MP51-05 DEFINING THE INCIDENCE OF POLYCYTHEMIA IN MEN USING INTRAMUSCULAR TESTOSTERONE SUPPLEMENTATION

Abstract

You have accessJournal of UrologySexual Function/Dysfunction/Andrology: Evaluation II1 Apr 2015MP51-05 DEFINING THE INCIDENCE OF POLYCYTHEMIA IN MEN USING INTRAMUSCULAR TESTOSTERONE SUPPLEMENTATION Serkan Deveci, Patrick Teloken, Keith O'Brien, Patricia Guhring, Marilyn Parker, Joseph Narus, and John P. Mulhall Serkan DeveciSerkan Deveci More articles by this author , Patrick TelokenPatrick Teloken More articles by this author , Keith O'BrienKeith O'Brien More articles by this author , Patricia GuhringPatricia Guhring More articles by this author , Marilyn ParkerMarilyn Parker More articles by this author , Joseph NarusJoseph Narus More articles by this author , and John P. MulhallJohn P. Mulhall More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2015.02.1742AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Polycythemia (PCT) is well-recognized adverse effect of testosterone supplementation. However, widely disparate rates exist in the literature (2-24%) based on varied definitions of PCT and modality of T supplementation. We attempted to determine the rate of PCT in patients in our intramuscular testosterone (IMT) program. METHODS Symptomatic men with two low total T (TT) levels (<350 ng/dl), using IMT for at least 6 months comprised the study cohort. Men used 200mg IM every 2 weeks and had peak (day 1-2) and trough T (day 13-14) levels checked after two cycles, and every 6 months. PCT was defined as hematocrit (HCT) ≥52%. Patients were excluded from IMT if they had baseline HCT >48%. A multivariate model was constructed to define predictors of PCT development. Factors assessed included: patient age, mean BMI, cigarette smoking history, baseline HCT, mean per patient peak TT level, mean per patient trough TT level, RESULTS 176 men were analyzed. 24% were diabetic, 48% prior or current cigarette smokers. At baseline, mean TT = 224±104 ng/dl. mean HCT = 38±6%, mean BMI = 32±6. Mean duration on IMT = 17±23 months. Mean peak TT level = 1164±240 ng/dl, mean trough TT level = 324±180 ng/dl. Mean HCT for entire cohort on IMT = 44±9 (39-57)%, representing a mean per patient change of 4.7±3.9 (2-11)%. 17% met the definition of HCT on IMT with a mean HCT = 54.2±1.8%. 23/30 patients with PCT developed it after 6 months on IMT. Factors found to be a predictor on multivariate analysis are listed in the Tables 1and 2, however cigarette smoking was not a predictor. CONCLUSIONS Almost one fifth of men on IMT experience PCT. Most men appear to develop it after 6 months of treatment. Predictors of PCT development are higher baseline HCT and higher peak TT levels. Categorical Variables Factor Odds Ratio 95% CI P value Baseline HCT >45% 2.8 1.6-5.9 <0.01 Baseline HCT per % point increase 1.4 1.1-3.4 <0.05 Any peak >1000 1.9 1.4-7.3 <0.01 Any trough >600 1.07 1.0-2.2 0.06 Continuous Variables Factor r P value Baseline HCT 0.58 <0.01 Mean peak 0.62 <0.01 © 2015 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 193Issue 4SApril 2015Page: e621 Advertisement Copyright & Permissions© 2015 by American Urological Association Education and Research, Inc.MetricsAuthor Information Serkan Deveci More articles by this author Patrick Teloken More articles by this author Keith O'Brien More articles by this author Patricia Guhring More articles by this author Marilyn Parker More articles by this author Joseph Narus More articles by this author John P. Mulhall More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...