You have accessJournal of UrologySexual Function/Dysfunction: Evaluation II1 Apr 2018MP74-05 SERUM PSA AS A PREDICTOR OF SYMPTOMATIC HYPOGONADISM PARTICULARLY IN RELATION TO PSYCHOLOGICAL SYMPTOMS Kazuhito Matsushita, Akira Tsujimura, and Shigeo Horie Kazuhito MatsushitaKazuhito Matsushita More articles by this author , Akira TsujimuraAkira Tsujimura More articles by this author , and Shigeo HorieShigeo Horie More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2018.02.2389AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES We often see low levels of PSA in men with symptomatic hypogonadism (HG). The relationship between serum PSA and testosterone level is still controversial. According to the saturation hypothesis, a significant relationship is apparent only in the low testosterone range. We hypothesized that PSA might represent a surrogate marker for symptomatic HG. METHODS Patients presenting to our academic men′s health clinic reported hypogonadal symptoms using the Aging Male′s Symptoms (AMS) scale which grades each hypogonadal symptom on a 5-point Likert scale. Several hormonal and biochemical parameters were measured the same day the survey was completed. The clinical values of total and free testosterone, and PSA for the detection of severe HG were compared using receiver operating characteristic (ROC) curves. Furthermore, relationships between each of the three AMS subscales (psychological, somatic, sexual) and the biochemical parameters were investigated. RESULTS 759 men were included for analysis (mean age=51y±10). At baseline, mean AMS scale was 43±12, mean total testosterone (TT) was 5.01±1.95 ng/mL, mean free testosterone (FT) was 9.53±3.9 pg/mL, and mean PSA was 1.07±0.64ng/mL. We tested the efficacy of PSA, TT, and FT in detecting severe HG, defined as AMS score ≥50. ROC curve analysis for PSA showed an accuracy (area under the curve, AUC) of 0.649±0.033 (p<0.01) in predicting severe HG. When a threshold of 0.7 ng/mL was chosen, sensitivity and specificity for severe HG was 70.1% and 52.8%, respectively. ROC curve analysis for TT and FT showed an AUC of 0.543 (p=0.229) and 0.554 (p=0.126), respectively. When the AMS scale was divided into the three subscales, psychological and somatic factors, while marginal, showed significant correlation with PSA. Multivariable analysis showed that only psychological factor was significantly associated with PSA levels (p=0.013). CONCLUSIONS Our data demonstrated that PSA levels were more accurate for the prediction of severe HG compared to testosterone levels. It was found that psychological factors were more strongly correlated than sexual factors. These results suggest that low PSA levels may represent a new marker for detecting severe HG. © 2018FiguresReferencesRelatedDetails Volume 199Issue 4SApril 2018Page: e1001-e1002 Advertisement Copyright & Permissions© 2018MetricsAuthor Information Kazuhito Matsushita More articles by this author Akira Tsujimura More articles by this author Shigeo Horie More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...