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Current Urology Reports

Erschienen in:

01.08.2015 | Benign Prostatic Hyperplasia (K McVary, Section Editor)

Testosterone Replacement Therapy on the Natural History of Prostate Disease

verfasst von: Aaron Moore, Michael J. Butcher, Tobias S. Köhler

Erschienen in: Current Urology Reports | Ausgabe 8/2015

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Abstract

The physiology of testosterone production and action are closely related to prostatic disease. An understanding of the natural history of testosterone and prostate growth and development is needed in order to understand this complex relationship. Lower urinary tract symptoms (LUTS), benign prostatic hyperplasia (BPH), prostate cancer, and sexual function are common disorders for which testosterone is thought to play a role. Proposed in this review are some theories as to how testosterone interacts to potentially ameliorate these conditions. Further research is needed, but we feel our proposed points are valid given the review of the literature.

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Brambilla DJ, Matsumoto AM, Araujo AB, McKinlay JB. The effect of diurnal variation on clinical measurement of serum testosterone and other sex hormone levels in men. J Clin Endocrinol Metab. 2009;94(3):907–13. doi:10.1210/jc.2008-1902.PubMedCentralPubMedCrossRef

Welliver Jr RC, Wiser HJ, Brannigan RE, Feia K, Monga M, Kohler TS. Validity of midday total testosterone levels in older men with erectile dysfunction. J Urol. 2014;192(1):165–9. doi:10.1016/j.juro.2014.01.085.PubMedCrossRef

Araujo AB, Esche GR, Kupelian V, O'Donnell AB, Travison TG, Williams RE, et al. Prevalence of symptomatic androgen deficiency in men. J Clin Endocrinol Metab. 2007;92(11):4241–7. doi:10.1210/jc.2007-1245.PubMedCrossRef

Gapstur SM, Gann PH, Kopp P, Colangelo L, Longcope C, Liu K. Serum androgen concentrations in young men: a longitudinal analysis of associations with age, obesity, and race. The CARDIA male hormone study. Cancer Epidemiol Biomark Prev: Publ Am Assoc Cancer Res Cosponsored Am Soc Prev Oncol. 2002;11(10 Pt 1):1041–7.

Gray A, Feldman HA, McKinlay JB, Longcope C. Age, disease, and changing sex hormone levels in middle-aged men: results of the Massachusetts Male Aging Study. J Clin Endocrinol Metab. 1991;73(5):1016–25. doi:10.1210/jcem-73-5-1016.PubMedCrossRef

Harman SM, Metter EJ, Tobin JD, Pearson J, Blackman MR. Longitudinal effects of aging on serum total and free testosterone levels in healthy men. Baltimore Longitudinal Study of Aging. J Clin Endocrinol Metab. 2001;86(2):724–31. doi:10.1210/jcem.86.2.7219.PubMedCrossRef

Liu PY, Beilin J, Meier C, Nguyen TV, Center JR, Leedman PJ, et al. Age-related changes in serum testosterone and sex hormone binding globulin in Australian men: longitudinal analyses of two geographically separate regional cohorts. J Clin Endocrinol Metab. 2007;92(9):3599–603. doi:10.1210/jc.2007-0862.PubMedCrossRef

Morley JE, Kaiser FE, Perry 3rd HM, Patrick P, Morley PM, Stauber PM, et al. Longitudinal changes in testosterone, luteinizing hormone, and follicle-stimulating hormone in healthy older men. Metab Clin Exp. 1997;46(4):410–3.PubMedCrossRef

10.

Zmuda JM, Cauley JA, Kriska A, Glynn NW, Gutai JP, Kuller LH. Longitudinal relation between endogenous testosterone and cardiovascular disease risk factors in middle-aged men. A 13-year follow-up of former multiple risk factor intervention trial participants. Am J Epidemiol. 1997;146(8):609–17.PubMedCrossRef

11.

Basaria S. Testosterone therapy in older men with late-onset hypogonadism: a counter-rationale. Endocrine Pract: Off J Am College Endocrinol Am Assoc Clin Endocrinol. 2013;19(5):853–63. doi:10.4158/ep13318.ra.CrossRef

12.

