Serum Testosterone Levels In Patients Research Articles

RELATIONSHIP BETWEEN HYPOGONADISM AND SERUM TESTOSTERONE LEVELS IN CHRONIC LIVER DISEASE

Background: Men with extensive chronic liver disease usually have low levels of testosterone in the serum. This study looked at the relationship between hypogonadism and low serum testosterone levels in patients with chronic liver disease. Methods: This retrospective study was conducted at Central Park Teaching Hospital, Lahore from Jan 2022 to Jan 2024, on patients between 5 to 60 years of age. After approval from ERB and permission from the authorities, records were retrieved. Two hundred records of men with hepatic cirrhosis and verified hypogonadism were divided into alcoholic liver disease (ALD) and non-alcoholic fatty liver disease (NAFLD), while records of 150 men as control group were include in the study. Patients’ data for ‘Sex Hormone Binding Globulin (SHBG)’ and ‘total testosterone’ were collected and entered into MS Excel file. Using SPSS-22 independent Student’s t-test was applied for statistical analysis. Results: No statistically significant variations were observed (p=0.101) in the means of SHBG across two groups but there was a statistically significant (p<0.05) variation in blood serum testosterone levels between age groups. Conclusion: Hypogonadism and low levels of testosterone are strongly linked to male patients with cirrhotic liver conditions, particularly in those with ALD, while no significant impact of SHBG was found between the two groups. Significant differences were observed between patients with ALD and NAFLD in terms of testosterone levels. Pak J Physiol 2024;20(3):53–5, DOI: https://doi.org/10.69656/pjp.v20i3.1687

Age-related impairment in testosterone elevation after anterior fibromuscular stroma preserved enucleation.

This study aims to evaluate the impact of anterior fibromuscular stroma preserved enucleation (AFSPE) of the prostate on serum testosterone levels in patients with benign prostatic obstruction (BPO) and to explore age-related differences in postoperative testosterone elevation. In a retrospective analysis, 304 patients from a pool of 560 who underwent AFSPE at Linkou Chang Gung Memorial Hospital between January 2018 and December 2021 were evaluated. Patients were stratified based on preoperative testosterone levels into low (<3.5 ng/mL) and normal (≥3.5 ng/mL) groups. Serum testosterone levels were measured preoperatively, at 1.5 and 3-6 months postoperatively. Age and other demographic data were analyzed as potential factors influencing testosterone changes. The low-testosterone group (n = 90) showed significant testosterone increases, from an average of 2.61 ng/mL preoperatively to 3.3 ng/mL at 1.5 months and 3.59 ng/mL at 3-6 months postoperatively (p < 0.0001). The normal-testosterone group (n = 214) maintained stable testosterone levels at 1.5 months but exhibited a significant rise to 6.06 ng/mL by 3-6 months (p = 0.0079). Older age was inversely associated with postoperative testosterone elevation in both groups. Improvements in nocturia were notable in both groups. AFSPE of the prostate significantly elevates serum testosterone levels in men with BPO, particularly benefiting those initially with low levels. Age is a crucial factor influencing postoperative testosterone changes, indicating that younger patients may benefit more from this intervention. AFSPE offers a promising approach for improving hormonal health in BPO patients, alongside alleviating urinary symptoms.

Association of Pre-Treatment Serum Testosterone Levels with Prostate Cancer: A Prospective Study

Introduction: It has been widely accepted that prostate cancer (PCa) growth is related to serum testosterone (ST). A direct correlation between pre-treatment ST level and PCa growth and progression has been reported. However, recent studies have shown that pre-treatment ST levels have a negative correlation with PCa. Thus, the literature is, at best, conflicting. In this study, we examined the pre-treatment serum total testosterone (ST) levels in PCa. Methods: In this prospective observational study, suspected cases of PCa underwent digital rectal examination, routine blood investigation, Prostate-Specific Antigen (PSA) measurement, and prostate biopsy. Diagnosed cases of PCa without any risk factors affecting testosterone levels were included. Their pre-treatment total ST levels were measured. All patients underwent staging evaluation with either Magnetic Resonance Imaging (MRI) &amp; Bone scan or Ga-68 Prostate Specific Membrane Antigen Positron Emission Tomography (PSMA PET). ST levels were also measured in patients with Benign Prostatic Hyperplasia (BPH) and compared with those in PCa patients. ST levels were also assessed according to Gleason Score (GS) and clinical stage in PCa. Results: 110 cases and 54 patients with BPH were included in the study. The median ST level in PCa patients was significantly lower as compared to BPH patients [352.28 ng/dL (Interquartile Range (IQR) 224.99-563.17) vs. 448.29 ng/dL (IQR 400.97-596.42) (p =0.004)]. The median ST level in metastatic PCa was significantly lower than the localized PCa group [298.20 ng/dL vs. 452.30 ng/dL (p=0.0001)]. Moreover, the median ST level was also significantly lower in patients with Gleason Score ≥ 8 than those with Gleason Score ≤ 7 [285.92 ng/dL (149.97-560.40) vs. 425.13 ng/dL (320.43-571.46) (p=0.002)]. Conclusion: This study shows lower ST levels in patients with PCa compared to patients with BPH, thus supporting a potential association as described in previous studies. ST levels may have prognostic value since a low pre-treatment ST level is associated with a higher clinical stage and aggressive PCa.

