MP31-14 THE ROLE OF HORMONAL ASSESSMENT IN PRE-VASECTOMY REVERSAL WORKUP

Abstract

You have accessJournal of UrologyInfertility: Therapy (MP31)1 Sep 2021MP31-14 THE ROLE OF HORMONAL ASSESSMENT IN PRE-VASECTOMY REVERSAL WORKUP Mohamed Ahmed, Engy Habashy, Matthew Ziegelmann, Tobias Kohler, and Sevann Helo Mohamed AhmedMohamed Ahmed More articles by this author , Engy HabashyEngy Habashy More articles by this author , Matthew ZiegelmannMatthew Ziegelmann More articles by this author , Tobias KohlerTobias Kohler More articles by this author , and Sevann HeloSevann Helo More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002035.14AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Testosterone is a sex hormone produced by Leydig cells essential for spermatogenesis and fertility. Treatment of hypogonadism in young infertile men can result in improvements in semen parameters. In this study, we sought to study – for the first time – hypogonadism in men undergoing vasectomy reversal (VR) who could benefit from medical intervention. METHODS: We reviewed our prospective database of all VRs performed for fertility at our institution between 10/1/2019 – 12/30/2020. Hormonal assessment included total and free testosterone, FSH, LH, and estradiol. Hypogonadism was defined as a total testosterone level <300 ng/dl. Patients were screened for symptoms of hypogonadism, including decreased libido, maintaining weight, fatigue, decreased motivation, erectile dysfunction, depression, difficulty concentrating, and somnolence. RESULTS: We identified 70 patients who met our inclusion criteria. All patients had a history of previous paternity. Median (IQR) time since vasectomy in our cohort was 6.5 (4-10) years, median (IQR) patients age at the time of vasectomy reversal was 40 (36 – 44) years old. On pre-VR hormonal assessment 85.7 % (n=60) of the patients showed normal testosterone levels (Group A) with a median (IQR) of 457 (366.5 – 530.3) ng/dl, 14.3% (n=10) were hypogonadal (Group B) with median (IQR) total testosterone level of 263 (198.8 – 284.8) ng/dl. Interestingly, in addition to Testosterone levels, Group B showed lower levels of LH, FSH, and T/E2 ratio (Table 1). Figure 1 shows the reported hypogonadal symptoms in group A versus group B in this cohort. CONCLUSIONS: Almost 15% of men undergoing VR demonstrated biochemical hypogonadism, of which 80% had shown associated symptoms. Libido was the most sensitive symptom in detecting hypogonadism in 100% of the patients, however, 77% of eugonadal patients also endorsed having decreased libido. Preoperative workup should include an assessment for hypogonadal symptoms, and if positive, prompt hormonal workup. Source of Funding: None © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e560-e560 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Mohamed Ahmed More articles by this author Engy Habashy More articles by this author Matthew Ziegelmann More articles by this author Tobias Kohler More articles by this author Sevann Helo More articles by this author Expand All Advertisement Loading ...