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Papers by Katherine Rotker

The journal of sexual medicine, Feb 1, 2024

Fertility and Sterility, Oct 1, 2019

Fertility and Sterility, Dec 1, 2020

Urology, Apr 1, 2021

This is a PDF file of an article that has undergone enhancements after acceptance, such as the ad... more This is a PDF file of an article that has undergone enhancements after acceptance, such as the addition of a cover page and metadata, and formatting for readability, but it is not yet the definitive version of record. This version will undergo additional copyediting, typesetting and review before it is published in its final form, but we are providing this version to give early visibility of the article. Please note that, during the production process, errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.

Asian Journal of Andrology, 2016

Postgraduate Medicine, Jul 1, 2013

Obesity, defined as a body mass index ≥ 30 kg/m² in adults by the National Institutes of Health, ... more Obesity, defined as a body mass index ≥ 30 kg/m² in adults by the National Institutes of Health, is associated with an increased risk for a number of health conditions, including hypertension, unfavorable lipid level, and diabetes mellitus. During the past 2 decades of the twentieth century, the prevalence of obesity has increased in the United States. In 2009 to 2010, 36% of adults were obese, including 41 million women and &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt; 37 million men. In addition, the prevalence of metabolic syndrome (MetS), which is a constellation of interrelated cardiac risk factors including visceral obesity, impaired insulin action (ie, insulin resistance), atherogenic dyslipidemia, endothelial dysfunction, and systemic inflammation, has been increasing in the United States. More recently, there has been greater interest in the effects of obesity and MetS on a variety of benign and malignant urologic conditions. Obesity/MetS has been shown to have an effect on urolithiasis; benign prostatic hyperplasia and lower urinary tract symptoms; female incontinence and pelvic prolapse; male hypogonadism; and male sexual function and infertility. These urologic diseases have a considerable impact on patients&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; quality of life. From a urologic cancer standpoint, obesity/MetS has been demonstrated to play a role in prostate cancer and in renal cell cancer; its role in bladder cancer remains ill defined. Furthermore, dietary or lifestyle modifications may improve outcomes in many of these urologic disease processes. Thus, it is imperative for physicians to understand these relationships in order to better screen obese patients and be aware of the potential impact of weight loss on affected benign and malignant urologic conditions.

Sperm DNA integrity assays have gained interest as a potential test to discriminate infertile fro... more Sperm DNA integrity assays have gained interest as a potential test to discriminate infertile from fertile men and to direct management of infertile men. Despite a growing body of literature, controversy still exists regarding the ability of these assays to provide clinically useful information in the evaluation of the infertile man. As a routine test in the infertile couple, sperm DNA testing adds expense to the healthcare system and does not provide a clinical benefit for most couples. The techniques and thresholds are not standardized, and the results are variable over time. Because of suboptimal sensitivity and specificity, the tests do not differentiate clinically significant from insignificant fragmentation. Finally, the current assays cannot evaluate individual sperm used for ART, and suggested treatments lack adequate trials proving effectiveness. As a result, the test fails to change management. Despite the potential, at this point, DNA fragmentation testing does not fulfill the criteria of a clinically useful diagnostic test in the evaluation of the infertile male.