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Urologist
31 years of experience
Video profile
Accepting new patients

Education ?

Medical School Score
University of Hawaii (1979)
  • Currently 2 of 4 apples

Awards & Distinctions ?

Awards  
Castle Connolly America's Top Doctors® (2009 - 2014)
Castle Connolly Top Doctors: New York Metro Area™ (2005 - 2008, 2010 - 2014)
Associations
American Board of Physical Medicine and Rehabilitation
American Board of Urology
American Urological Association

Affiliations ?

Dr. Linsenmeyer is affiliated with 6 hospitals.

Hospital Affilations

  • Kessler Institute for Rehabilitation - West Orange *
    1199 Pleasant Valley Way, West Orange, NJ 07052
  • Kessler Institute for Rehabilitation - Welkind Facility
    201 Pleasant Hill Rd, Chester, NJ 07930
  • Monmouth Medical Center
  • Kessler Institute Rehab
  • Kessler Institute for Rehabilitation - North Facility
    300 Market St, Saddle Brook, NJ 07663
  • St Barnabas Medical Center
  • * This information was reported to Vitals by the doctor or doctor's office.

    Publications & Research

    Dr. Linsenmeyer has contributed to 14 publications.
    Title The Reproducibility of Urodynamic Studies of Neurogenic Bladders in Spinal Cord Injury.
    Date July 2007
    Journal The Journal of Spinal Cord Medicine
    Excerpt

    OBJECTIVE: To evaluate the reproducibility (test-retest reliability) of urodynamic studies in neurogenic bladders of subjects with spinal cord injuries (SCI). DESIGN: Retrospective case series. SETTING: Urology department of a major rehabilitation center. SUBJECTS: Fifty individuals with SCI who had urodynamic studies performed from February 2000 to April 2000. MAIN OUTCOME MEASURES: Two trials (Time 1 and Time 2) of urodynamic studies done 5 minutes apart, with the following collected: bladder volume at first sensation, maximum cystometric capacity, presence of uninhibited contractions, opening pressure, maximum detrusor pressure, duration of bladder contraction, volume voided, and post-void residual (PVR) volume. The corresponding data were then compared. Statistical analysis was performed using the Lin's concordance correlation coefficient and kappa. RESULTS: Analysis of the data showed statistically significant levels of agreement between Time 1 and Time 2 with regard to the various corresponding parameters for both the filling and voiding phases. For 3 of the most important parameters-the opening pressure, maximum detrusor pressure, and duration of contraction-the Lin's concordance correlation coefficient (r(c)) was .86 (95% CI, .78-.95; p < .0005), .91 (95% CI, .86-.96; p < .0005), and .97 (95% CI, .95-.99, p < .0005), respectively. CONCLUSION: The study demonstrates good short-term intrasubject reproducibility of urodynamic studies in individuals with SCI.

    Title Normal Ranges of Variability for Urodynamic Studies of Neurogenic Bladders in Spinal Cord Injury.
    Date June 2006
    Journal The Journal of Spinal Cord Medicine
    Excerpt

    BACKGROUND/OBJECTIVE: Urodynamic studies are conducted on a regular basis to evaluate changes in bladder function after spinal cord injury. Often, differences in urodynamic parameters exist from one study or one year to the next. The objective of this study was to provide reference ranges for "normal" variability in urodynamic parameters that can be considered as "no real change" from one study to the next. DESIGN: Retrospective chart review. METHODS: Fifty consecutive individuals with spinal cord injury had 2 trials (trial 1 and trial 2) of urodynamic studies done 5 minutes apart, and the following data were collected: maximum cystometric capacity, opening pressure, maximum detrusor pressure, volume voided, and postvoid residual. The corresponding data were compared, and the frequency distribution for the change between consecutive studies was plotted. Because there is no standard, variability ranges for 5th to 95th, 10th to 90th, and 25th to 75th percentiles were calculated to give health care providers more choices. RESULTS: Ranges of variability are as follows in the following format (urodynamic parameter; mean value; +, maximum increase; -, maximum decrease)--5th to 95th percentile: cystometric capacity (234.63 mL, +213.50 mL, -158.05 mL); opening pressure (54.56 cmH2O, +30 cmH2O, -18.00 cmH2O); maximum detrusor pressure (60.82 cmH2O, +17.35 cmH2O, -27.80 cmH2O); volume voided (122.20 mL, +177.25 mL, -176.00 mL); postvoid residual (176.06 mL, +197.25 mL, -118.00 mL); 10th to 90th percentile: cystometric capacity (234.63 mL, +126.40 mL, -74.60 mL); opening pressure (54.56 cmH2O, +13.70 cmH2O, -12.00 cmH2O); maximum detrusor pressure (60.82 cmH2O, +10.00 cmH2O, -20.00 cmH2O); volume voided (122.20 mL, +105.60 mL, -82.00 mL); postvoid residual (176.06 mL, +131.00 mL, -86.00 mL); 25th to 75th percentile: cystometric capacity (234.63 mL, +72.00 mL, -27.00 mL); opening pressure (54.56 cmH2O, +4.00 cmH2O, -9.50 cmH2O; maximum detrusor pressure (60.82 cmH2O, +4.00 cmH2O, -10.00 cmH2O); volume voided (122.20 mL, +50.00 mL, -30.00 mL); postvoid residual (176.06 mL, +50.00 mL, -30.00 mL). CONCLUSIONS: Urodynamic studies have variability. Knowing these ranges of variability can be helpful in determining whether differences between filling trial 1 and filling trial 2 in a single study or year-to-year changes in urodynamic studies are significant or simply the normal variability of the urodynamic study.

