns acro...

Introduction Peyronie's Disease (PD) is currently treated with intralesional collagenase injection, the only FDA-approved medical therapy. Platelet-derived therapies, such as autologous platelet rich plasma (PRP), have shown potential in tissue regeneration. We are investigating the safety and efficacy of PRP in PD with an ongoing randomized, place...

Introduction In performing both vasectomy and vasectomy reversal, a precise understanding of the local anatomy and blood supply of the vas deferens and associated structures is essential. However, the exact importance and contribution of the perivasal versus intramural vessels in perfusion to the vas deferens has not been investigated. This may be...

Introduction Sleep quality and sexual satisfaction are contributors to overall well-being, yet little research has investigated the impact of orgasms on subsequent sleep quality in women. This study aims to address this gap by analyzing sleep data from the Fitbit Versa 3 and self-reported sexual encounters to determine if sleep quality improves fol...

Introduction Understanding the physiological changes during sexual arousal and function in males with psychogenic erectile dysfunction remains an area of limited comprehension, despite a well-established understanding of erection physiology. To bridge this gap, we conducted a prospective study employing both qualitative and quantitative methods, to...

Introduction Cystic Fibrosis (CF) is a genetically inherited disease with a highly variable phenotype that results from a mutation in the cystic fibrosis transmembrane conductance regulator (CFTR) gene. Manifestations of CF include impacts on function of the lungs, liver, pancreas, and reproductive system. While CF is known to be associated with in...