ARAMON: A phase 2, randomized, open-label study comparing darolutamide (DARO) vs enzalutamide (ENZA) monotherapy on serum testosterone levels in patients (pts) with castration-sensitive prostate cancer (CSPC) after biochemical recurrence (BCR).

TPS243 Background: DARO, a structurally distinct and highly potent androgen receptor inhibitor, has low blood–brain barrier (BBB) penetration and limited potential for drug–drug interactions. In phase 3 trials, DARO showed significant efficacy and a favorable safety profile. In ARAMIS (NCT02200614), DARO and androgen-deprivation therapy (ADT) significantly improved metastasis-free survival and overall survival (OS) vs placebo + ADT in pts with nonmetastatic castration-resistant prostate cancer. In ARASENS (NCT02799602), DARO + ADT + docetaxel significantly improved OS in pts with metastatic hormone-sensitive prostate cancer vs placebo + ADT + docetaxel. In both studies, the incidence of adverse events (AEs) was similar between treatment groups. Currently, the ARASTEP study (NCT05794906) is evaluating DARO and ADT in pts with high-risk BCR following primary therapy who have prostate-specific membrane antigen PET/CT-positive lesions. Based on a neuroimaging study of healthy volunteers, cerebral blood flow was not altered with DARO but was significantly reduced in brain areas related to cognition with ENZA. It is postulated that the low BBB penetration of DARO may result in lower serum testosterone elevations than those seen with ENZA, which may reduce the frequency of AEs. The ARAMON study (NCT05526248) will compare the effect of DARO and ENZA monotherapy on post-treatment testosterone levels in pts with CSPC who developed a BCR after definitive treatment for localized disease. Methods: ARAMON is a two-stage, open-label, phase 2 study of pts with histologically or cytologically confirmed adenocarcinoma of the prostate who experienced BCR after radical primary prostatectomy (RP) or radiation therapy (RT), with &lt;5 asymptomatic oligometastatic disease sites. Key inclusion criteria are prostate-specific antigen (PSA) ≥2 ng/mL, PSA doubling time of ≤20 months, serum testosterone &gt;150 ng/dL, and Eastern Cooperative Oncology Group performance status 0/1. During the lead-in phase, 25 pts will receive DARO 600 mg twice daily for 52 weeks. If serum testosterone criteria are met at 12 weeks, the study will proceed to the randomized phase where approximately 40 pts will be randomized 1:1 to DARO (600 mg twice daily) or ENZA (160 mg once daily) for 52 weeks. The primary endpoint is the change in serum testosterone level from baseline to Week 12. Secondary endpoints include the change in serum testosterone levels from baseline to Weeks 24 and 52; PSA at Weeks 4, 12, 24, 36, and 52; changes in blood levels of endocrine, glycemic, and lipid metabolism markers; incidence of AEs; and quality of life. As of September 2023, 23 of 25 planned pts in the lead-in phase have been enrolled. Clinical trial information: NCT05526248 .

Prognostic significance of serum testosterone level in patients with castration-resistant prostate cancer treated with cabazitaxel.

