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  1. Article ; Online: How I Maintain Resilience in an Era of Physician Burnout.

    Wheeler, Karen M

    The Journal of urology

    2019  Volume 202, Issue 2, Page(s) 220

    MeSH term(s) Burnout, Professional/psychology ; Humans ; Physicians/psychology ; Resilience, Psychological
    Language English
    Publishing date 2019-07-08
    Publishing country United States
    Document type Editorial ; Personal Narrative
    ZDB-ID 3176-8
    ISSN 1527-3792 ; 0022-5347
    ISSN (online) 1527-3792
    ISSN 0022-5347
    DOI 10.1097/01.JU.0000576804.44936.d2
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  2. Article ; Online: The Microbiome and Prostate Cancer Risk.

    Wheeler, Karen M / Liss, Michael A

    Current urology reports

    2019  Volume 20, Issue 10, Page(s) 66

    Abstract: Purpose of the review: There is an abundance of evidence that the human microbiome plays an important and nuanced role in controlling human metabolism, immunity, and cancer. Herein we aim to review the most current research looking at prostate cancer ... ...

    Abstract Purpose of the review: There is an abundance of evidence that the human microbiome plays an important and nuanced role in controlling human metabolism, immunity, and cancer. Herein we aim to review the most current research looking at prostate cancer and its link with the gut and genitourinary microbiome. There is now a host of evidence for a unique genitourinary (GU) microbiome. The prostate microbiota, to include viral, bacterial, fungal, and parasitic contributions, as assessed from formalin-fixed tissue is described nicely in the study by Banerjee et al. Further hierarchical analysis by this group found a unique microbiome signature for higher Gleason score cancers and validation PCR studies noted a marked number of viral genomic insertions into host DNA. Shretha et al. also recently established unique GU microbiomes in patients with prostate cancer or benign prostate pathology based on urine samples. The gut microbiome likely also has an indirect but significant role in prostate cancer development and treatment. Liss et al. and Golombos et al. found significant associations between specific gut microbiota and prostate cancer. Interestingly, the balance of inflammatory and anti-inflammatory bacterial lipopolysaccharides, production of bile salts, and metabolism of dietary fiber to short chain fatty acids all likely play important roles in creating systemic pro- or anti-carcinogenic states. In terms of prostate cancer treatment effects, Sfanos et al. noted a unique microbial signature in patients undergoing oral androgen deprivation therapy (ADT) as compared with prostate cancer patients not on ADT. Patients undergoing ADT also had enrichment of bacterial metabolic pathways promoting androgen synthesis. Together, these studies have identified a unique GU microbiome and linked both the GU microbiome and unique gut microbial signatures with prostate cancer and prostate cancer treatments. Whether this information can be used in cancer prevention, treatment, or diagnosis are areas of ongoing and active research.
    MeSH term(s) Animals ; Gastrointestinal Microbiome/physiology ; Humans ; Male ; Mice ; Microbiota/physiology ; Prostate/microbiology ; Prostate/virology ; Prostatic Neoplasms/etiology ; Prostatic Neoplasms/microbiology ; Prostatic Neoplasms/therapy ; Prostatic Neoplasms/virology ; Urine/microbiology ; Urine/virology ; Urogenital System/microbiology
    Language English
    Publishing date 2019-09-07
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 2057354-6
    ISSN 1534-6285 ; 1527-2737
    ISSN (online) 1534-6285
    ISSN 1527-2737
    DOI 10.1007/s11934-019-0922-4
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  3. Article ; Online: Bacillus Calmette-Guérin treatment of bladder cancer: a systematic review and commentary on recent publications.

    Mukherjee, Neelam / Wheeler, Karen M / Svatek, Robert S

    Current opinion in urology

    2019  Volume 29, Issue 3, Page(s) 181–188

    Abstract: Purpose of review: Bacillus Calmette-Guérin (BCG) is the standard immune therapy for nonmuscle invasive bladder cancer. A systematic review of published articles regarding BCG treatment of bladder cancer was conducted and a commentary of these is ... ...