Mulligan T, Iranmanesh A, Johnson ML, Straume M, Veldhuis JD. Aging alters feed-forward and feedback linkages between LH and testosterone in healthy men. Am J Physiol. 1997;273(4 Pt 2):R1407–13.PubMed

13.••

Jarvis TR, Chughtai B, Kaplan SA. Testosterone and benign prostatic hyperplasia. Asian J Androl. 2015;17:212–26. doi:10.4103/1008-682x.140966. This is a great review of the effects of testosterone on BPH. With the FDA warning on worseining BPH symptoms with testosteorne supplementation, all patients should be warned about this potential complication. The studies that show no worsening in LUTS/BPH are not high level evidence making clinical decisions difficult.PubMedCrossRef

14.

Kaplan SA, Roehrborn CG, McConnell JD, Meehan AG, Surynawanshi S, Lee JY, et al. Long-term treatment with finasteride results in a clinically significant reduction in total prostate volume compared to placebo over the full range of baseline prostate sizes in men enrolled in the MTOPS trial. J Urol. 2008;180(3):1030–2. doi:10.1016/j.juro.2008.05.004. discussion 2–3.PubMedCrossRef

15.

Fan Y, Hu S, Liu J, Xiao F, Li X, Yu W, et al. Low intraprostatic DHT promotes the infiltration of CD8+ T cells in BPH tissues via modulation of CCL5 secretion. Mediat Inflamm. 2014;2014:397815. doi:10.1155/2014/397815.CrossRef

16.

Araujo AB, O'Donnell AB, Brambilla DJ, Simpson WB, Longcope C, Matsumoto AM, et al. Prevalence and incidence of androgen deficiency in middle-aged and older men: estimates from the Massachusetts Male Aging Study. J Clin Endocrinol Metab. 2004;89(12):5920–6. doi:10.1210/jc.2003-031719.PubMedCrossRef

17.•

Bhasin S, Cunningham GR, Hayes FJ, Matsumoto AM, Snyder PJ, Swerdloff RS, et al. Testosterone therapy in men with androgen deficiency syndromes: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab. 2010;95(6):2536–59. doi:10.1210/jc.2009-2354. These are clinical guidelines for testosterone replacement per the Endocrine Society. This is one accepted way to correctly diagnosis, treat, and follow hypogonadal men.PubMedCrossRef

18.

Wang C, Nieschlag E, Swerdloff R, Behre HM, Hellstrom WJ, Gooren LJ, et al. Investigation, treatment, and monitoring of late-onset hypogonadism in males: ISA, ISSAM, EAU, EAA, and ASA recommendations. Eur Urol. 2009;55(1):121–30. doi:10.1016/j.eururo.2008.08.033.PubMedCrossRef

19.••

Wu FC, Tajar A, Beynon JM, Pye SR, Silman AJ, Finn JD, et al. Identification of late-onset hypogonadism in middle-aged and elderly men. N Engl J Med. 2010;363(2):123–35. doi:10.1056/NEJMoa0911101. A prospective study of 3,369 men in Europe screened and treated for hypogonadism. The aim was to help identify late-onset hypogondism. Erectile dysfunction, poor morning erections, and few thoughts about sex along with total testosterone levels of <11nmol/l and free testosterone of <200pmol/l can be diagnostic of late-onset hypogonadsim. PubMedCrossRef

20.

Kelleher S, Conway AJ, Handelsman DJ. Blood testosterone threshold for androgen deficiency symptoms. J Clin Endocrinol Metab. 2004;89(8):3813–7. doi:10.1210/jc.2004-0143.PubMedCrossRef

21.

Zitzmann M, Nieschlag E. The CAG repeat polymorphism within the androgen receptor gene and maleness. Int J Androl. 2003;26(2):76–83.PubMedCrossRef

22.

Wang C, Catlin DH, Demers LM, Starcevic B, Swerdloff RS. Measurement of total serum testosterone in adult men: comparison of current laboratory methods versus liquid chromatography-tandem mass spectrometry. J Clin Endocrinol Metab. 2004;89(2):534–43. doi:10.1210/jc.2003-031287.PubMedCrossRef

23.

Cooper LA, Page ST. Androgens and prostate disease. Asian J Androl. 2014;16(2):248–55. doi:10.4103/1008-682x.122361.PubMedCentralPubMedCrossRef

24.