Serum testosterone level is a potential prognostic marker for castration-resistant prostate cancer. However, its role as a prognostic marker in cabazitaxel chemotherapy remains unclear. This study aimed to elucidate the clinical significance of serum testosterone levels before cabazitaxel chemotherapy. This single-institution, retrospective study included 47 patients with metastatic castration-resistant prostate cancer (mCRPC) who received cabazitaxel therapy. Serum testosterone levels were measured before the initiation of cabazitaxel therapy. Progression-free survival and overall survival (OS) were not significantly different between patients with high and low serum testosterone levels. Analysis of patients aged <70 years revealed that those with high serum testosterone levels (total testosterone level > 0.055 ng/mL) had significantly longer OS than those with low serum testosterone levels (total testosterone level < 0.055 ng/mL, p = 0.012). Multivariate analysis revealed that low serum testosterone levels (hazard ratio [HR] = 11.874, 95% confidence interval [CI] 2.076-67.953, p = 0.005) and high prostate-specific antigen levels (HR = 18.051, 95% CI 2.462-132.347, p = 0.004) in the pretreatment phase were independent prognostic factors for OS in patients receiving cabazitaxel therapy. Serum testosterone level may be a prognostic marker for cabazitaxel therapy in patients with mCRPC who are younger than 70 years, and high serum testosterone levels may lead to longer survival.

A phase 2, randomized, open-label study comparing the effects of darolutamide versus enzalutamide monotherapy on serum testosterone levels in patients with hormone-naive prostate cancer: ARAMON study.

TPS5111 Background: Darolutamide is a structurally distinct and highly potent androgen receptor inhibitor with low blood–brain barrier penetration. In the phase 3 ARAMIS study (NCT02200614) of patients with nonmetastatic castration-resistant prostate cancer, treatment with darolutamide significantly improved metastasis-free survival and overall survival versus placebo, with a favorable safety profile. The incidences of central nervous system adverse events (AEs; e.g. falls, memory impairment, and depression) showed a ≤2% difference between the darolutamide and placebo groups. Fatigue was the only AE with an incidence of &gt; 10% for darolutamide (13.2% vs 8.3% for placebo). In a separate neuroimaging study of healthy volunteers, cerebral blood flow was not altered in patients treated with darolutamide but was significantly reduced in brain areas related to cognition in patients treated with enzalutamide. Furthermore, it is postulated that the low blood–brain barrier penetration of darolutamide may result in lower serum testosterone elevations than those seen with enzalutamide, with the potential of leading to fewer associated feminizing AEs. The objective of ARAMON (NCT05526248) is to compare the effect of darolutamide and enzalutamide monotherapy on post-treatment testosterone levels in patients with hormone-naive prostate cancer experiencing biochemical recurrence after definitive treatment for localized disease. Methods: ARAMON is a two-stage, open-label, phase 2 study of patients with histologically or cytologically confirmed adenocarcinoma of the prostate who have biochemical recurrence after radical primary prostatectomy or radiation therapy, with a prostate-specific antigen (PSA) doubling time of ≤20 months, baseline serum testosterone &gt; 150 ng/dL, and Eastern Cooperative Oncology Group performance status 0/1. During a 52-week lead-in phase, 25 patients will receive darolutamide 600 mg twice daily. If criteria based on serum testosterone increase from baseline to Week 12 are met, the study will proceed to a 52-week randomized phase in which the effects of darolutamide (600 mg twice daily, n = 20) will be compared with the effects of enzalutamide (160 mg once daily, n = 20). The primary endpoint of both phases is the change in serum testosterone level from baseline to Week 12. Secondary endpoints of the randomized phase include the change in serum testosterone levels from baseline to Weeks 24 and 52; PSA at Weeks 4, 12, 24, 36, and 52; changes in blood levels of markers for glucose, lipid metabolism, and endocrine function related to sex hormones; safety; and quality of life. Safety will be assessed through AE monitoring. The first of the 25 planned patients in the lead-in phase was enrolled on January 13, 2023. Clinical trial information: NCT05526248 .

Is There a Two-Way Risk between Decreased Testosterone Levels and the Progression and Prognosis of Chronic Kidney Disease? A Cohort Study Based on the National Health and Nutrition Examination Survey Database.

