MP36-09 URINARY FUNCTION AND PROSTATE SAFETY OF LONG-TERM TESTOSTERONE THERAPY (TTh) IN MEN WITH FUNCTIONAL HYPOGONADISM IN A UROLOGICAL REGISTRY STUDY

Abstract

You have accessJournal of UrologySexual Function/Dysfunction: Medical, Hormonal & Non-surgical Therapy II (MP36)1 Sep 2021MP36-09 URINARY FUNCTION AND PROSTATE SAFETY OF LONG-TERM TESTOSTERONE THERAPY (TTh) IN MEN WITH FUNCTIONAL HYPOGONADISM IN A UROLOGICAL REGISTRY STUDY Ahmad Haider, Karim Sultan Haider, Gheorghe Doror, and Abdulmaged Traish Ahmad HaiderAhmad Haider More articles by this author , Karim Sultan HaiderKarim Sultan Haider More articles by this author , Gheorghe DororGheorghe Doror More articles by this author , and Abdulmaged TraishAbdulmaged Traish More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002045.09AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: According to current guidelines, there is no evidence for an increased risk for prostate diseases with testosterone therapy (TTh). Concerns are still common in general practice as well as urology offices. To provide more data from clinical experience, we analyzed a registry database of men with functional hypogonadism. METHODS: 779 men with functional hypogonadism were analysed. 386 men received testosterone undecanoate injections 1000 mg/12 weeks following an initial 6-week interval (T-group), 393 opted against TTh and served as controls (CTRL). 11-year results were analyzed. Changes over time between groups were compared and adjusted for age, weight, waist circumference, fasting glucose, blood pressure, lipids and quality of life to account for baseline differences between groups. RESULTS: Baseline age: 58.4±6.4 (T-group), 63.1±4.8 years (CTRL) (p<0.0001). At baseline, alpha-blockers were used by 44.3% (T-group) and 50.4% (CTRL) (p=0.1534), 5α-reductase inhibitors by 2.6% and 8.4% (p<0.0005), and PDE5-Inhibitors by 25.9% and 22.1% (p=0.2181). T-group: IPSS declined by 5.1±0.1 in year 11. CTRL: IPSS increased by 4.1±0.1. Estimated adjusted difference between groups at 11 years: -9.2 (p<0.0001 for all). Prostate volume increased by 3.1±0.2 mL (T-group) and by 3.9±0.2 mL (CTRL) (p<0.0001 for both), difference between groups: -0.8 mL (p<0.01). PSA increased by 0.06±0.1 ng/mL (T-group) (p=0.5508) and by 1.1±0.1 ng/mL (CTRL) (p<0.0001), difference between groups: -1.0 (p<0.0001). Prostate cancer (PCa) incidence: 12 patients (3.1%) in the T-group were diagnosed with PCa, 50 (12.7%) in CTRL (p<0.0001). All PCas in the T-group were diagnosed within 18 months after receiving the first injection of TU. In CTRL, PCa was diagnosed at any time during the observation period. Only in CTRL, biochemical recurrence occurred in 18 (36%) patients. These patients received LHRHa. 18 (36%) patients died of whom 11 were on LHRHa. CONCLUSIONS: Long-term TTh in men with functional hypogonadism improved urinary function which worsened in untreated controls. TTh was not associated with an increased PCa risk. The fact that PCa in the T-group was always detected within the first 18 months of TTh suggests that TTh unveiled PCa that had previously been undetectable. Incidence of PCa was four times higher in untreated patients with functional hypogonadism, suggesting a protective effect of maintaining stable testosterone levels. Source of Funding: Data entry and statistical analysis was compensated by Bayer AG. © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e639-e639 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Ahmad Haider More articles by this author Karim Sultan Haider More articles by this author Gheorghe Doror More articles by this author Abdulmaged Traish More articles by this author Expand All Advertisement Loading ...