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Developed by the Medical Student Membership Workgroup, the Urology Spotlight Series educates medical students about a particular subspecialty within urology, including common cases and procedures. In this episode, Daniela Orozco-Rendon, medical student at Geisel School of Medicine at Dartmouth, is joined by Dr. Mohit Khera, Professor of Urology and F. Brantley Scott Chair in Urology at Baylor College of Medicine, for a discussion on the field of Andrology/Men’s Health.
Exploring Men's Health and Sexual Medicine: Insights from Dr. Khera
The American Urological Association's (AUA) Sidetracked podcast recently featured an in-depth interview with Dr. Khera, a leading urologist at Baylor College of Medicine specializing in men's health. Hosted by Daniella, a fourth-year medical student at Dartmouth and the New England representative for the AUA Medical Student Work Group, the conversation offered a comprehensive look at the evolving field of sexual medicine, its challenges, and its future[1].
Understanding Men's Health in Urology
Dr. Khera began by distinguishing between surgeries that prolong life and those that improve quality of life. While initially drawn to oncology, he found his passion in procedures like penile implants and artificial sphincters—interventions that restore function and dignity to patients. "There are surgeries that we do to prolong life and save life. And then there are surgeries that we do to improve the quality of life," he explained, emphasizing the profound impact of the latter on patient satisfaction[1].
His typical week is a blend of high-volume clinics, surgical procedures, teaching at the VA hospital, and research. The diversity and intensity of his schedule reflect both the demand for men's health services and the opportunities for professional growth within the field[1].
A Non-Traditional Path to Urology
Dr. Khera’s journey into medicine was unconventional. After earning an MBA and working as an analyst in Boston, he realized the corporate world was unfulfilling. Inspired by his then-girlfriend’s medical studies, he pivoted to medicine, eventually finding his calling in urology due to its technological innovation, collegial environment, and the growing need for specialists as the population ages[1].
Mentorship played a pivotal role in his sub specialization. A transformative rotation with Dr. Lipschultz in men's health and infertility convinced him to pursue sexual medicine—a decision he attributes to the exposure and guidance he received during training[1].
Quality of Life and the Concept of 'Sex Span'
Reflecting on his early experiences, Dr. Khera recounted how patients who underwent prostatectomies often faced incontinence and erectile dysfunction (ED), leading to significant distress. "Patients really weren't satisfied... The quality of life is just as important as extending the life itself," he observed[1].
He introduced the concept of "sex span"—the period in life during which individuals can engage in satisfying sexual activity. For many, maintaining sexual health is as important as longevity and general health, underscoring the vital role of sexual medicine in holistic patient care[1].
Scope of Men's and Sexual Health
Men's health encompasses a broad range of conditions, including:
Hypogonadism (low testosterone)
Peyronie's disease
Premature ejaculation
Erectile dysfunction
Prostate issues (BPH, prostate cancer)
Dr. Khera highlighted that urologists are uniquely positioned to manage these issues comprehensively, unlike other specialties that often refer patients to urology for advanced care[1].
He also stressed the importance of addressing female sexual dysfunction, noting that treating one partner's sexual issues often impacts the other. "This is a couple's disease," he said, citing studies showing that improving one partner’s sexual health can significantly benefit the other’s[1].
Current Trends: Regenerative Therapies and Lifestyle Medicine
The field is rapidly evolving, with research focusing on regenerative therapies such as stem cells, platelet-rich plasma (PRP), shockwave therapy, and radiofrequency treatments. However, Dr. Khera is most excited about the power of lifestyle modification—diet, exercise, sleep, and stress reduction—to reverse sexual dysfunction and improve overall health[1].
He pointed out that young men often seek care for ED before other health issues, presenting a critical window for early detection of conditions like diabetes and cardiovascular disease. "The mistake which most of us commit is we hand him a Viagra and we say goodbye—that's the problem," he cautioned, advocating for a more proactive, preventive approach to health[1].
The Impact of the TRAVERSE Trial
Dr. Khera played a key role in the TRAVERSE trial, a landmark study mandated by the FDA to assess whether testosterone therapy increases cardiovascular risk. The trial found no increased risk of cardiovascular events or prostate cancer, leading the FDA to remove previous warnings from testosterone product labels. The study also confirmed that while testosterone boosts libido and sexual activity, it should not be used alone to treat ED[1].
Balancing Clinical, Research, and Personal Life
Dr. Khera attributes his ability to juggle clinical duties, research, and teaching to effective time management, prioritization, and building strong teams. He encourages colleagues and trainees to focus on the "four pillars": diet, exercise, sleep, and stress reduction, for both personal well-being and professional effectiveness[1].
Advice for Aspiring Urologists and Medical Students
For students considering urology, Dr. Khera recommends keeping an open mind and seeking exposure to subspecialties like sexual medicine and infertility, even if their home institutions lack such programs. He encourages participation in virtual research groups and highlights the importance of mentorship, which can profoundly shape a career[1].
When reaching out to potential mentors, he advises students to express genuine interest, reference the mentor’s research, and include a CV to facilitate meaningful connections[1].
Final Thoughts
Dr. Khera’s journey illustrates the dynamic nature of men’s health and sexual medicine—a field that blends cutting-edge science, surgical skill, and a deep commitment to improving quality of life. His message to students is clear: "If you love the field, don't be discouraged. It's not a matter of if, it's a matter of when. Just remember that. Don't give up"[1].
For more insights and episodes, visit the AUA News Sidetracked podcast.
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