    Title Evaluation of Cranberry Supplement for Reduction of Urinary Tract Infections in Individuals with Neurogenic Bladders Secondary to Spinal Cord Injury. A Prospective, Double-blinded, Placebo-controlled, Crossover Study.
    Date June 2004
    Journal The Journal of Spinal Cord Medicine
    Excerpt

    To determine the effectiveness of cranberry supplement at preventing urinary tract infections (UTIs) in persons with spinal cord injury (SCI).

    Title Effects of the Routine Change of Chronic Indwelling Foley Catheters in Persons with Spinal Cord Injury.
    Date February 2002
    Journal The Journal of Spinal Cord Medicine
    Excerpt

    OBJECTIVE: To determine whether routine catheter changes have any effect on the urinary white blood cell count (WBC) and bacterial culture in asymptomatic individuals with spinal cord injury (SCI) who have indwelling Foley catheters. DESIGN: Prospective case series. SETTING: Urology and SCI outpatient departments of a rehabilitation center. SUBJECTS: Twelve asymptomatic individuals (male and female) with SCI who have chronic indwelling urethral Foley catheters that are changed routinely every month. MAIN OUTCOME MEASURES: Two sets of urinalysis and urinary culture and sensitivity from each individual, one set taken through the Foley catheter before the catheter change and another set after the catheter change. WBC, bacterial identity, and colony count were measured, and the corresponding data were compared. RESULTS: All subjects had pyuria and bacteriuria before and after the catheter change. Analysis of the data showed a statistically significant increase in WBC in the urine after the indwelling Foley catheter was changed (P = .0039). However, bacterial types and corresponding colony counts remained almost completely unchanged. CONCLUSIONS: Routine change of chronic indwelling Foley catheters in asymptomatic individuals with SCI causes a significant rise in the urinary WBC, without altering the bacterial identity or colony count. Pyuria and bacteriuria are prevalent among individuals with SCI (including those who are asymptomatic) with indwelling Foley catheters. This study suggests that urinalysis should be taken before a catheter change.

    Title Epididymal Sperm Transport in Normal and Recent Spinal Cord Injured Sprague Dawley Rats.
    Date June 2000
    Journal The Journal of Spinal Cord Medicine
    Excerpt

    Causes of poor semen quality following spinal cord injury (SCI) are not known. One possible reason, based upon studies that reported improved semen quality in SCI men after several induced ejaculations, is delayed epididymal sperm transport. Our study was designed to establish baseline epididymal sperm transport values in the Sprague Dawley rat and evaluate effects of SCI on this process. Spermatozoa protamine was labeled with tritiated arginine, and the rats were sacrificed various times after injection. Each epididymis was divided into six equal sections from proximal to distal. Sperm tails were dissolved with 8 molar (M) urea in the presence of 2 mM dithiothreitol (DTT); sperm heads were collected by centrifugation (3,000 rpms, 10 min.). The radioactivity in sperm heads from each section was counted and expressed as counts per million sperm heads. To account for different rates of labeled arginine incorporation, the percentage of counts per million sperm heads in each section was calculated relative to the total number of counts in all six sections. Our results showed there was an orderly progression of sperm through the epididymis. It took 8 days for labeled sperm to enter the epididymis and 28 days to peak in the caudal (tail) section in non-SCI rats. Stasis was present 10 days after T-9 SCI in rats compared with transport in sham controls. This was evidenced by a significant increase in the percentage of labeled sperm in proximal sections of the epididymis (sections 1, 2, and 4) in T-9 transected animals (p < 0.01). If similar stasis occurs in SCI men, it could obviously contribute to poor semen quality. However, it remains to be determined how long this stasis persists after SCI in rats.