    Abstract Purpose of review: Bacillus Calmette-Guérin (BCG) is the standard immune therapy for nonmuscle invasive bladder cancer. A systematic review of published articles regarding BCG treatment of bladder cancer was conducted and a commentary of these is provided to gain a perspective of the current major developments in the field.
    Recent findings: Several BCG strains are utilized worldwide. As the understanding of genetic and phenotypic differences in these strains is elucidated, inquiries into the potential clinical effects of these various strains have been studied. Data suggest that some strains could be more effective than others but further study is needed. Although response to BCG is heterogenous, current clinical practice does not incorporate use of biomarkers to delegate treatment selection. Thus, biomarker prediction is an important area of research in this area. Novel urine and tissue markers show promise in this endeavor. Notable publications also include mechanistic studies showing a role for T cells, natural killer cells, mast cells, and granulocytes in BCG's antitumor efficacy.
    Summary: Significant developments have occurred in understanding BCG's response and mechanism of action, which remains incompletely understood. Future work includes efforts to create recombinant BCG strains to decrease side effects, repeated instillations, and increase overall efficacy.
    MeSH term(s) Administration, Intravesical ; BCG Vaccine/administration & dosage ; BCG Vaccine/adverse effects ; BCG Vaccine/therapeutic use ; Humans ; Urinary Bladder Neoplasms/therapy
    Chemical Substances BCG Vaccine
    Language English
    Publishing date 2019-02-11
    Publishing country United States
    Document type Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't ; Research Support, U.S. Gov't, Non-P.H.S. ; Systematic Review
    ZDB-ID 1091792-5
    ISSN 1473-6586 ; 0963-0643
    ISSN (online) 1473-6586
    ISSN 0963-0643
    DOI 10.1097/MOU.0000000000000595
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    Zs.A 3345: Show issues Location:
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  4. Article ; Online: Impact of Finasteride on Survival in Bladder Cancer: A Retrospective Multi-institutional Database Analysis.

    Garg, Harshit / Wheeler, Karen M / Dursun, Furkan / Cooper, Robert E / Pruthi, Deepak K / Kaushik, Dharam / Thompson, Ian M / Svatek, Robert S / Liss, Michael A

    Clinical genitourinary cancer

    2022  Volume 21, Issue 2, Page(s) 314.e1–314.e7

    Abstract: Introduction: Androgen suppression therapy has been associated with a lower incidence of bladder cancer (BCa) or improved overall/cancer-specific survival. Results are ofent conflicting; therefore, we aim to assess the impact of use of finasteride on ... ...

    Abstract Introduction: Androgen suppression therapy has been associated with a lower incidence of bladder cancer (BCa) or improved overall/cancer-specific survival. Results are ofent conflicting; therefore, we aim to assess the impact of use of finasteride on overall survival (OS) for BCa using multi-institutional database.
    Methods: The South Texas Veterans Healthcare System from 5 medical centers was queried for patients with BCa with or without use of finasteride after diagnosis of BCa. The primary outcome was the impact of finasteride use after diagnosis on the OS in BCa and in the high-risk Non-muscle invasive BCa (NMIBC) cohort.
    Results: A total of 1890 patients were included, amongst which 619 (32.8%) men were classified as finasteride users and 1271 (67.2%) men as controls. At a median (IQR) follow up of 53.8 (27.4, 90.9) months, death due to any cause was noted in 272 (43.9%) finasteride-treated, and 672 (49.3%) control groups (P = .028). The patients in the finasteride group had significantly better OS in overall cohort (112.1 months vs. 84.8 months, P < .001) as well as in the NMIBC cohort (129.3months vs. 103.2 months, P = .0046). The use of finasteride was independently associated with improved OS in both, overall cohort (HR 0.74, 95% CI 0.63-0.86; P < .001) and in the NMIBC cohort (HR = 0.71, 95% CI 0.55-0.93; P = .011).
    Conclusion: Finasteride use is associated with the improved overall survival in patients with BCa, specifically in patients with NMIBC. We, further, propose a randomized clinical trial to investigate the use of finasteride in BCa patients.
    MeSH term(s) Male ; Humans ; Female ; Finasteride/therapeutic use ; Retrospective Studies ; Urinary Bladder Neoplasms
    Chemical Substances Finasteride (57GNO57U7G)
    Language English
    Publishing date 2022-10-29
    Publishing country United States
    Document type Randomized Controlled Trial ; Journal Article
    ZDB-ID 2225121-2
    ISSN 1938-0682 ; 1558-7673
    ISSN (online) 1938-0682
    ISSN 1558-7673
    DOI 10.1016/j.clgc.2022.10.014
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    Zs.A 6168: Show issues Location:
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  5. Article: Development and implementation of competency-based assessment for urological ultrasound training using SonoSim: A preliminary evaluation.