The causal relationship between the incidence and prognosis of chronic kidney disease (CKD) and serum testosterone levels in patients is not yet fully understood. This study aims to use the National Health and Nutrition Examination Survey (NHANES), a large-scale nationally representative sample, to investigate the relationship between CKD and testosterone. This study included six NHANES cycles for linear regression analysis, verified by multiple imputation methods. Stratified analysis and subgroup analysis were used to demonstrate the stability of CKD's effect on testosterone. Furthermore, we used Kaplan-Meier plots and log-rank tests to evaluate differences in survival rates between CKD male patients with low and normal levels of testosterone. From a total of 71,163 subjects, the cohort selected 28,663 eligible participants. Results showed that CKD patients had testosterone levels 28.423 ng/mL (24.762, 32.083) lower than non-CKD patients. The results of multiple imputations (β=27.700, 95% confidence interval: 23.427, 31.974) were consistent with those of linear regression analysis, and the numerical match was good. Stratified regression analysis, and subgroup analysis results showed that CKD had a significant impact on testosterone at different dimensions. Kaplan-Meier plots showed significantly reduced survival rates in low testosterone CKD male patients (p<0.0001). The results of this big data analysis suggest that there may be a two-way risk between low levels of testosterone and CKD. The testosterone levels of CKD patients were significantly lower than those of the non-CKD population, and CKD patients with low testosterone levels had poorer prognoses. These results suggest that correcting testosterone levels in a timely manner can have preventive and therapeutic effects on the progression of CKD.

A study of retinal changes in women with polycystic ovarian syndrome.

To compare the optical coherence tomography (OCT)-based retinal nerve fiber layer (RNFL) and ganglion cell layer (GCL) thickness at the posterior pole, and total macular thickness of women with the polycystic ovarian syndrome (PCOS) versus healthy reproductive age group females. The study included 110 eyes of 55 diagnosed cases of PCOS (study group) and 110 eyes of 55 healthy reproductive age group (15-49 years) females (control group). All patients underwent a detailed ophthalmological evaluation followed by an OCT to measure their retinal thicknesses. The body mass index (BMI) of patients was noted and compared with the retinal thickness. Also, the lipid profile and serum testosterone levels of PCOS patients were recorded. The retinal thicknesses in the two study were similar and there was no statistically significant difference. However, on stratification with BMI, it was seen that in patients with BMI>30 kg/m2, the superior Retinal Nerve Fibre Layer (RNFL) was significantly thicker in the PCOS group as compared with the control group (P = 0.0006). The mean serum testosterone level in patients with PCOS was 141.3 ± 23.2. Also, 65.45% of patients had a serum testosterone level of more than 70 ng/dL. The mean HDL cholesterol in patients with PCOS was 38.1 ± 15.6. The mean LDL cholesterol in PCOS patients was 98.4 ± 21.7, and the mean total cholesterol in PCOS patients was 153.6 ± 27.3. Androgens have a trophic action on nerves, which could explain the increased RNFL thickness in these patients.

Impact of Serum Prolactin and Testosterone Levels on Male Infertility in Sulaimanyah City

The appropriateness of the interactions between Prolactin, gonadotrophins and testicular hormones ensures that normal spermatogenesis takes place in the male. So this study is an attempt to classify male infertility depending on WHO criteria of seminal changes and to evaluate serum Prolactin, Testosterone FSH and LH levels in the participants, also determine the association between serum Prolactin, Testosterone levels and subtypes of male infertility. This study involved three hundred infertile males having infertility more than one year (cases group) and three hundred age-matched fertile males with definite paternity in past two years (control group) were included to the study from Jan 2018 -Dec 2020 at Shahid Ali Qader consultant clinic in the Sulaimanyah city. Serum levels of hormones were measured by electrochemiluminescense immunoassay technique. Approximately half of patient's age ranged between 30- 39 years. Sixty eight percentage of cases complained from primary infertility. About 71.3% of patients had infertility duration between 1 - 5 years. This percentage decreased with increasing the infertility years. Most common infertile group was Asthenospermia (34.3%). A higher significant levels of serum Prolactin, FSH and LH found in cases than controls (p<0.001). However, the serum Testosterone levels was significantly lower in cases than controls (p<0.05). Moreover, serum Prolactin levels were found significantly elevated in all infertile subgroups (except Normospermic subgroup) compared to control group, while serum Testosterone levels were significantly decreased in all infertile subgroups (except Normospermic subgroup) compared to control group (p<0.05). So we conclude that; Poor spermatogenesis is associated with high serum Prolactin, FSH,LH levels and low serum Testosterone levels in patients with male infertility. Moreover, elevated serum Prolactin levels and decreased serum Testosterone levels were significantly associated with A, AT, OAT, Azoo and OA infertile males. Keywords: Male infertility, primary and secondary infertility, Prolactin, Testosterone, spermatogenesis.

