Allen D. Seftel’s research while affiliated with Cooper University Hospital and other places

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Publications (276)


MP12-05 RELATIVE IMPACT OF URINARY CONDITIONS ON OVERALL QUALITY OF LIFE
  • Article

May 2024

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4 Reads

The Journal of Urology

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Rodney L. Dunn

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Martin Miner

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[...]

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Aruna Sarma








Trends in patient characteristics and attitudes in men who were diagnosed with HG and who initiated TRT (TRT+), compared with men who were diagnosed with HG but did not initiate TRT (TRT−).
Note. HCP = health care professional; HG = hypogonadism; TRT = testosterone replacement therapy; Tx = treatment/treating. Knowledge of/attitudes toward HG, TRT, and identification of most bothersome symptoms (rated from “very bothersome” to “extremely bothersome”) were examined as potential predictors of treatment uptake and p values were calculated with Fisher’s exact test.
*Of these most bothersome symptoms prior to diagnosis, men indicated that the lack of energy prompted them to seek help.
Patient Demographics and Clinical Characteristics.
A Pilot Study Using a Web Survey to Identify Characteristics That Influence Hypogonadal Men to Initiate Testosterone Replacement Therapy
  • Article
  • Full-text available

May 2018

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50 Reads

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7 Citations

Men with hypogonadism (HG) who choose testosterone replacement therapy (TRT) may have distinct characteristics that provide insight as to why they may/may not initiate therapy. The aim of the current study was to identify trends in patient characteristics and attitudes in men diagnosed with HG who initiated TRT (TRT+) compared with men who were diagnosed with HG but did not initiate TRT (TRT-). The market research-based online survey conducted between 2012 and 2013 included patients from a Federated Sample, a commercially available panel of patients with diverse medical conditions. The current analysis was composed of two groups: TRT+ (n = 155) and TRT- (n = 157). Patient demographics, clinical characteristics, and attitudes toward HG and TRT were examined as potential predictors of primary adherence in men with HG; cohorts were compared by using Fisher's exact test. Significant associations among sexual orientation, relationship status, educational level, presence of comorbid erectile dysfunction, area of residence, and TRT initiation were present (p ≤ .05). College-educated, heterosexual, married men with comorbid erectile dysfunction living in suburban and urban areas were more likely to initiate treatment. The most bothersome symptoms reported were lack of energy (90% vs. 81%, p = .075), decreased strength and endurance (86% vs. 76%, p = .077), and deterioration in work performance (52% vs. 31%, p = .004); lack of energy prompted men to seek help. Patients (48%) in the TRT+ group were more knowledgeable regarding HG as compared with TRT- respondents (14%, p < .001), and most men obtained their information from a health care professional (89% vs. 82%, p = .074). The current analysis identified distinct demographic and clinical characteristics and attitudes among TRT users compared with men who were diagnosed with HG yet remained untreated.

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Study design.
Note. @ = at; ↑ = increase to; ↓ = decrease to; T = testosterone; V = visit. All subjects began treatment with 2% topical testosterone solution, 60 mg once daily, and were titrated as needed (range 30-120 mg/day). Duration of treatment was up to 9 weeks (64 days) with a lead-in washout period of up to 30 days. Drug was administered once each day. Subjects could complete the study any time after V4. There was no comparator or reference therapy in this single-arm study.
Subjects Who Achieved a Serum Testosterone Level in the Normal Range (From ≥300 to ≤1,050 ng/dL) During the 2% Topical Testosterone Solution Treatment Period.
Serum Testosterone (ng/dL) Change From Baseline to Endpoint.
Symptom Improvement as Measured by Patient-Rated PGI Scales.
The Effect of Testosterone Topical Solution in Hypogonadal Men With Suboptimal Response to a Topical Testosterone Gel