Parsons JK, Carter HB, Platz EA, Wright EJ, Landis P, Metter EJ. Serum testosterone and the risk of prostate cancer: potential implications for testosterone therapy. Cancer Epidemiol Biomark Prev: Publ Am Assoc Cancer Res Cosponsored Am Soc Prev Oncol. 2005;14(9):2257–60. doi:10.1158/1055-9965.epi-04-0715.CrossRef

25.

Pierorazio PM, Ferrucci L, Kettermann A, Longo DL, Metter EJ, Carter HB. Serum testosterone is associated with aggressive prostate cancer in older men: results from the Baltimore Longitudinal Study of Aging. BJU Int. 2010;105(6):824–9. doi:10.1111/j.1464-410X.2009.08853.x.PubMedCentralPubMedCrossRef

26.

Roddam AW, Allen NE, Appleby P, Key TJ. Endogenous sex hormones and prostate cancer: a collaborative analysis of 18 prospective studies. J Natl Cancer Inst. 2008;100(3):170–83. doi:10.1093/jnci/djm323.PubMedCrossRef

27.

Fernandez-Balsells MM, Murad MH, Lane M, Lampropulos JF, Albuquerque F, Mullan RJ, et al. Clinical review 1: adverse effects of testosterone therapy in adult men: a systematic review and meta-analysis. J Clin Endocrinol Metab. 2010;95(6):2560–75. doi:10.1210/jc.2009-2575.PubMedCrossRef

28.

Berry SJ, Coffey DS, Walsh PC, Ewing LL. The development of human benign prostatic hyperplasia with age. J Urol. 1984;132(3):474–9.PubMed

29.

McVary KT, Rademaker A, Lloyd GL, Gann P. Autonomic nervous system overactivity in men with lower urinary tract symptoms secondary to benign prostatic hyperplasia. J Urol. 2005;174(4 Pt 1):1327–433.PubMedCrossRef

30.

Gacci M, Corona G, Vignozzi L, Salvi M, Serni S, De Nunzio C, et al. Metabolic syndrome and benign prostatic enlargement: a systematic review and meta-analysis. BJU Int. 2015;115(1):24–31. doi:10.1111/bju.12728.PubMedCrossRef

31.

Cattabiani C, Basaria S, Ceda GP, Luci M, Vignali A, Lauretani F, et al. Relationship between testosterone deficiency and cardiovascular risk and mortality in adult men. J Endocrinol Investig. 2012;35(1):104–20. doi:10.3275/8061.

32.

Bekaert M, Van Nieuwenhove Y, Calders P, Cuvelier CA, Batens AH, Kaufman JM, et al. Determinants of testosterone levels in human male obesity. Endocrine. 2015. doi:10.1007/s12020-015-0563-4.PubMed

33.

De Nunzio C, Aronson W, Freedland SJ, Giovannucci E, Parsons JK. The correlation between metabolic syndrome and prostatic diseases. Eur Urol. 2012;61(3):560–70. doi:10.1016/j.eururo.2011.11.013.PubMedCrossRef

34.

Parsons JK, Carter HB, Partin AW, Windham BG, Metter EJ, Ferrucci L, et al. Metabolic factors associated with benign prostatic hyperplasia. J Clin Endocrinol Metab. 2006;91(7):2562–8. doi:10.1210/jc.2005-2799.PubMedCentralPubMedCrossRef

35.

Kopp RP, Han M, Partin AW, Humphreys E, Freedland SJ, Parsons JK. Obesity and prostate enlargement in men with localized prostate cancer. BJU Int. 2011;108(11):1750–5. doi:10.1111/j.1464-410X.2011.10227.x.PubMedCrossRef

36.

Kupelian V, McVary KT, Kaplan SA, Hall SA, Link CL, Aiyer LP, et al. Association of lower urinary tract symptoms and the metabolic syndrome: results from the Boston Area Community Health Survey. J Urol. 2009;182(2):616–24. doi:10.1016/j.juro.2009.04.025. discussion 24–5.PubMedCentralPubMedCrossRef

37.

Rohrmann S, Smit E, Giovannucci E, Platz EA. Association between markers of the metabolic syndrome and lower urinary tract symptoms in the Third National Health and Nutrition Examination Survey (NHANES III). Int J Obes. 2005;29(3):310–6. doi:10.1038/sj.ijo.0802881.CrossRef

38.

Rosen R, Altwein J, Boyle P, Kirby RS, Lukacs B, Meuleman E, et al. Lower urinary tract symptoms and male sexual dysfunction: the multinational survey of the aging male (MSAM-7). Eur Urol. 2003;44(6):637–49.PubMedCrossRef

39.