Evaluation of Serum Testosterone Level in Patients with Psoriasis and Its Correlation to Severity of the Disease

Background: Psoriasis is a chronic inflammatory, immune-mediated systemic disease with skin manifestations that typically follow a relapsing and remitting course. The most common form, plaque psoriasis, occurs in ∼80–90% of psoriatic patients. Objective: The aim of the current work was to evaluate level of serum testosterone in psoriasis male patients and its relation to severity of the disease. Patients and methods: This cohort study included a total of 35 psoriatic patients, attending At Outpatient Clinic, Dermatology and Venereology Department, Zagazig University Hospital, Egypt. This study was conducted between January 2020 to October 2020. Serum free and total testosterone and total cholesterol were measured. Result: About two thirds of the studied group (71.4 %) had normal testosterone level and (28.6 %) had low testosterone level. Conclusion: Low serum total and free testosterone levels in male psoriasis patients are present and they correlate with disease severity.

Changes in sexual function and serum testosterone levels in patients with prostate cancer after image-guided proton therapy.

Since sexual function and testosterone levels after image-guided proton therapy (IGPT) have not yet been examined in detail, we prospectively evaluated changes before and after IGPT. Among patients treated with IGPT with or without combined androgen blockade (CAB) therapy between February 2013 and September 2014, patients who agreed to participate in the study and were followed up for >3 years after IGPT were evaluated. Serum testosterone levels were regularly measured together with prostate-specific antigen (PSA) levels before and after IGPT. The Erection Hardness Score (EHS) and the sexual domain summary, function subscale and bother subscale of the sexual domain in the Expanded Prostate Cancer Index Composite (EPIC) were assessed. There were 38 low-risk, 46 intermediate-risk and 43 high- or very-high-risk patients (NCCN classification). Although serum testosterone levels in low-risk patients did not decrease after IGPT, reductions were observed in the average EHS and the sexual domain summary score of the EPIC. In intermediate-, high- and very-high-risk patients, testosterone and PSA levels both increased following the termination of CAB after IGPT, and the average EHS increased. The sexual domain summary score gradually increased, but not above minimally important differences. In intermediate-risk patients, the function subscale increased from 4.4 to 14.8 (P < 0.05) 12 months after IGPT and reached a plateau after 60 months. The results of the present study would suggest the potential of IGPT, and further prospective studies to directly compare IGPT with other modalities are warranted.

Serum Progesterone and Testosterone Levels in Schizophrenia Patients at Different Stages of Treatment.

It has been suggested that dysregulation of hormones is associated with schizophrenia (SCZ). This study aimed to measure the serum levels of progesterone and testosterone in 125 SCZ patients at different stages of treatment and 96 healthy control (HC) subjects. Our results showed that first-episode drug-free SCZ patients had significantly increased testosterone levels when compared with HC subjects, and chronic medication, but not short-term medication, further increased the serum testosterone levels in the patients. Further analysis suggested that the sex of the patients did not affect testosterone levels. In contrast, serum progesterone levels did not show significant differences between first-episode, drug-free SCZ patients and controls, and the antipsychotics increased progesterone levels in the male SCZ patients, but not female patients. Interestingly, our analyses demonstrated that the serum progesterone levels were negatively correlated with PANSS total score and PNASS positive score, suggesting a correlation between blood hormone levels and disease severity in SCZ patients. Taken together, our data showed differential changes in serum testosterone and progesterone levels in SCZ patients with or without antipsychotics, and our results suggest that increased sex hormone levels may be a defensive response to protect the human body under stress.

EFFECT OF A COMBINATION OF OMEGA-3 AND ORAL TESTOSTERONE UNDECANOATE ON SERUM TESTOSTERONE LEVELS IN PATIENTS WITH TESTOSTERONE DEFICIENCY