May 2018

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66 Reads

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5 Citations

This study evaluated the effect of axillary administration of a 2% testosterone solution (Axiron(®)) in hypogonadal (HGN) men who had had a suboptimal response to treatment with a commercially available topical testosterone gel. HGN men averaging 57 years old, with a mean body mass index of 31.9 kg/m(2) and median baseline testosterone level (T-level) of 185.2 ng/dL, who had failed to reach normal T-levels with a topical testosterone gel (Androgel 1.62%, Androgel, Testim, or Fortesta) were treated with a 2% testosterone solution until T-levels reached a normal range (from ≥300 to ≤1,050 ng/dL) or for up to 9 weeks. Outcomes included the cumulative percentage of men with a serum T-level in the normal range during treatment with Axiron and improvement in symptoms of low energy level and low sexual drive. During the study, 95% of HGN men (72/78) attained a T-level in the normal range. The median T-level at endpoint was 495.7 ng/dL, a threefold increase over baseline, p < .001, 70% achieving normal T-levels within the first 2 weeks of treatment. In a post hoc analysis, all subjects with baseline body mass indexes >35 kg/m(2) (n = 19) achieved T-levels in the normal range. Prior to treatment, over 61% of subjects (48/78) reported impairment in either energy level or sexual drive. After treatment (or testosterone normalization), energy level improved in 75% of subjects and sexual drive improved in 70%. Topical 2% testosterone solution is a safe and effective treatment for HGN men who have had a suboptimal response to previous treatment with topical testosterone gels.


Citations (42)


... In the past decades, several studies across different medical disciplines have indicated the therapeutic efficacy of ESWT to various degrees against diverse medial conditions, including spasticity after upper motor neuron injury [26], tendinopathies, musculoskeletal conditions and soft tissue disorders [27][28][29][30][31][32], refractory angina pectoris [33], erectile dysfunction [34], and sexual conditions other than erectile dysfunction [35,36]. While several studies have also suggested that the use of ESWT exerts a beneficial effect in patients with CP/CPPS [8,[15][16][17][18][19][20][21][22][23][24], as with erectile dysfunction [37], the application of ESWT in the management of CP/CPPS is not without its controversies [23,25]. ...

Reference:

Extracorporeal Shockwave Therapy (ESWT) Alleviates Pain, Enhances Erectile Function and Improves Quality of Life in Patients with Chronic Prostatitis/Chronic Pelvic Pain Syndrome
Controversies in low intensity extracorporeal shockwave therapy for erectile dysfunction
  • Citing Article
  • February 2019

International Journal of Impotence Research

... In the case of earlystage prostate cancer, for example, patients and clinicians must carefully consider the patients' capacities and preferences when choosing among alternative treatment choices, including active surveillance, surgery, or various forms of radiation treatment [24,25]. Thus, promoting patients' autonomy in urological decision-making is crucial, and implementation of SDM is demanded by current urological and urooncological treatment guidelines [26][27][28]. Consistently, a survey among German urologists indicated that 84% consider SDM the preferred method of patient-clinician communication [29]. ...

Erectile Dysfunction: AUA Guideline

The Journal of Urology

... The USA Government provides funding and support for the Office on Women's Health (OWH), which coordinates women's health initiatives across the Department of Health and Human Services. To demonstrate and prioritize the social and economic importance of MRH, legislation should be passed to establish an Office on Men's Health (OMH) with the vision of: 'all men and boys achieve the best possible health' (Miner et al., 2018). For men's overall and reproductive health care seeking and needs to be met, there must be an investment by the government to formulate policy changes and provide funding to support reorientation of men's health care services (Shand and Marcell, 2021), and that starts with identifying how men best communicate. ...

The Intersection of Medicine and Urology: An Emerging Paradigm of Sexual Function, Cardiometabolic Risk, Bone Health, and Men's Health Centers
  • Citing Article
  • March 2018

Medical Clinics of North America

... [26][27][28] Other studies report on recurrent complications related to this treatment, like infection of the stent-graft with the need to convert to open surgery. 6,[29][30][31] However, all of these studies did not determine the rate of stent-graft infection and recurrent bleeding. In our study, we used endovascular treatment in 80% of our patients. ...

Uretero-Arterio-Enteric Fistula Formation and Stent Thrombosis After Endovascular Treatment of Ureteroarterial Fistula: A Case Report and Review of Literature

Journal of Endourology Case Reports

... Failure was assumed to be associated with the peripherally acting nature of epelsiban. However, interest in the inhibition of both central and peripheral oxytocin receptors in the treatment of PE remained, leading to research on another oxytocin antagonist, cligosiban 6 . ...

