About

James M. Hotaling, MD, MS, FECSM, is a board-certified, fellowship-trained urologist specializing in male infertility, erectile dysfunction, Peyronie’s Disease, testicular pain, and other complex men’s health conditions. He is the highest-volume male infertility surgeon in the Mountain West and offers advanced treatments including penile implant surgery, microsurgical testicular sperm extraction (microTESE), and vasectomy reversal, with excellent outcomes. At the University of Utah Health, Dr. Hotaling leads a comprehensive men’s health practice dedicated exclusively to male reproductive and sexual health, performing numerous surgical procedures each year. He is also the Medical Director of the Fertility Integrated Practice Unit, Director of the Men’s Health Program, and Co-Director of the Reconstructive Urology and Men’s Health Fellowship. His research in male infertility and erectile dysfunction is NIH-funded, and he has published over 300 peer-reviewed articles. Dr. Hotaling earned his undergraduate degree from Dartmouth College, his medical degree from Duke University, completed a urology residency at the University of Washington, and a fellowship in Male Infertility and Men’s Health at the University of Illinois at Chicago.

Research topics

• Medicine
• Internal medicine
• Biology
• Surgery
• Cell biology
• Urology
• Genetics
• Andrology
• Endocrinology
• Finance
• Intensive care medicine
• Business
• Emergency medicine
• Pharmacology
• Anatomy
• Statistics
• Gynecology
• Ecology
• Anesthesia
• Animal science
• Oncology
• Bioinformatics
• Pediatrics
• Virology

Selected publications

• Colibactin-associated mutations in the human colon appear to reflect anatomy and early exposure, not oncogenesis

  medRxiv · 2026-04-15

  articleOpen access

  Abstract Colorectal cancer (CRC) is the second leading cause of cancer death globally and the number one cause of cancer death in people under 50 years old. The reasons for the rise of early-onset CRC are unknown, and while anatomically distinct subtypes of CRC have substantial clinical and molecular associations, the etiology of region-specific disease, such as early-onset CRC’s enrichment in the distal colon, remains unclear. Understanding regional mutagenesis may identify risk factors for this public health concern and CRC more broadly. To evaluate mutational dynamics across the premalignant colon, we performed whole-genome sequencing of 125 individual colon crypts taken from six standardized regions biopsied during colonoscopy, collected from 11 donors without polyps and 10 with polyps. We observed mutation spectra and accumulation rates consistent with previous whole-organ studies, with greater subclonal mutation capture enabled by experimental design. T>[A,C,G] mutations, which are associated with colibactin genotoxicity from pks+ Escherichia coli , were significantly enriched in the rectum of donors with and without polyps (adjusted p-values < 0.01). Moreover, when comparing findings to crypts from individuals with CRC and sequenced CRC tumors, we observed consistent enrichment of the colibactin-associated mutational signature “ID18” in the rectum in both normal colon crypts and CRC tumors, without significant difference in colibactin-specific single nucleotide variant or insertion-deletion burden in crypts across the three clinical groups (i.e., no polyp, polyp, and CRC). These findings argue against a causal or prognostic role for colibactin in CRC, instead indicating that the proposed association with early-onset disease reflects anatomic specificity rather than cancer-specific clinical relevance.

  PublisherDOI

• Conserved shifts in sperm small non-coding RNA profiles during mouse and human aging

  The EMBO Journal · 2026-01-20 · 2 citations

  articleOpen access

  Sperm aging impacts male fertility and offspring health, highlighting the need for reliable aging biomarkers to guide reproductive decisions. However, the molecular determinants of sperm fitness during aging remain ill-defined. Here, we profiled sperm small non-coding RNAs (sncRNAs) using PANDORA-seq, which overcomes RNA modification-induced detection bias to capture previously undetectable sncRNA species associated with mouse and human spermatozoa throughout the lifespan. We identified an "aging cliff" in mouse sperm RNA profiles-a sharp age-specific transition marked by significant shifts in genomic and mitochondrial tRNA-derived small RNAs (tsRNAs) and rRNA-derived small RNAs (rsRNAs). Notably, rsRNAs in mouse sperm heads exhibited a transformative length shift, with longer rsRNAs increasing and shorter ones decreasing with age, suggesting altered biogenesis or processing with age. Remarkably, this sperm head-specific shift in rsRNA length was consistently observed in two independent human aging cohorts. Moreover, transfecting a combination of tsRNAs and rsRNAs resembling the RNA species in aged sperm was able to induce transcriptomic changes in mouse embryonic stem cells, impacting metabolism and neurodegeneration pathways, mirroring the phenotypes observed in offspring fathered by aged sperm. These findings provide novel insights into longitudinal dynamics of sncRNAs during sperm aging, highlighting an rsRNA length shift conserved in mice and humans.