Background and Objective Oral testosterone undecanoate (TU) is taken up by the intestinal lymphatic system. Thus, the dietary lipid content affects TU absorption. This study aimed to investigate the effect of combined omega-3 fatty acids (OMG3) and oral TU on serum testosterone levels in patients with testosterone deficiency (TD). Material and Methods Sixty consecutive patients with symptomatic TD and low serum total testosterone (TT) levels were enrolled and divided randomly into group 1, oral TU 80 mg twice daily for 30 days, and group 2, OMG3 and oral TU 80 mg twice daily for 30 days. Serum TT concentrations and male function scales were evaluated at baseline and 7 days and 1 month post-treatment. Dietary habits were investigated, and caloric and lipid intakes were measured during the treatment periods. Results The groups did not differ in terms of mean age, body mass index, comorbidities, initial serum TT concentrations, and IIEF/AMS scores. After 7 days and 1 month of treatment, serum TT concentrations were only significantly increased in group 2. The degree of increase in TT was higher in group 2 than in group 1 at 7 days and 1 month, although the difference was only significant at 1 month. Both groups exhibited significant improvements in IIEF and AMS scores at 1 month, with no significant inter-group difference. A diet diary study revealed that 23.3% and 20% of both groups did not eat breakfast and both groups consumed <12 g of lipids and <500 Kcals, without significance differences. Conclusion We observed a significant increase in serum TT concentration after 1 month of treatment with the combination of OMG3 and oral TU, compared to with oral TU monotherapy. Therefore, the combination of OMG3 and oral TU can be considered for the treatment of TD in Korean patients with irregular breakfast habits.

The impact of hyperbaric oxygen therapy on erectile functions and serum testosterone levels in patients with erectile dysfunction

Objective: To evaluate the effects of hyperbaric oxygen therapy (HBOT) on erectile functions and serum testosterone levels in patients with erectile dysfunction (ED).Methods: The patients treated by HBOT for several diseases between July 2017–May 2018 and had erectile dysfunction were included in the study. All patients filled the International Index of Erectile Function (IIEF) questionnaire form; serum total testosterone (TT) and free testosterone (FT) levels were examined before the first day and after the last day of HBOT. The effects of demographic characteristics of patients on erectile functions were evaluated. Patients were categorized according to the risk factors. The IIEF scores, TT and FT levels of patients in first day and after last day of HBOT were compared.Results: Totally 43 patients were included in the study. The mean post-HBOT IIEF-EF score was significantly higher than the mean pre-HBOT IIEF-EF score of patients (25.4 ± 5.3 vs 20.6 ± 5.1; p < .001). There was no statistical difference between the pre-HBOT and post-HBOT serum TT and FT levels of patients (4.0 ± 2.3 ng/ml vs 4.1 ± 2.0 ng/ml, p = .797; 8.6 ± 3.8 pg/ml vs 8.9 ± 3.5 pg/ml, p = .658).Conclusions: HBOT improved the erectile functions in ED patients however we cannot detect any effect on testosterone levels in our study.

1068 - The association between structural brain alterations and serum testosterone levels in patients with type 2 diabetes mellitus

1068 - The association between structural brain alterations and serum testosterone levels in patients with type 2 diabetes mellitus

Which Exercise Is Better for Increasing Serum Testosterone Levels in Patients with Erectile Dysfunction?

PurposeWe investigated the correlations of serum total testosterone (TT) levels with body composition and physical fitness parameters in patients with erectile dysfunction (ED) to know the best exercise for testosterone deficiency.Materials and MethodsEighty-seven ED patients underwent serum TT assessment as well as body composition and basic exercise testing. The bioelectrical impedance analysis was used to assess body composition. Seven types of basic exercise tests were used to determine physical fitness. Correlations between serum TT levels and body composition/physical function parameters were evaluated using partial correlation analyses. A serum TT cut-off value was obtained for the parameters significantly correlated with serum TT levels.ResultsThe subjects had a mean serum TT level of 342.1 ng/dL. Among the body composition parameters, body and abdominal fat percentages showed statistically significant negative correlations with serum TT levels. Among the basic exercise test parameters, only the cycle ergometer test for cardiorespiratory fitness showed a statistically significant positive correlation with serum TT levels.ConclusionsSerum TT levels in patients with ED, may be increased by reducing fat percentage and improving cardiorespiratory fitness via aerobic exercise.