PD69-01 A PHASE IIA STUDY TO INVESTIGATE THE EFFICACY AND SAFETY OF THE SELECTIVE OXYTOCIN RECEPTOR ANTAGONIST, IX-01, IN MEN WITH LIFELONG PREMATURE EJACULATION
  • Citing Article
  • April 2017

The Journal of Urology

... Surveillance rectal swab is performed in various hospitals worldwide to monitor the gut colonization by MDR bacteria during long-term hospitalization. Diverse studies in the last year showed how these surveillances provide valuable information to clinicians [95,96], helping them define the empirical treatment for severe diseases such as sepsis and preventing post-operatory or trauma-related infections, besides informing about MDR dissemination through colonization [97][98][99]. The current problem is how to refine the methods to enable the search of multiple pathogens, including non-MDR, to prevent infection in intensive care units and hospital wards. ...

Impact of preoperative screening for rectal colonization with fluoroquinolone-resistant enteric bacteria on the incidence of sepsis following transrectal ultrasound guided prostate biopsy

... In the European Male Ageing Study (EMAS), only three sexual symptoms (poor morning erections, low frequency of sexual thoughts and erectile dysfunction) showed a clear Table 4 Signs and symptoms potentially indicative of (acquired) testosterone deficiency in ageing men [12 for review] Sexual symptoms -Decreased sexual desire (libido) -Decreased sexual thoughts -Decreased sexual activity -Decreased frequency of morning erections -Erectile dysfunction General physical symptoms -Fatigue -Lack of energy -Decreased work capacity, vitality, strength -Hot flushes -sweats -Decreased general wellbeing Psychological and neurological symptoms -Depressed mood -Poor motivation, initiative -Poor self-confidence -Mood changes, irritability -Poor concentration -Impaired short-term memory -Sleep disturbances -daytime sleepiness Physical signs -Decreased lean muscle mass -Decreased muscle strength, sarcopenia -Increased (abdominal) adiposity -Gynecomastia -Decreased testis volume -Loss of facial, axillary, pubic hair -slow beard growth -Unexplained anaemia (mild, normocytic, normochromic) -Height loss -low bone mineral density -osteoporosis -Frailty interview (Androtest) concentrating on sexual symptoms showed a somewhat better specificity (~ 65-70%) to predict low T in a specific population of patients consulting with sexual dysfunction [40,41]. For the Sexual Arousal, Interest, and Drive Scale [42,43] and the Hypogonadism Impact of Symptoms Questionnaire [44], which have been more recently developed, available clinical data is limited and obtained more in the context of treatment-outcome measure than as diagnostic tool. ...

Psychometric Evaluation of the Hypogonadism Impact of Symptoms Questionnaire

Journal of Sexual Medicine

... The practice of physical activity was assessed using the physical activity scale for individuals with physical disabilities score (10). Low total testosterone was defined as ≤ 300 ng/dL (11). The diagnostic criteria outlined by the international consensus for MASLD were applied (8). ...

Adult-Onset Hypogonadism

Mayo Clinic Proceedings

... The results of this study was limited by the characteristics of study participants. The study did not include men with severe LUTS, who were the main concern in prescribing testosterone replacement 38 . Since the problem remains unsolved, patients with LUTS should be treated carefully regarding testosterone replacement therapy. ...

Re: Effects of Testosterone Replacement Therapy on Lower Urinary Tract Symptoms: A Systematic Review and Meta-Analysis
  • Citing Article
  • May 2016

The Journal of Urology

... Clinical trial proved that the tadalafil once daily treatment could be used to maintain cavernosal tissue integrity. More trials confirm that state [30][31]. Moreover, one of these studies proved that stretched penile length was significantly more retained after tadalafil once a day than after a placebo [31]. ...

Efficacy of Continuous Dosing of Tadalafil Once Daily vs Tadalafil On Demand in Clinical Subgroups of Men With Erectile Dysfunction: A Descriptive Comparison Using the Integrated Tadalafil Databases

Journal of Sexual Medicine