Bozkurt O, Bolat D, Demir O, Ucer O, Sahin A, Ozcift B, et al. Erectile function and late-onset hypogonadism symptoms related to lower urinary tract symptom severity in elderly men. Asian J Androl. 2013;15(6):785–9. doi:10.1038/aja.2013.44.PubMedCentralPubMedCrossRef

40.

Macfarlane GJ, Botto H, Sagnier PP, Teillac P, Richard F, Boyle P. The relationship between sexual life and urinary condition in the French community. J Clin Epidemiol. 1996;49(10):1171–6.PubMedCrossRef

41.

Chung WS, Nehra A, Jacobson DJ, Roberts RO, Rhodes T, Girman CJ, et al. Lower urinary tract symptoms and sexual dysfunction in community-dwelling men. Mayo Clin Proc. 2004;79(6):745–9. doi:10.4065/79.6.745.PubMedCrossRef

42.

Blanker MH, Bohnen AM, Groeneveld FP, Bernsen RM, Prins A, Thomas S, et al. Correlates for erectile and ejaculatory dysfunction in older Dutch men: a community-based study. J Am Geriatr Soc. 2001;49(4):436–42.PubMedCrossRef

43.

McVary KT. Erectile dysfunction and lower urinary tract symptoms secondary to BPH. Eur Urol. 2005;47(6):838–45. doi:10.1016/j.eururo.2005.02.001.PubMedCrossRef

44.

Pradidarcheep W. Lower urinary tract symptoms and its potential relation with late-onset hypogonadism. Aging Male: Off J Int Soc Study Aging Male. 2008;11(2):51–5. doi:10.1080/13685530801954026.CrossRef

45.

Sommers SC. Endocrine changes with prostatic carcinoma. Cancer. 1957;10(2):345–58.PubMedCrossRef

46.

Chokkalingam AP, Nyren O, Johansson JE, Gridley G, McLaughlin JK, Adami HO, et al. Prostate carcinoma risk subsequent to diagnosis of benign prostatic hyperplasia: a population-based cohort study in Sweden. Cancer. 2003;98(8):1727–34. doi:10.1002/cncr.11710.PubMedCrossRef

47.

Orsted DD, Bojesen SE, Nielsen SF, Nordestgaard BG. Association of clinical benign prostate hyperplasia with prostate cancer incidence and mortality revisited: a nationwide cohort study of 3,009,258 men. Eur Urol. 2011;60(4):691–8. doi:10.1016/j.eururo.2011.06.016.PubMedCrossRef

48.

Guess HA. Benign prostatic hyperplasia and prostate cancer. Epidemiol Rev. 2001;23(1):152–8.PubMedCrossRef

49.

Orsted DD, Bojesen SE. The link between benign prostatic hyperplasia and prostate cancer. Nat Rev Urol. 2013;10(1):49–54. doi:10.1038/nrurol.2012.192.PubMedCrossRef

50.

Morgentaler A, Traish AM. Shifting the paradigm of testosterone and prostate cancer: the saturation model and the limits of androgen-dependent growth. Eur Urol. 2009;55(2):310–20. doi:10.1016/j.eururo.2008.09.024.PubMedCrossRef

51.

Page ST, Lin DW, Mostaghel EA, Hess DL, True LD, Amory JK, et al. Persistent intraprostatic androgen concentrations after medical castration in healthy men. J Clin Endocrinol Metab. 2006;91(10):3850–6. doi:10.1210/jc.2006-0968.PubMedCrossRef

52.

Page ST, Lin DW, Mostaghel EA, Marck BT, Wright JL, Wu J, et al. Dihydrotestosterone administration does not increase intraprostatic androgen concentrations or alter prostate androgen action in healthy men: a randomized-controlled trial. J Clin Endocrinol Metab. 2011;96(2):430–7. doi:10.1210/jc.2010-1865.PubMedCentralPubMedCrossRef

53.

