Presentation Authors: Khalid Alrumaihi, Riad Talib, Sabah Alkadhi, Abdulla Al Ansari, Aksam Yassin*, Doha, Qatar
Introduction: : Long-term effectiveness and safety of TU in hypogonadal men were studied in a urological setting. One of the concerns regarding testosterone therapy (TTh) in elderly men remains increasing prostate volume and worsening urinary function parameters.
Methods: Observational, prospective, cumulative registry study in 321 men (age: 58.9 Â± 9.8 years, range: 19-84) with total testosterone (T) levels â‰¤350 ng/dL and symptoms of hypogonadism. All men received parenteral TU 1000 mg/12 weeks following an initial 6-week interval for up to 14 years (T-group). In 147 men, TTh had been temporarily discontinued between years 6 and 8, due to reimbursement issues or diagnosis of prostate cancer, as published previously (Yassin et al. Aging Male 2016; 19: 64-69; Yassin et al. Clin Endocrinol 2016; 84:107-114). Parameters related to voiding function were measured between one and four times per year.
Results: Total T rose from 223Â±62 to trough levels between 460 and 535 ng/dL (p < 0.0001).IPSS decreased from 10.1Â±5.0 to 8.3Â±4.5 after 1 year, 7.6Â±4.2 after 2 years, 7.2Â±3.8 after 3 years, 6.8Â±3.6 after 4 years, 6.9Â±3.6 after 5 years, 7.5Â±3.7 after 6 years, 8.6Â±4.0 after 7 years, 8.4Â±3.9 after 8 years, 7.3Â±2.9 after 9 years, 7.3Â±2.6 after 10 years, 7.3Â±2.7 after 11 years, and 6.6Â±2.7 after 12 years (p < 0.0001 vs. baseline).Post-voiding residual bladder volume decreased from 23.8Â±16.2 to 16.7Â±6.4 mL (p < 0.0001 vs. baseline) with a temporary increase in years 6 to 8.Prostate volume increased steadily from 28.7Â±8.3 to 39.0Â±6.4 mL (p < 0.0001 vs. baseline) without deviation from the trend during years 6 to 8, when TTh was interrupted in 147 men.The Aging Malesâ€™ Symptoms scale (AMS), a quality of life (QoL) instrument, improved from 53.7Â±9.5 to 27.5Â±4.0 (p < 0.0001 vs. baseline) with a temporary increase in years 6 to 8.Medication adherence in the T-group was 100 per cent as all injections were administered in the office and documented. 3 patients were lost to follow-up and considered drop-outs.
Conclusions: Long-term TTh with TU in an unselected hypogonadal men resulted in improvement of voiding function which seemed to be independent of prostate volume. QoL, closely related to voiding function, developed in parallel. All parameters except prostate volume worsened in those patients in whom TTh was temporarily interrupted.