    Title Removal of Urolume Endoprosthesis: Experience of the North American Study Group for Detrusor-sphincter Dyssynergia Application.
    Date March 2000
    Journal The Journal of Urology
    Excerpt

    PURPOSE: We present the experience of the North American UroLume Multicenter Study Group with removal of the UroLume endoprosthesis. MATERIALS AND METHODS: A total of 160 neurologically impaired patients were enrolled in the North American UroLume Multicenter Study Group for detrusor external sphincter dyssynergia application. Analysis was performed in 2 groups of patients in which the device was removed during insertion and after implantation, respectively. RESULTS: Device retrieval was required during insertion in 21 patients (13%) mainly due to misplacement or migration in 17. Extraction was done with minimal complications and in all but 2 cases subsequent UroLume implantation was successful. Of 158 men with the device in place 31 (19.6%) required removal. In 34 procedures 44 devices were removed, mainly due to migration. Time from implantation to removal ranged from 4 days to 66 months (mean 22 months). The UroLume was removed en bloc in 20 cases and in parts or wire by wire in 19. The majority of patients had no or minimal complications after extraction. Only 2 patients had serious temporary complications, including bleeding and urethral injury, with no lasting consequences. No malignancy developed as a result of UroLume insertion. CONCLUSIONS: While there is a potential for urethral injury and bleeding, UroLume endoprosthesis removal is largely a simple procedure with minimal complications and consequences.

    Title Does Refrigeration of Urine Alter Culture Results in Hospitalized Patients with Neurogenic Bladders?
    Date June 1999
    Journal The Journal of Spinal Cord Medicine
    Excerpt

    A prospective, blinded study of 40 hospitalized spinal cord injured (SCI) patients was conducted to evaluate the effects of refrigeration on urinalysis and culture results. Urine samples were divided, with one aliquot examined within 4 hours and the other after 24 hours of refrigeration. Comparisons using Wilcoxon Signed Rank analysis showed no significant difference between fresh and refrigerated samples in white blood cell (WBC) count (z = -0.353, p = 0.724), number of bacteria (z = -0.772, p = 0.440), leukocytes (z = -0.277, p = 0.782), or colony counts of E. fecalis, E. coli, Citrobacter, Pseudomonas, Streptococcus, Yeast, or Acinetobacter (z = -1.00, p = 0.317; z = 0.00, p = 1.0; z = 0.00, p = 1.0; z = 0.00, p = 1.0; z = -1.00, p = 0.317; z = 0.00, p = 1.0; z = 0.00, p = 1.0, respectively). A statistically significant difference between fresh and refrigerated samples was found with "mixed" organisms (z = -2.565, p = 0.010) and a difference approaching significance was found with Staph aureus (z = -1.841, p = 0.066), both with colony counts of less than 50 k. No changes in cultures or colony counts occurred following refrigeration that would have resulted in altered treatment regimens. This study indicates that refrigeration of urine samples for up to 24 hours in the hospital setting rarely causes changes in identified organism type and causes no clinically significant changes in urinalysis or urine culture results in SCI patients.

    Title Long-term Followup of the North American Multicenter Urolume Trial for the Treatment of External Detrusor-sphincter Dyssynergia.
    Date May 1999
    Journal The Journal of Urology
    Excerpt

    PURPOSE: We determine the long-term efficacy and safety of the UroLume stent as minimally invasive treatment for external detrusor-sphincter dyssynergia in spinal cord injured men. MATERIALS AND METHODS: A total of 160 spinal cord injured men with a mean age plus or minus standard deviation of 36.3 +/- 12.1 years (range 16 to 74) were prospectively treated with an endoprosthesis at 15 centers as part of the North American UroLume trial for external detrusor-sphincter dyssynergia. Urodynamic parameters, including voiding pressure, residual urine volume and bladder capacity, were compared before treatment and at 1, 2, 3, 4 and 5 years after treatment. RESULTS: Mean voiding pressure was 75.1 +/- 28.2 cm. water before treatment in the 160 patients, and 37.4 +/- 23.9 at year 1 in 97, 39.5 +/- 22.2 at year 2 in 84, 42.6 +/- 27.3 at year 3 in 61, 46.3 +/- 33.2 at year 4 in 57 and 44.2 +/- 28.9 cm. at year 5 in 41 after stent insertion (p <0.001). Residual urine volume decreased after stent placement and was maintained throughout the 5-year followup (p <0.001). Mean cystometric capacity remained constant from 269 +/- 155 before insertion to 337 +/- 182 ml. 5 years later (p = 0.17). Hydronephrosis and autonomic dysreflexia improved or stabilized in most patients with functioning stents. Stent explant was necessary in 24 patients (15%), of whom 4 (16.7%) had another stent implanted. CONCLUSIONS: The UroLume stent demonstrates long-term safety and efficacy for the treatment of external detrusor-sphincter dyssynergia. The outcome was similar in men with and without previous sphincterotomy.