    Rowley, Keri Jinju / Wheeler, Karen M / Pruthi, Deepak K / Mansour, Ahmed M / Kaushik, Dharam / Basler, Joseph W / Liss, Michael A

    Indian journal of urology : IJU : journal of the Urological Society of India

    2020  Volume 36, Issue 4, Page(s) 270–275

    Abstract: Introduction: Urology residents are encouraged to learn ultrasound (U/S) imaging, yet there are few tools available for teaching and assessing a resident`s competence. The aim of this study was to test the new SonoSim LiveScan: Materials and methods: ...

    Abstract Introduction: Urology residents are encouraged to learn ultrasound (U/S) imaging, yet there are few tools available for teaching and assessing a resident`s competence. The aim of this study was to test the new SonoSim LiveScan
    Materials and methods: Urology residents attended an interactive training session covering the urological U/S techniques guided by the assessment model developed by the authors. Faculty members evaluated the residents using defined objectives, and the residents were surveyed on their comfort level for performing each of the model tasks. A subset of the residents then underwent a structured testing using the SonoSim LiveScan device 6 months following the training. The model developed assessed: general U/S setup, structure identification, and pathologic clinical scenarios.
    Results: The residents felt most comfortable in identifying the bladder (4.73/5) and the kidneys (4.53/5) during the training sessions. They felt least comfortable while testing for total ureteric obstruction (3.13/5). All the residents were confident that additional U/S training sessions would improve their comfort level in performing the assessed objectives. Resident`s assessment performed at 6 months had a median test score of 15.5/20 and the assessment scores increased with resident seniority. Self-reported comfort, however, did not seem to correlate with seniority. In general, the residents felt that the SonoSim device was highly functional (4.4/5) and the pathologic assessments in particular were very helpful (4.4/5).
    Conclusions: Through pilot testing, we propose that a competency-based assessment used with the SonoSim LiveScan could guide the resident`s education through the acquisition of U/S skills and warrants testing in a larger cohort.
    Language English
    Publishing date 2020-10-01
    Publishing country India
    Document type Journal Article
    ZDB-ID 639268-4
    ISSN 1998-3824 ; 0970-1591
    ISSN (online) 1998-3824
    ISSN 0970-1591
    DOI 10.4103/iju.IJU_22_20
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    Zs.B 3165: Show issues Location:
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  6. Article ; Online: Clomiphene Citrate for the Treatment of Hypogonadism.

    Wheeler, Karen M / Sharma, Devang / Kavoussi, Parviz K / Smith, Ryan P / Costabile, Raymond

    Sexual medicine reviews

    2018  Volume 7, Issue 2, Page(s) 272–276

    Abstract: Introduction: Clomiphene citrate (CC) is a selective estrogen receptor modulator that has been used for the treatment of hypogonadism in men since the 1970s. It acts centrally to increase secretion of luteinizing hormone and follicle-stimulating hormone, ...

    Abstract Introduction: Clomiphene citrate (CC) is a selective estrogen receptor modulator that has been used for the treatment of hypogonadism in men since the 1970s. It acts centrally to increase secretion of luteinizing hormone and follicle-stimulating hormone, thereby increasing testosterone production and serum levels. Unlike testosterone replacement therapy, CC does not suppress the hypothalamic-pituitary-gonadal axis, preserving intratesticular testosterone production and spermatogenesis. This is especially useful in treating hypogonadal men who are interested in fertility.
    Aim: To review the literature regarding the use of CC in the setting of hypogonadism.
    Methods: A review of the relevant literature through September 2018 was performed via PubMed.
    Main outcome measure: The data regarding the efficacy and safety of CC when used in the setting of hypogonadism is summarized.
    Results: Although results are mixed, many studies show CC reduces symptoms in hypogonadal men. Studies have also shown improvement in erectile function and bone mineral density, as well as a reduction in body mass index. There have been few studies investigating fertility rates in hypogonadal men treated with CC, but a metaanalysis of these shows significant improvement in fertility rates. Several studies show improvement in semen parameters. Few studies have investigated adverse effects of the drug. Reports include headache, dizziness, gynecomastia, and exacerbation of psychiatric illnesses. Despite these reports, CC is generally considered to be safe and well tolerated.
    Conclusion: CC is safe and effective and should remain in the armament of urologists treating hypogonadal men, especially men interested in preservation of fertility. Wheeler KM, Sharma D, Kavoussi PK, et al. Clomiphene citrate for the treatment of hypogonadism. Sex Med Rev 2019;7:272-276.
    MeSH term(s) Clomiphene/adverse effects ; Clomiphene/therapeutic use ; Female ; Fertility/drug effects ; Humans ; Hypogonadism/drug therapy ; Male ; Selective Estrogen Receptor Modulators/therapeutic use
    Chemical Substances Selective Estrogen Receptor Modulators ; Clomiphene (1HRS458QU2)
    Language English
    Publishing date 2018-12-03
    Publishing country Netherlands
    Document type Journal Article ; Review
    ZDB-ID 2722257-3
    ISSN 2050-0521 ; 2050-0513
    ISSN (online) 2050-0521
    ISSN 2050-0513
    DOI 10.1016/j.sxmr.2018.10.001
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  7. Article ; Online: Cutting edge: normal regional lymph node enrichment of antigen-specific regulatory T cells with autoimmune disease-suppressive capacity.