Gat Y, Joshua S, Gornish MG. Prostate cancer: a newly discovered route for testosterone to reach the prostate: treatment by super-selective intraprostatic androgen deprivation. Andrologia. 2009;41(5):305–15. doi:10.1111/j.1439-0272.2009.00972.x.PubMedCrossRef

54.••

van der Sluis TM, Meuleman EJ, van Moorselaar RJ, Bui HN, Blankenstein MA, Heijboer AC, et al. Intraprostatic testosterone and dihydrotestosterone. Part II: concentrations after androgen hormonal manipulation in men with benign prostatic hyperplasia and prostate cancer. BJU Int. 2012;109(2):183–8. doi:10.1111/j.1464-410X.2011.10652.x. This reference in part 1 and part 2 both demonstrate how DHT in the prostate and testosterone in the serum and prostate are related to each other. Homonal manipulation with drugs and the physiology of DHT and testostoerone in the prostate leading to pathology is explored. See Van der Sluis et al. Part I for further details.PubMedCrossRef

55.

van der Sluis TM, Vis AN, van Moorselaar RJ, Bui HN, Blankenstein MA, Meuleman EJ, et al. Intraprostatic testosterone and dihydrotestosterone. Part I: concentrations and methods of determination in men with benign prostatic hyperplasia and prostate cancer. BJU Int. 2012;109(2):176–82. doi:10.1111/j.1464-410X.2011.10651.x.PubMedCrossRef

56.

Marks LS, Mazer NA, Mostaghel E, Hess DL, Dorey FJ, Epstein JI, et al. Effect of testosterone replacement therapy on prostate tissue in men with late-onset hypogonadism: a randomized controlled trial. JAMA. 2006;296(19):2351–61. doi:10.1001/jama.296.19.2351.PubMedCrossRef

57.

St Sauver JL, Jacobson DJ, McGree ME, Girman CJ, Klee GG, Lieber MM, et al. Associations between longitudinal changes in serum estrogen, testosterone, and bioavailable testosterone and changes in benign urologic outcomes. Am J Epidemiol. 2011;173(7):787–96. doi:10.1093/aje/kwq438.PubMedCentralPubMedCrossRef

58.

Parsons JK, Palazzi-Churas K, Bergstrom J, Barrett-Connor E. Prospective study of serum dihydrotestosterone and subsequent risk of benign prostatic hyperplasia in community dwelling men: the Rancho Bernardo Study. J Urol. 2010;184(3):1040–4. doi:10.1016/j.juro.2010.05.033.PubMedCrossRef

59.

Trifiro MD, Parsons JK, Palazzi-Churas K, Bergstrom J, Lakin C, Barrett-Connor E. Serum sex hormones and the 20-year risk of lower urinary tract symptoms in community-dwelling older men. BJU Int. 2010;105(11):1554–9. doi:10.1111/j.1464-410X.2009.09090.x.PubMedCrossRef

60.

Kristal AR, Schenk JM, Song Y, Arnold KB, Neuhouser ML, Goodman PJ, et al. Serum steroid and sex hormone-binding globulin concentrations and the risk of incident benign prostatic hyperplasia: results from the prostate cancer prevention trial. Am J Epidemiol. 2008;168(12):1416–24. doi:10.1093/aje/kwn272.PubMedCentralPubMedCrossRef

61.

Litman HJ, Bhasin S, O'Leary MP, Link CL, McKinlay JB. An investigation of the relationship between sex-steroid levels and urological symptoms: results from the Boston Area Community Health survey. BJU Int. 2007;100(2):321–6. doi:10.1111/j.1464-410X.2007.06938.x.PubMedCrossRef

62.

Lee JH, Kim Y, Park YW, Lee DG. Relationship between benign prostatic hyperplasia/lower urinary tract symptoms and total serum testosterone level in healthy middle-aged eugonadal men. J Sex Med. 2014;11(5):1309–15. doi:10.1111/jsm.12489.PubMedCrossRef

63.

Liu CC, Huang SP, Li WM, Wang CJ, Chou YH, Li CC, et al. Relationship between serum testosterone and measures of benign prostatic hyperplasia in aging men. Urology. 2007;70(4):677–80. doi:10.1016/j.urology.2007.05.025.PubMedCrossRef

64.

Roberts RO, Jacobson DJ, Rhodes T, Klee GG, Leiber MM, Jacobsen SJ. Serum sex hormones and measures of benign prostatic hyperplasia. Prostate. 2004;61(2):124–31. doi:10.1002/pros.20080.PubMedCrossRef

65.•

Pearl JA, Berhanu D, Francois N, Masson P, Zargaroff S, Cashy J, et al. Testosterone supplementation does not worsen lower urinary tract symptoms. J Urol. 2013;190(5):1828–33. doi:10.1016/j.juro.2013.05.111. Administration of testosterone in 120 hypogondal men did not cause a worsening in LUTS/BPH per the AUASI validated questionaaire in these patients.PubMedCrossRef

66.

