Abstract
Objective To evaluate cardiovascular risk, metabolic profile, low urinary tract symptoms (LUTS), and sexual function in patients with nonfunctional pituitary macroadenoma (NFPMA) and hypogonadotropic hypogonadism with testosterone therapy (TTh). Methods A retrospective clinical study at a tertiary care center was performed in 101 men with NFPMA, HH, and TTh; metabolic profile, cardiovascular risk, International Prostate Symptoms Score (IPSS), and International Index of Erectile Function 5 (IIEF-5) scores were evaluated before initiation of TTh and at the last checkup with TTh. Results Age was 49.3 ± 8.8 years; T before TTh was 195 ng/mL (101–259) vs. 574 (423–774) at the last checkup. The time of TTh administration was 34 months (12–72). An increase in triglyceride levels (200 (153–294) vs. 174 (134–233) mg/dL; p=0.03), dyslipidemia (40% vs. 52%; p=0.03), and MetS (25% vs. 34%; p=0.05) was corroborated. A statistical difference in the Globorisk score and cardiovascular (CV) risk stratification was not found. IIEF-5 score was 15.5 ± 6.5 vs. 17.8 ± 5.3 (p=0.11). An improvement in penetration quality (2.0 ± 1.5 vs. 2.6 ± 1.3; p=0.05), erection after penetration (1.8 ± 1.2 vs. 2.5 ± 1.6; p=0.02), completion of intercourse (1.8 ± 1.2 vs. 2.4 ± 1.3; p=0.03), and satisfaction of sexual intercourse (1.8 ± 1.3 vs. 2.5 ± 1.5; p=0.01) was evidenced. IPSS score was 6 (IQR 2–10) vs. 7 (IQR 4–12); p=0.30. A lower rate of intermittency (14% vs. 3%; p=0.02), urgency (39% vs. 16%; p=0.01), and episodes of nocturia (18% vs. 4%; p=0.02) was found. An increase of hematocrit (44.1 ± 4.4 vs. 47.3 ± 4.4%; p=0.001), hemoglobin (14.9 ± 1.4 vs. 15.9 ± 1.4 g/dL; p=0.001), and prostatic specific antigen (0.59 (0.43–1.19) vs. 0.82 (0.45–1.4) ng/mL; p=0.02) was evidenced during TTh. Conclusion TTh in young men with NFPMA improves LUTS, sexual function, and some metabolic parameters, and it is relatively safe in the prostatic context.
Highlights
Hypogonadism in men is a clinical syndrome that results from failure of the testis to produce physiological levels of testosterone and a normal number of spermatozoa due to disruption of one or more levels of the hypothalamic-pituitary-testicular axis [1, 2].Androgen deficiency (AD) is characterized by chronic fatigue, diminution of libido, depression, erectile dysfunction, anhedonia, abdominal obesity, and diminution on quality of life (QoL)
T in young men with nonfunctional pituitary macroadenomas (NFPMA) improves low urinary tract symptoms (LUTS), sexual function, and some metabolic parameters, and it is relatively safe in the prostatic context
AD is related with decreased lean body mass, low bone density, and anemia [2,3,4,5]. ere has been an emerging controversy in the past several years regarding the safety of testosterone replacement therapy (T ) due to a suggested increased risk of cardiovascular disease (CVD) among its users
Summary
Hypogonadism in men is a clinical syndrome that results from failure of the testis to produce physiological levels of testosterone and a normal number of spermatozoa due to disruption of one or more levels of the hypothalamic-pituitary-testicular axis [1, 2].Androgen deficiency (AD) is characterized by chronic fatigue, diminution of libido, depression, erectile dysfunction, anhedonia, abdominal obesity, and diminution on quality of life (QoL). Low testosterone levels are associated with hypertension, hypercholesterolemia, diabetes, osteoporosis, and ischaemic heart disease. AD impacts negatively in male health and is associated with an increase in weight, International Journal of Endocrinology adiposity, waist circumference, insulin resistance, diabetes, hypertension, inflammation, atherosclerosis, metabolic syndrome, infertility, cardiovascular disease, erectile dysfunction, and mortality. T has been associated with a positive effect on cardiovascular disease, low urinary tract symptoms (LUTS), and erectile function [1, 2]. Hypogonadrotropic hypogonadism (HH) is common in patients with nonfunctional pituitary macroadenomas (NFPMA); but the specific effect of T in NFPMA has been less studied. E aim of this study was to evaluate cardiovascular risk, metabolic profile, low urinary tract symptoms (LUTS), and erectile dysfunction in patients with NFPMA and HH treatment with testosterone Hypogonadrotropic hypogonadism (HH) is common in patients with nonfunctional pituitary macroadenomas (NFPMA); but the specific effect of T in NFPMA has been less studied. e aim of this study was to evaluate cardiovascular risk, metabolic profile, low urinary tract symptoms (LUTS), and erectile dysfunction in patients with NFPMA and HH treatment with testosterone
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