    Wheeler, Karen M / Samy, Eileen T / Tung, Kenneth S K

    Journal of immunology (Baltimore, Md. : 1950)

    2009  Volume 183, Issue 12, Page(s) 7635–7638

    Abstract: Natural CD4(+)CD25(+)Foxp3(+) regulatory T cells (Treg) effectively prevent autoimmune disease development, but their role in maintaining physiological tolerance against self-Ag of internal organs is not yet defined. In this study, we quantified disease- ... ...

    Abstract Natural CD4(+)CD25(+)Foxp3(+) regulatory T cells (Treg) effectively prevent autoimmune disease development, but their role in maintaining physiological tolerance against self-Ag of internal organs is not yet defined. In this study, we quantified disease-specific Treg (DS-Treg) as Treg that preferentially suppress one autoimmune disease over another in day 3 thymectomized recipients. A striking difference was found among individual lymph nodes (LN) of normal mice; Treg from draining LN were 15-50 times more efficient than those of nondraining LN at suppressing autoimmune diseases of ovary, prostate, and lacrimal glands. The difference disappeared upon auto-Ag ablation and returned upon auto-Ag re-expression. In contrast, the CD4(+)CD25(-) effector T cells from different individual LN induced multiorgan inflammation with comparable organ distribution. We propose that peripheral tolerance for internal organs relies on the control of autoreactive effector T cells by strategic enrichment of Ag-specific Treg in the regional LN.
    MeSH term(s) Animals ; Autoimmune Diseases/immunology ; Autoimmune Diseases/pathology ; Autoimmune Diseases/prevention & control ; CD4 Antigens/biosynthesis ; Cell Movement/immunology ; Cell Proliferation ; Epitopes, T-Lymphocyte/biosynthesis ; Female ; Interleukin-2 Receptor alpha Subunit/biosynthesis ; Lymph Nodes/cytology ; Lymph Nodes/immunology ; Lymph Nodes/metabolism ; Mice ; Mice, Inbred C57BL ; Mice, Knockout ; Organ Specificity/immunology ; Ovarian Diseases/immunology ; Ovarian Diseases/pathology ; Ovarian Diseases/prevention & control ; Self Tolerance/immunology ; T-Lymphocytes, Regulatory/immunology ; T-Lymphocytes, Regulatory/metabolism ; T-Lymphocytes, Regulatory/pathology
    Chemical Substances CD4 Antigens ; Epitopes, T-Lymphocyte ; Interleukin-2 Receptor alpha Subunit
    Language English
    Publishing date 2009-11-18
    Publishing country United States
    Document type Journal Article ; Research Support, N.I.H., Extramural
    ZDB-ID 3056-9
    ISSN 1550-6606 ; 0022-1767 ; 1048-3233 ; 1047-7381
    ISSN (online) 1550-6606
    ISSN 0022-1767 ; 1048-3233 ; 1047-7381
    DOI 10.4049/jimmunol.0804251
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  8. Article ; Online: Phosphatidylserine on viable sperm and phagocytic machinery in oocytes regulate mammalian fertilization.

    Rival, Claudia M / Xu, Wenhao / Shankman, Laura S / Morioka, Sho / Arandjelovic, Sanja / Lee, Chang Sup / Wheeler, Karen M / Smith, Ryan P / Haney, Lisa B / Isakson, Brant E / Purcell, Scott / Lysiak, Jeffrey J / Ravichandran, Kodi S

    Nature communications

    2019  Volume 10, Issue 1, Page(s) 4456

    Abstract: Fertilization is essential for species survival. Although Izumo1 and Juno are critical for initial interaction between gametes, additional molecules necessary for sperm:egg fusion on both the sperm and the oocyte remain to be defined. Here, we show that ... ...