Haider A, Gooren LJ, Padungtod P, Saad F. Concurrent improvement of the metabolic syndrome and lower urinary tract symptoms upon normalisation of plasma testosterone levels in hypogonadal elderly men. Andrologia. 2009;41(1):7–13. doi:10.1111/j.1439-0272.2008.00880.x.PubMedCrossRef

67.

Amano T, Imao T, Takemae K, Iwamoto T, Nakanome M. Testosterone replacement therapy by testosterone ointment relieves lower urinary tract symptoms in late onset hypogonadism patients. Aging Male: Off J Int Soc Study Aging Male. 2010;13(4):242–6. doi:10.3109/13685538.2010.487552.CrossRef

68.

Kalinchenko S, Vishnevskiy EL, Koval AN, Mskhalaya GJ, Saad F. Beneficial effects of testosterone administration on symptoms of the lower urinary tract in men with late-onset hypogonadism: a pilot study. Aging Male: Off J Int Soc Study Aging Male. 2008;11(2):57–61. doi:10.1080/13685530801953994.CrossRef

69.

Karazindiyanoglu S, Cayan S. The effect of testosterone therapy on lower urinary tract symptoms/bladder and sexual functions in men with symptomatic late-onset hypogonadism. Aging Male: Off J Int Soc Study Aging Male. 2008;11(3):146–9. doi:10.1080/13685530802290438.CrossRef

70.

Pechersky AV, Mazurov VI, Semiglazov VF, Karpischenko AI, Mikhailichenko VV, Udintsev AV. Androgen administration in middle-aged and ageing men: effects of oral testosterone undecanoate on dihydrotestosterone, oestradiol and prostate volume. Int J Androl. 2002;25(2):119–25.PubMedCrossRef

71.

Shigehara K, Sugimoto K, Konaka H, Iijima M, Fukushima M, Maeda Y, et al. Androgen replacement therapy contributes to improving lower urinary tract symptoms in patients with hypogonadism and benign prostate hypertrophy: a randomised controlled study. Aging Male: Off J Int Soc Study Aging Male. 2011;14(1):53–8. doi:10.3109/13685538.2010.518178.CrossRef

72.

Page ST, Hirano L, Gilchriest J, Dighe M, Amory JK, Marck BT, et al. Dutasteride reduces prostate size and prostate specific antigen in older hypogonadal men with benign prostatic hyperplasia undergoing testosterone replacement therapy. J Urol. 2011;186(1):191–7. doi:10.1016/j.juro.2011.03.026.PubMedCentralPubMedCrossRef

73.

Francomano D, Ilacqua A, Bruzziches R, Lenzi A, Aversa A. Effects of 5-year treatment with testosterone undecanoate on lower urinary tract symptoms in obese men with hypogonadism and metabolic syndrome. Urology. 2014;83(1):167–73. doi:10.1016/j.urology.2013.08.019.PubMedCrossRef

74.

Yassin DJ, El Douaihy Y, Yassin AA, Kashanian J, Shabsigh R, Hammerer PG. Lower urinary tract symptoms improve with testosterone replacement therapy in men with late-onset hypogonadism: 5-year prospective, observational and longitudinal registry study. World J Urol. 2014;32(4):1049–54. doi:10.1007/s00345-013-1187-z.PubMedCrossRef

75.

Aversa A, Bruzziches R, Francomano D, Rosano G, Isidori AM, Lenzi A, et al. Effects of testosterone undecanoate on cardiovascular risk factors and atherosclerosis in middle-aged men with late-onset hypogonadism and metabolic syndrome: results from a 24-month, randomized, double-blind, placebo-controlled study. J Sex Med. 2010;7(10):3495–503. doi:10.1111/j.1743-6109.2010.01931.x.PubMedCrossRef

76.

Rosner W, Hryb DJ, Khan MS, Nakhla AM, Romas NA. Androgen and estrogen signaling at the cell membrane via G-proteins and cyclic adenosine monophosphate. Steroids. 1999;64(1–2):100–6.PubMedCrossRef

77.

