1498 TESTOSTERONE REPLACEMENT THERAPY IN HIGH RISK PATIENTS FOLLOWING RADICAL PROSTATECTOMY

Abstract

You have accessJournal of UrologySexual Function/Dysfunction/Andrology: Medical and Non-Surgical Therapy II1 Apr 20101498 TESTOSTERONE REPLACEMENT THERAPY IN HIGH RISK PATIENTS FOLLOWING RADICAL PROSTATECTOMY Kumaran Sathyamoorthy, Marshall Stein, Osama Mohammed, Larry Lipshultz, and Mohit Khera Kumaran SathyamoorthyKumaran Sathyamoorthy Houston, TX More articles by this author , Marshall SteinMarshall Stein New Orleans, LA More articles by this author , Osama MohammedOsama Mohammed Houston, TX More articles by this author , Larry LipshultzLarry Lipshultz Houston, TX More articles by this author , and Mohit KheraMohit Khera Houston, TX More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2010.02.1235AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Testosterone replacement therapy (TRT) is the main treatment for symptomatic hypogonadism, and can help mitigate the sequelae of hypogonadism such as increased cardiovascular disease, erectile dysfunction and osteoporosis. However, significant controversy exists regarding the role of TRT in patients with a history of prostate cancer. Several series have demonstrated the low risk of PSA biochemical recurrence with TRT in radical prostatectomy (RP) patients. We present the largest series in the literature of post RP patients receiving TRT, and the first data on the risk of TRT in a series of high risk patients following RP. METHODS A total of 133 hypogonadal patients with history of RP were treated with TRT. Of these patients, 21 were classified as high risk (Gleason greater than or equal to 8, positive margins or node positive disease). Patients were all started on TRT for symptomatic hypogonadism following RP. Serum prostate specific antigen (PSA) and testosterone levels were measured every three months. Data analysis was completed with SPSS. RESULTS Mean patient age was 64.9 years. Patients were followed for a mean of 363 days. There were no PSA recurrences, and there was no statistically significant increase in PSA over the course of treatment. Among high risk patients, eight patients had a Gleason 8 or greater, 16 had positive margins and 1 patient had a positive lymph node. Mean PSA was .003 ng/mL (+/- .001) at the start of therapy, .016 (+/- .027) at three months, .011 (+/- .008) at six months, .010 (+/- .01) at 9 months, .010 (+/- .01) at 12 months and .01 (+/-.008) at 15 months. Testosterone increased from 262 to 418 ng/dL. There was no significant change in PSA during the duration of treatment (p > .05 at all intervals). CONCLUSIONS These data demonstrate that there was no statistically significant change in PSA among men placed on TRT with a history of RP and high risk characteristics. Although these results are encouraging, randomized clinical trials are needed to validate these findings. © 2010 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 183Issue 4SApril 2010Page: e577 Advertisement Copyright & Permissions© 2010 by American Urological Association Education and Research, Inc.MetricsAuthor Information Kumaran Sathyamoorthy Houston, TX More articles by this author Marshall Stein New Orleans, LA More articles by this author Osama Mohammed Houston, TX More articles by this author Larry Lipshultz Houston, TX More articles by this author Mohit Khera Houston, TX More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...