Serum testosterone changes in patients treated with radiation therapy alone for prostate cancer on NRG oncology RTOG 9408

ObjectivesWe reviewed testosterone changes for patients who were treated with radiation therapy (RT) alone on NRG oncology RTOG 9408. Methods and materialsPatients (T1b-T2b, prostate-specific antigen <20 ng/mL) were randomized between RT alone and RT plus 4 months of androgen ablation. Serum testosterone (ST) levels were investigated at enrollment, RT completion, and the first follow-up 3 months after RT. The Wilcoxon signed rank test was used to compare pre- and post-treatment ST levels in patients who were randomized to the RT-alone arm. ResultsOf 2028 patients enrolled, 992 patients were randomized to receive RT alone and 917 (92.4%) had baseline ST values available and completed RT. Of these 917 patients, immediate and 3-month post-RT testosterone levels were available for 447 and 373 patients, respectively. Excluding 2 patients who received hormonal therapy off protocol after RT, 447 and 371 patients, respectively, were analyzed. For all patients, the median change in ST values at completion of RT and at 3-month follow-up were −30.0 ng/dL (p5-p95; −270.0 to 162.0; P < .001) and −34.0 ng/dL (p5-p95, −228.0 to 160.0; P < .01), respectively. ConclusionRT for prostate cancer was associated with a median 9.2% decline in ST at completion of RT and a median 9.3% decline 3 months after RT. These changes were statistically significant.

Effect of pituitary adenomas on male sexual function: a multivariate analysis

Objective To investigate the effect of pituitary adenomas on male sexual function. Methods The clinical data of 155 male patients with pituitary adenoma admitted to the Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University from January 2012 to November 2013 were analyzed retrospectively. The effects of the volume of pituitary adenoma, invasiveness, pathologic type, and serum testosterone level of the patients on sexual function in the males were analyzed. Results The rate of postoperative sexual function returning to normal in patients with pituitary microadenoma was 100.0%. It was significantly higher than that in patients with large adenoma (32.8%) and giant adenoma (18.6%) (all P 0.05). The incidence of sexual dysfunction (SD) in patients with prolactinoma before procedure was 92.9%, which was higher than 69.9% in patients with nonfunctional pituitary adenoma (P 0.05), and the postoperative SD was improved significantly in patients with nonfunctional pituitary adenoma (P<0.01). The postoperative serum testosterone level in patients with pituitary adenoma was significantly correlated with whether SD could be improved or not (P<0.01). Conclusions The volume and pathological types of pituitary adenomas are both the factors affecting SD in male patients with pituitary adenoma. The postoperative serum testosterone level can be used to measure the sexual function recovery of patients. Key words: Pituitary neoplasms; Male; Sexual dysfunction

Urolithiasis is associated with higher prevalence of low serum testosterone level in patients with erectile dysfunction

Urolithiasis is associated with higher prevalence of low serum testosterone level in patients with erectile dysfunction

Study evaluating testosterone deficiency as a cause of anemia and reduced responsiveness to erythropoiesis-stimulating agents in men on maintenance hemodialysis

IntroductionChronic kidney disease (CKD) is a worldwide disease that is classified into five stages according to the glomerular filtration rate and presents through a variety of symptoms and signs. Anemia is one of the first signs of kidney dysfunction. The most common causes of anemia in CKD are erythropoietin (EPO) hormone deficiency and iron deficiency. Anemia and hyporesponsiveness to erythropoietin-stimulating agents (ESAs) are commonly observed in CKD patients and are associated with increased morbidity, mortality, and a significant healthcare economic burden. Although testosterone deficiency is a prevalent condition in men with CKD, it has so far received relatively little attention in practice. Testosterone stimulates erythropoiesis through the production of hematopoietic growth factors and possible improvement of iron bioavailability.AimThe aim of this study was to evaluate serum testosterone levels in patients on maintenance hemodialysis (MHD) and correlate its level with anemia and response to ESAs therapy.Patients and methodsThis study included 40 male patients from dialysis units, where they were divided equally into group A, group taking ESAs, and group B, group not taking ESAs (EPO-naive group). Another 20 men were included in group C (control group). All groups were subjected to a full assessment of history, full clinical examination, and laboratory investigations to exclude all possible causes of anemia.ResultsThis study showed that in group A, 75% of the participants were anemic, whereas in group B, 100% of the participants were anemic, with a higher degree of anemia. The testosterone level was slightly higher in group B than group A; despite being within the normal range, it was relatively deficient on the basis of the age of the participants in the control group.ConclusionTestosterone deficiency is a prevalent condition in CKD that starts at an earlier age than the normal population. It is an evident independent cause of anemia in EPO-naive CKD patients and is a possible cause of resistance of ESAs in CKD patients; still, the most important causes of anemia in CKD are EPO and iron deficiency.