MP25-02 TESTOSTERONE REPLACEMENT THERAPY FOR HYPOGONADAL PATIENTS WITH CHRONIC PROSTATITIS / CHRONIC PELVIC PAIN SYNDROME

Abstract

You have accessJournal of UrologyInfections/Inflammation of the Genitourinary Tract: Prostate & Genitalia1 Apr 2015MP25-02 TESTOSTERONE REPLACEMENT THERAPY FOR HYPOGONADAL PATIENTS WITH CHRONIC PROSTATITIS / CHRONIC PELVIC PAIN SYNDROME Ran Pang, Jianxin Lu, Xinyao Zhou, Xiaosong Gao, and Yaqiang Zhang Ran PangRan Pang More articles by this author , Jianxin LuJianxin Lu More articles by this author , Xinyao ZhouXinyao Zhou More articles by this author , Xiaosong GaoXiaosong Gao More articles by this author , and Yaqiang ZhangYaqiang Zhang More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2015.02.1205AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) affects about 10-15% of male population and dramatically diminishes quality of life (QOL). It has been shown that patients with CP/CPPS have a lower serum testosterone level compared to controls. The aim of this study was to evaluate the effect of testosterone replacement therapy (TRT) on symptoms of CP/CPPS in patients with hypogonadism. METHODS Forty-eight patients affected by CP/CPPS were prospectively recruited in the study. Diagnosis of CP/CPPS was performed according to the National Institutes of Health (NIH) criteria. Inclusion criteria were patients aged 18 to 60 years, with a CP/CPPS history of more than one year, a score of at least 15 on NIH Chronic Prostatitis Symptoms Index (NIH-CPSI), and a serum total testosterone concentration of less than 300 ng/dl. Patients with diagnosed or suspected prostate cancer, severe bladder outlet obstruction (Qmax < 10 ml/s) and polycythemia (HCT > 48% or hemoglobin >16 g/dl ) were excluded. Eligible patients received treatment with testosterone undecanoate 80mg orally twice a day for 12 weeks. NIH-CPSI, Hamilton Anxiety Scale (HAM-A), Hamilton Depression Scale (HAM-D) and serum total testosterone concentration were measured before and after treatment to assess the effect of TRT. RESULTS Of the 48 patients, 45 completed 12-week follow-up. The mean (SD) age of patients was 47 (8) years and the duration of CP/CPPS since diagnosis varied from one to 17 years. The mean (SD) prostate volume and maximal urine flow at baseline were 34 (9.3) ml and 16.5 (4.3) ml/s respectively. After 12-week treatment, patients' total NIH-CPSI score reduced significantly, so did pain domain, urinary domain and QOL domain score (Table 1). Furthermore, both HAM-A and HAM-D score dropped dramatically (Table 1). Additionally, the serum total testosterone concentration was also increased significantly (Table 1). CONCLUSIONS Our study suggested that TRT could improve clinical symptoms, QOL and psychological status in hypogonadal patients affected by CP/CPPS. TRT might be a therapeutic strategy for CP/CPPS in patients with hypogonadism. Table 1. Summary of NIH-CPSI, HAM-A, HAM-D and serum total testosterone at baseline and post-treatment Baseline Post-treatment P-value NIH-CPSI (Pain) a 11.9 ± 3.1 5.3 ± 3.5 P< 0.01 NIH-CPSI (Urinary symptoms) a 2.3 ± 1.5 2 ± 1.3 P> 0.05 NIH-CPSI (QOL)a 7.8 ± 2.1 3.8 ± 2.2 P< 0.01 NIH-CPSI (Total) a 22 ± 5.2 11.2 ± 5.5 P< 0.01 HAM-A a 19.7 ± 7.3 8.3 ± 6.2 P< 0.01 HAM-D a 16.9 ± 6 10.1 ± 4.8 P< 0.01 Serum total testosterone b (ng/dl) 257.8 ± 34.9 386.1 ± 63 P< 0.01 Values were given as mean ± SD. aDifferences were analyzed by the Wilcoxon signed-rank test between baseline and post-treatment; bDifference was compared by paired t-test between baseline and post-treatment. Abbreviations: NIH-CPSI, National Institutes of Health Chronic Prostatitis Symptom Index; HAM-A, Hamilton Anxiety Scale; HAM-D, Hamilton Depression Scale; QOL, quality of life. © 2015 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 193Issue 4SApril 2015Page: e285 Advertisement Copyright & Permissions© 2015 by American Urological Association Education and Research, Inc.MetricsAuthor Information Ran Pang More articles by this author Jianxin Lu More articles by this author Xinyao Zhou More articles by this author Xiaosong Gao More articles by this author Yaqiang Zhang More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...