    Abstract Fertilization is essential for species survival. Although Izumo1 and Juno are critical for initial interaction between gametes, additional molecules necessary for sperm:egg fusion on both the sperm and the oocyte remain to be defined. Here, we show that phosphatidylserine (PtdSer) is exposed on the head region of viable and motile sperm, with PtdSer exposure progressively increasing during sperm transit through the epididymis. Functionally, masking phosphatidylserine on sperm via three different approaches inhibits fertilization. On the oocyte, phosphatidylserine recognition receptors BAI1, CD36, Tim-4, and Mer-TK contribute to fertilization. Further, oocytes lacking the cytoplasmic ELMO1, or functional disruption of RAC1 (both of which signal downstream of BAI1/BAI3), also affect sperm entry into oocytes. Intriguingly, mammalian sperm could fuse with skeletal myoblasts, requiring PtdSer on sperm and BAI1/3, ELMO2, RAC1 in myoblasts. Collectively, these data identify phosphatidylserine on viable sperm and PtdSer recognition receptors on oocytes as key players in sperm:egg fusion.
    MeSH term(s) Adaptor Proteins, Signal Transducing/metabolism ; Angiogenic Proteins/metabolism ; Animals ; CD36 Antigens/metabolism ; Cytoskeletal Proteins/metabolism ; Epididymis ; Female ; Humans ; Male ; Membrane Proteins/metabolism ; Mice ; Mice, Inbred C57BL ; Models, Animal ; Myoblasts, Skeletal ; Nerve Tissue Proteins/metabolism ; Neuropeptides/metabolism ; Oocytes/metabolism ; Phagocytes/metabolism ; Phosphatidylserines/genetics ; Phosphatidylserines/metabolism ; Receptors, Cell Surface/genetics ; Receptors, Cell Surface/metabolism ; Sperm-Ovum Interactions/physiology ; Spermatozoa/metabolism ; c-Mer Tyrosine Kinase/metabolism ; rac1 GTP-Binding Protein/metabolism
    Chemical Substances Adaptor Proteins, Signal Transducing ; Adgrb1 protein, mouse ; Adgrb3 protein, mouse ; Angiogenic Proteins ; CD36 Antigens ; Cd36 protein, mouse ; Cytoskeletal Proteins ; ELMO1 protein, mouse ; Elmo2 protein, mouse ; Membrane Proteins ; Nerve Tissue Proteins ; Neuropeptides ; Phosphatidylserines ; Rac1 protein, mouse ; Receptors, Cell Surface ; TIM-4 protein, mouse ; phosphatidylserine receptor ; Mertk protein, mouse (EC 2.7.10.1) ; c-Mer Tyrosine Kinase (EC 2.7.10.1) ; rac1 GTP-Binding Protein (EC 3.6.5.2)
    Language English
    Publishing date 2019-10-01
    Publishing country England
    Document type Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
    ZDB-ID 2553671-0
    ISSN 2041-1723 ; 2041-1723
    ISSN (online) 2041-1723
    ISSN 2041-1723
    DOI 10.1038/s41467-019-12406-z
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  9. Article ; Online: Urinary Diversion Disparity Following Radical Cystectomy for Bladder Cancer in the Hispanic Population.

    Rios, Emily M / Parma, Mitchell A / Fernandez, Roman A / Clinton, Timothy N / Reyes, Ryan M / Kaushik, Dharam / Pruthi, Deepak / Mansour, Ahmed M / Mukherjee, Neelam / Gelfond, Jon / Wheeler, Karen M / Svatek, Robert S

    Urology

    2019  Volume 137, Page(s) 66–71

    Abstract: Objective: To determine if disparities in quality of surgical care exist between Hispanics and non-Hispanics undergoing radical cystectomy for bladder cancer.: Materials and methods: An observational cohort study was conducted retrospectively on ... ...