Traish AM. Testosterone and weight loss: the evidence. Curr Opin Endocrinol Diabetes Obes. 2014;21(5):313–22. doi:10.1097/med.0000000000000086.PubMedCentralPubMedCrossRef

78.

Cunningham GR. Testosterone and metabolic syndrome. Asian J Androl. 2015;17(2):192–6. doi:10.4103/1008-682x.148068.PubMedCrossRef

79.

Ficarra V, Rossanese M, Zazzara M, Giannarini G, Abbinante M, Bartoletti R, et al. The role of inflammation in lower urinary tract symptoms (LUTS) due to benign prostatic hyperplasia (BPH) and its potential impact on medical therapy. Curr Urol Rep. 2014;15(12):463. doi:10.1007/s11934-014-0463-9.PubMedCrossRef

80.•

Vignozzi L, Cellai I, Santi R, Lombardelli L, Morelli A, Comeglio P, et al. Antiinflammatory effect of androgen receptor activation in human benign prostatic hyperplasia cells. J Endocrinol. 2012;214(1):31–43. doi:10.1530/joe-12-0142. This article connects hypogonadism and BPH, revealing a 5 fold increase in BPH symptoms and inflammation in vitro due to hypogonadism and low DHT. DHT helps prevent autoimmunity and inflmaation.PubMedCrossRef

81.

Bodie J, Lewis J, Schow D, Monga M. Laboratory evaluations of erectile dysfunction: an evidence based approach. J Urol. 2003;169(6):2262–4. doi:10.1097/01.ju.0000063940.19080.58.PubMedCrossRef

82.

Kohler TS, Kim J, Feia K, Bodie J, Johnson N, Makhlouf A, et al. Prevalence of androgen deficiency in men with erectile dysfunction. Urology. 2008;71(4):693–7. doi:10.1016/j.urology.2007.11.073.PubMedCrossRef

83.

Nieschlag E. Current topics in testosterone replacement of hypogonadal men. Best Pract Res Clin Endocrinol Metab. 2015;29(1):77–90. doi:10.1016/j.beem.2014.09.008.PubMedCrossRef

84.

Gray PB, Singh AB, Woodhouse LJ, Storer TW, Casaburi R, Dzekov J, et al. Dose-dependent effects of testosterone on sexual function, mood, and visuospatial cognition in older men. J Clin Endocrinol Metab. 2005;90(7):3838–46. doi:10.1210/jc.2005-0247.PubMedCrossRef

85.

Corona G, Isidori AM, Buvat J, Aversa A, Rastrelli G, Hackett G, et al. Testosterone supplementation and sexual function: a meta-analysis study. J Sex Med. 2014;11(6):1577–92. doi:10.1111/jsm.12536.PubMedCrossRef

86.

Isidori AM, Giannetta E, Gianfrilli D, Greco EA, Bonifacio V, Aversa A, et al. Effects of testosterone on sexual function in men: results of a meta-analysis. Clin Endocrinol. 2005;63(4):381–94. doi:10.1111/j.1365-2265.2005.02350.x.CrossRef

Titel: Testosterone Replacement Therapy on the Natural History of Prostate Disease
verfasst von: Aaron Moore
Michael J. Butcher
Tobias S. Köhler
Publikationsdatum: 01.08.2015
Verlag: Springer US
Erschienen in: Current Urology Reports / Ausgabe 8/2015
Print ISSN: 1527-2737
Elektronische ISSN: 1534-6285
DOI: https://doi.org/10.1007/s11934-015-0526-6

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Erst PSA-Test, dann Kallikrein-Score, schließlich MRT und Biopsie – ein vierstufiges Screening-Schema kann die Zahl der unnötigen Prostatabiopsien erheblich reduzieren: Die Hälfte der Männer, die in einer finnischen Studie eine Biopsie benötigten, hatte einen hochgradigen Tumor.

Harnwegsinfektprophylaxe: Es geht auch ohne Antibiotika

20.04.2024 EAU 2024 Kongressbericht

Beim chronischen Harnwegsinfekt bei Frauen wird bisher meist eine Antibiotikaprophylaxe eingesetzt. Angesichts der zunehmenden Antibiotikaresistenz erweist sich das Antiseptikum Methenamin-Hippurat als vielversprechende Alternative, so die Auswertung einer randomisierten kontrollierten Studie.

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