    Title The Impact of Urodynamic Parameters on the Upper Tracts of Spinal Cord Injured Men Who Void Reflexly.
    Date June 1998
    Journal The Journal of Spinal Cord Medicine
    Excerpt

    Few studies have evaluated which urodynamic parameters impact the upper urinary tracts in men with complete spinal cord injuries (SCI) who void reflexly. Previous studies focused primarily on voiding pressures. This study investigated the effects of bladder wall compliance, opening pressure, maximum detrusor voiding pressure, duration of the uninhibited contraction, cystometric bladder capacity and post-void residual on vesicoureteral reflux and stasis of the upper tracts. Urodynamic studies, cystograms and renal scans of 84 consecutive men with complete SCI who void reflexly were evaluated. Of the 84 patients (168 renal units), 71 men (142 renal units) had normal upper tracts, four patients (four renal units) had vesicoureteral reflux and nine patients (15 renal units--12 bilateral, three unilateral) had upper urinary tract stasis. There was no statistical difference between those with reflux and those without reflux with regards to any urodynamic parameter evaluated. When comparing those with and without upper urinary tract stasis, the only statistically significant difference in urodynamic parameters was the duration of bladder contraction. The mean duration of the uninhibited contraction in the non-stasis group was 113.7 seconds +/- 84 seconds (1.9 minutes +/- 1.4 minutes). The mean duration of the uninhibited contraction in the stasis group was 236.4 seconds +/- 139.1 seconds (3.9 minutes +/- 2.3 minutes, p = 0.0098). In summary, the duration of bladder contraction, which reflects both detrusor and sphincter function, was found to be an important variable in those with upper tract stasis. This should be considered when evaluating and treating men with complete SCI who void reflexly.

    Title Detrusor-sphincter Dyssynergia and Vesico Urethral Reflux: Management.
    Date March 1998
    Journal Spinal Cord : the Official Journal of the International Medical Society of Paraplegia
    Title The Effects of Spinal Cord Injury on the Status of Messenger Ribonucleic Acid for Trpm 2 and Androgen Receptor in the Prostate of the Rat.
    Date August 1997
    Journal Journal of Andrology
    Excerpt

    The prostate is one of the male accessory sex glands that produce fluid components of the seminal plasma. In addition to androgen, a normal innervation of the prostate is believed to be important for maintaining normal function of the prostate. Previously we noted that, in the rat, the weight of the prostate decreased following surgically induced spinal cord injury (SCI). This observation suggests that growth, and possibly function, of the prostate may be compromised after SCI. To explore this possibility, we examined the effects of SCI on the androgen-related biochemical properties and morphology of the prostate in the rat at various times after surgically induced SCI. SCI resulted in an acute decrease in prostate weight and an increase in steady state level of mRNA for testosterone-repressed prostate message 2 (TRPM 2) during the first 2 weeks postinjury. These changes perhaps relate to an increase in cell death or a decrease in secretory activity due to an acute suppression of serum testosterone after the injury. Concomitantly, there was a transient, but significant, decrease in the steady state level of androgen receptor (AR) mRNA in the prostate during the first 2 weeks after SCI, an indication of an altered autoregulation of AR by its own ligand. Despite the fact that growth of the prostate, as indicated by weight increase, in SCI rats resumed 2 weeks postinjury, prostate weights were persistently lower in SCI rats than sham-operated controls for at least 3 months. Furthermore, prostate TRPM 2 mRNA levels remained elevated throughout the recovery period even after a normal prostate weight had been restored. In addition, a decrease in the height of ventral prostate epithelial cells was noted in SCI rats 28 and 90 days postinjury. These results demonstrate a prolonged effect of SCI on prostate function. These findings and our unreported observation of persistently smaller seminal vesicles in the same groups of SCI rats suggest that functions of male accessory sex glands may also be compromised after SCI. These changes may affect biochemical properties of the secretory products of these glands and may provide some explanation for the reported changes in the composition of the seminal plasma and abnormal sperm motility seen in the semen of SCI men.