  PublisherOA PDFDOI

• Multicenter examination of contemporary penile prosthesis surgery infection prophylaxis practices

  The Journal of Sexual Medicine · 2025-06-18 · 1 citations

  articleOpen access
  PublisherOA PDFDOI

• IP09-26 RISK OF HYPOSPADIAS INCREASES WITH PRECONCEPTION AND PRENATAL EXPOSURES TO INDUSTRIAL CHEMICAL AIR POLLUTION

  The Journal of Urology · 2025-04-08

  article
  PublisherDOI

• DESCRIBING PATTERNS OF INCREASED RISK FOR AUTISM SPECTRUM DISORDER (ASD) IN FAMILIES OF SUBFERTILE MEN USING POPULATION PEDIGREE DATA

  Fertility and Sterility · 2025-12-01

  articleOpen accessSenior author
  PublisherOA PDFDOI

• (389) Multicenter Evaluation on the Use of Down-Sized Cylinders Penile Prosthesis: When to Go Narrow?

  The Journal of Sexual Medicine · 2025-11-01

  articleOpen access

  Abstract Introduction Down-sized inflatable penile prosthesis (IPP) cylinders are useful in cases with substantial penile fibrosis such as history of priapism or prior infection. Although down-sized IPP cylinders have a clear role in fibrotic corpora, their role in primary implant cases is unclear. Objective To identify factors associated with the use of down-sized cylinders in men undergoing primary IPP placement. Methods We conducted a retrospective analysis of 4,389 patients undergoing primary IPP placement from our multicenter database. Patients were categorized by down-sized (AMS 700 CXR, Coloplast NB) vs. standard sized cylinders (AMS 700 CX, AMS 700 LGX, Coloplast Titan). We collected demographic, intraoperative, and postoperative data. A multivariable analysis was performed to identify factors associated with use of down-sized cylinders Results A total of 4,389 men undergoing primary inflatable penile prosthesis (IPP) placement were included in the study, with a mean age of 62.3 ± 10.3 years. Among them, 1,485 (34%) had diabetes and 2,131 (49%) had hypertension. A total of 406 down-sized cylinders and 3,983 standard cylinders were implanted. Non-infectious complications occurred more frequently with the use of down-sized cylinders (odds ratio [OR] = 2.0, p < 0.001). Specifically, non-infectious complications were reported in 44 out of 185 men (23.8%) with down-sized cylinders, compared to 192 out of 2,727 men (10.9%) with standard cylinders. Cylinder complications constituted 13.9% and 13.0% of the non-infectious complications in the down-sized and standard cylinder groups, respectively. Conclusions The rate of cylinder-related complications were similar between the down-sized cylinder and standard cylinder groups. Urologists should be prepared to place down-sized cylinders during IPP placement in diabetic men and in men requiring serial dilation due to fibrosis. Disclosure Any of the authors act as a consultant, employee or shareholder of an industry for: Intuitive Surgical, Fidelis, Urofill, Boston Scientific, Coloplast, Cynosure, Antares Pharma, Clarus Pharmaceuticals, Acerus Pharma; Endo Pharma.

  PublisherOA PDFDOI

• Prior Radiation Therapy is Associated With Increased Risk of Intraoperative Complications in Patients Undergoing Primary Inflatable Penile Prosthesis Placement: Results From a Large Multi-institutional Collaborative

  Urology · 2025-08-08 · 1 citations

  article
  PublisherDOI

• MP12-14 IMPACT OF HEPATITIS B VIRUS AND HEPATITIS C VIRUS INFECTION ON SEMEN PARAMETERS; A SYSTEMATIC REVIEW AND META-ANALYSIS

  The Journal of Urology · 2025-04-08

  reviewSenior author
  PublisherDOI

• IP18-13 A MULTI-INSTITUTIONAL ANALYSIS OF REAR TIP EXTENDER USE AND INFLATABLE PENILE PROSTHESIS COMPLICATIONS IN PATIENTS UNDERGOING PRIMARY INFLATABLE PENILE PROSTHESIS PLACEMENT: RESULTS FROM PUMP COLLABORATIVE

  The Journal of Urology · 2025-04-08

  article
  PublisherDOI

• Environmental PM2.5 Exposure and Socioeconomic Deprivation Are Independent Risk Factors for Impaired Semen Parameters

  Urology · 2025-08-01 · 1 citations

  article
  PublisherDOI

Recent grants

• Susceptibility Genes for Erectile Dysfunction

  NIH · $768k · 2016–2022

Frequent coauthors

• Jeremy B. Myers

  185 shared

• Sorena Keihani

  University of Utah

  137 shared

• Benjamin N. Breyer

  University of California, San Francisco

  120 shared

• Bradley A. Erickson

  NYU Langone Health

  117 shared

• Nima Baradaran

  University of California, San Francisco

  113 shared

• Sarah Majercik

  Intermountain Medical Center

  108 shared

• Sean P. Elliott

  University of Minnesota

  106 shared

• Raminder Nirula

  University of Utah

  105 shared

Education

• B.A., History and Biophysical Chemistry

  Dartmouth College

• M.D.

  Duke University

• Other, Urology Residency

  University of Washington

• Other, Fellowship in Male Infertility and Men’s Health

  University of Illinois at Chicago

Awards & honors

• Fellow of the European College of Sexual Medicine (FECSM)