    Abstract Objective: To determine if disparities in quality of surgical care exist between Hispanics and non-Hispanics undergoing radical cystectomy for bladder cancer.
    Materials and methods: An observational cohort study was conducted retrospectively on patients who underwent radical cystectomy for urothelial carcinoma of the bladder at our institution between January 2005 and July 2018. Data was collected on demographic, clinical, and pathological characteristics of patients, including self-reported ethnicity. Univariable and multivariable logistic or linear regression analyses were used to evaluate the association of ethnicity with receipt of neoadjuvant chemotherapy, utilization of laparoscopic surgery, number of lymph nodes removed, and continent urinary diversion.
    Results: We identified 507 patients in our database out of which, 136 (27%) were Hispanic and 371 (73%) were non-Hispanic. Compared to non-Hispanics, Hispanics had a higher body mass index (26.9 kg/m
    Conclusion: Disparity exists in the delivery of continent urinary diversions for Hispanic patients undergoing radical cystectomy for bladder cancer. Further investigation is needed to determine the potential causes for this disparity in care delivered.
    MeSH term(s) Aged ; Cohort Studies ; Cystectomy/methods ; Female ; Healthcare Disparities/statistics & numerical data ; Hispanic or Latino/statistics & numerical data ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Urinary Bladder Neoplasms/surgery ; Urinary Diversion/statistics & numerical data
    Language English
    Publishing date 2019-12-27
    Publishing country United States
    Document type Journal Article ; Observational Study
    ZDB-ID 192062-5
    ISSN 1527-9995 ; 0090-4295
    ISSN (online) 1527-9995
    ISSN 0090-4295
    DOI 10.1016/j.urology.2019.12.017
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  10. Article ; Online: A Comparison of Secondary Polycythemia in Hypogonadal Men Treated with Clomiphene Citrate versus Testosterone Replacement: A Multi-Institutional Study.

    Wheeler, Karen M / Smith, Ryan P / Kumar, Raj A / Setia, Shaan / Costabile, Raymond A / Kavoussi, Parviz K

    The Journal of urology

    2016  Volume 197, Issue 4, Page(s) 1127–1131

    Abstract: Purpose: We evaluated the relative prevalence of secondary polycythemia in hypogonadal men treated with clomiphene citrate or testosterone replacement therapy.: Materials and methods: In this retrospective, multi-institutional study, we included 188 ... ...

    Abstract Purpose: We evaluated the relative prevalence of secondary polycythemia in hypogonadal men treated with clomiphene citrate or testosterone replacement therapy.
    Materials and methods: In this retrospective, multi-institutional study, we included 188 men who received clomiphene citrate and 175 who received testosterone replacement therapy with symptomatic hypogonadism. The overall prevalence and ORs of secondary polycythemia for clomiphene citrate treatment vs testosterone replacement were primarily measured, as were baseline characteristics. Subset analysis included polycythemia rates for different types of testosterone replacement therapy.
    Results: Overall, men on testosterone replacement therapy were older than clomiphene citrate treated men (age 51.5 vs 38 years). Men on testosterone replacement had longer treatment duration than clomiphene citrate treated men (19.6 vs 9.2 months). For testosterone replacement therapy and clomiphene citrate the mean change in hematocrit was 3.0% and 0.6%, and the mean change in serum testosterone was 333.1 and 367.6 ng/dl, respectively. The prevalence of polycythemia in men on testosterone replacement was 11.2% vs 1.7% in men on clomiphene citrate (p = 0.0003). This significance remained on logistic regression after correcting for age, site, smoking history and pretreatment hematocrit.
    Conclusions: The prevalence of polycythemia in men treated with clomiphene citrate was markedly lower than that in men on testosterone replacement therapy. The improvement in absolute serum testosterone levels was similar to that in men on testosterone replacement. There is no significant risk of polycythemia in men treated with clomiphene citrate for hypogonadism.
    MeSH term(s) Adult ; Androgens/adverse effects ; Androgens/therapeutic use ; Clomiphene/adverse effects ; Clomiphene/therapeutic use ; Cohort Studies ; Hormone Replacement Therapy/adverse effects ; Humans ; Hypogonadism/drug therapy ; Male ; Middle Aged ; Polycythemia/chemically induced ; Retrospective Studies ; Selective Estrogen Receptor Modulators/adverse effects ; Selective Estrogen Receptor Modulators/therapeutic use ; Testosterone/adverse effects ; Testosterone/therapeutic use
    Chemical Substances Androgens ; Selective Estrogen Receptor Modulators ; Clomiphene (1HRS458QU2) ; Testosterone (3XMK78S47O)
    Language English
    Publishing date 2016-10-27
    Publishing country United States
    Document type Comparative Study ; Journal Article ; Multicenter Study
    ZDB-ID 3176-8
    ISSN 1527-3792 ; 0022-5347
    ISSN (online) 1527-3792
    ISSN 0022-5347
    DOI 10.1016/j.juro.2016.10.068
    Database MEDical Literature Analysis and Retrieval System OnLINE

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