    Title Epidemiology of Current Treatment for Sexual Dysfunction in Spinal Cord Injured Men in the Usa Model Spinal Cord Injury Centers.
    Date December 1996
    Journal The Journal of Spinal Cord Medicine
    Excerpt

    This study is a prospective multicenter cooperative survey of the evaluation and treatment of erectile dysfunction in men with spinal cord injury (SCI). Uniform database questionnaires were completed prospectively by patients seeking therapy for erectile dysfunction. Eighty-five SCI men aged 17-68 years (mean age = 26 +/- 17) were enrolled. Mean duration of traumatic SCI was 3 +/- 3.2 years (Range = 0.3-18 years). The level of injury was cervical in 20 patients, thoracic in 31, lumbar in 29 and sacral in five. Patients were fully evaluated and then counseled as to their therapeutic options. Twenty-eight chose to use a vacuum erection device (VED), 26 preferred pharmacological penile injection and five used both intracorporeal therapy and VED. The remainder were managed with marriage and sexual counseling in 10 patients, three underwent penile prosthesis placement and two used topical pharmacotherapy. Four patients used other forms of treatment and in nine no therapy was recommended. Of the patients that used pharmacologic injection only, 74 percent used papaverine as a single agent, 20 percent used papaverine with phentolamine, five percent used prostaglandin E (PGE1) alone and one percent used a mixture. Patients using injection therapy report sexual intercourse a mean of 3 +/- 3.4 times per month as compared with 5 +/- 3.2 times per month in those using VED. Five intracorporeal injection patients developed priapism while two patients using the VED developed subcutaneous bleeding and one developed penile ischemia. We conclude that although a spectrum of erectile dysfunction treatment is present among SCI centers, VED and pharmacological penile injection are by far the two most popular methods of treatment and papaverine is the most common drug. The incidence of complications is small in the model centers.

    Title Silent Autonomic Dysreflexia During Voiding in Men with Spinal Cord Injuries.
    Date February 1996
    Journal The Journal of Urology
    Excerpt

    PURPOSE: We determined whether symptoms of autonomic dysreflexia correlated with elevations in blood pressure in men with spinal cord injuries. MATERIALS AND METHODS: During a routine yearly urodynamic evaluation 45 consecutive men with complete spinal cord injuries above T6 underwent simultaneous monitoring of blood pressure and symptoms of autonomic dysreflexia. Those with systolic blood pressure of greater than 160 mm. Hg or diastolic blood pressure of greater than 90 mm. Hg during voiding were assigned to the hypertensive group. During voiding 35 men (78%) had significant hypertension. RESULTS: Before voiding there was no statistical difference in mean systolic blood pressure between men with and without hypertension (117 versus 110 mm. Hg, p = 0.28). During uninhibited contractions and voiding mean systolic blood pressure of the normotensive group (131 mm. Hg) versus the hypertensive group (169 mm. Hg) was statistically significant (p < 0.0001). Of the 35 hypertensive patients 15 (43%) had no symptoms of autonomic dysreflexia. There was no correlation of autonomic dysreflexia with length of injury, maximum voiding pressure or bladder capacity (p = 0.59, 0.85 and 0.34, respectively). CONCLUSIONS: Urodynamics are helpful to detect symptomatic and asymptomatic autonomic dysreflexia. Significant elevations in blood pressure can occur without the symptoms of autonomic dysreflexia.

    Title Spermatogenesis and the Pituitary-testicular Hormone Axis in Rats During the Acute Phase of Spinal Cord Injury.
    Date September 1994
    Journal The Journal of Urology
    Excerpt

    Male infertility frequently occurs after spinal cord injury (SCI). However, little is known about the acute effects of SCI on male reproductive function. This study evaluated the effects of SCI on spermatogenesis and testicular-pituitary function in rats 2 and 4 weeks after injury. Spinal cord injury was produced in rats by T9 spinal cord transection. Controls received similar surgery without transection. Complete spermatogenesis was seen 2 weeks after SCI; however, abnormalities were present in the seminiferous tubules. Hormone levels were similar in the two groups. Four weeks after SCI, incomplete spermatogenesis was noted in 3 of 9 rats, 4 others had delayed spermiation, and the last 2 had nonspecific regression of seminiferous epithelium. Serum testosterone levels were lower at 4 weeks in SCI rats than in controls, but testicular testosterone content was not. Plasma gonadotropin levels were similar in the two groups 4 weeks after SCI. Quantitative analysis revealed a 26 to 33% decrease in the number of spermatogenic cells in stage VII seminiferous tubules at 4 weeks in SCI rats (p < 0.01). This study demonstrated that qualitative and quantitative impairments of spermatogenesis occur during the acute phase of SCI in rats.

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