MP36-03 LOW TESTOSTERONE LEVELS PREDISPOSE TO URETHRAL ATROPHY DUE TO DECREASED URETHRAL VASCULARITY VIA AN ANDROGEN RECEPTOR-MEDIATED PROCESS

Abstract

You have accessJournal of UrologyTrauma/Reconstruction/Diversion: Urethral Reconstruction (including Stricture, Diverticulum) I1 Apr 2017MP36-03 LOW TESTOSTERONE LEVELS PREDISPOSE TO URETHRAL ATROPHY DUE TO DECREASED URETHRAL VASCULARITY VIA AN ANDROGEN RECEPTOR-MEDIATED PROCESS Matthias D Hofer, Payal Kapur, Billy H Cordon, Farrah Hamoun, David Russell, Jeremy M Scott, Claus G Roehrborn, and Allen F Morey Matthias D HoferMatthias D Hofer More articles by this author , Payal KapurPayal Kapur More articles by this author , Billy H CordonBilly H Cordon More articles by this author , Farrah HamounFarrah Hamoun More articles by this author , David RussellDavid Russell More articles by this author , Jeremy M ScottJeremy M Scott More articles by this author , Claus G RoehrbornClaus G Roehrborn More articles by this author , and Allen F MoreyAllen F Morey More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2017.02.1114AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES We recently identified that hypogonadism predisposes to artificial urinary sphincter (AUS) erosion. The aim of this study was to compare histologic features of human periurethral tissue among eugonadal and hypogonadal patients in order to identify pathologic mechanisms for this predisposition. METHODS Among a cohort of over 1200 men having urethroplasty at our institution, we retrospectively identified 11 patients who had serum testosterone levels drawn within 2 years of surgery and who had tissue samples available. Low serum testosterone was defined as <280 ng/dl. Tissue samples were analyzed by immunohistochemistry to determine expression of androgen receptor (AR), TIE-2 (a downstream target of activated AR linking it to angiogenesis), and CD31 (to highlight vessels). Microscopic images were objectively evaluated for protein expression and vessel counts using Image J software. RESULTS We found a significant decrease of AR expression (1.11%HPF vs. 1.62, p=0.016), TIE-2 expression (1.84%HPF vs. 3.08, p=0.006), and vessel counts (44.47 vessels/HPF vs. 98.33, p=0.004) in men with low serum testosterone. Expression levels of AR and TIE-2 were directly correlated to serum testosterone levels (rho 0.685, p=0.029, and rho 0.773, p=0.005, respectively). We did not find a difference in age, prior radiation, co-morbidities such as coronary artery disease or hypertension among patients with normal or low testosterone levels with the exception of higher body mass index in patients with low testosterone levels. CONCLUSIONS Men with low serum testosterone levels demonstrate decreased expression of AR and TIE-2 and lower vessel count in periurethral tissues. Our results provide a rationale for a mechanistic relationship between low testosterone levels and subsequent decreased periurethral vascularity. We believe that this results in urethral atrophy conferring a higher risk of AUS erosion. © 2017FiguresReferencesRelatedDetails Volume 197Issue 4SApril 2017Page: e466-e467 Advertisement Copyright & Permissions© 2017MetricsAuthor Information Matthias D Hofer More articles by this author Payal Kapur More articles by this author Billy H Cordon More articles by this author Farrah Hamoun More articles by this author David Russell More articles by this author Jeremy M Scott More articles by this author Claus G Roehrborn More articles by this author Allen F Morey More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...