Long-term TRT improves urinary, erectile function
‘Excellent adherence’ points to high satisfaction with treatment, author says
Bremerhaven, Germany—Long-term testosterone therapy (TT) in hypogonadal men improves urinary function and erectile function compared with untreated controls, according to registry data from a single practice.
At the AUA annual meeting in San Diego, Ahmad Haider, MD, PhD, a urologist from Bremerhaven, Germany, presented his experience with TT at his practice.
Dr. Haider and colleagues examined a registry of 658 symptomatic hypogonadal men (mean age, 61 years). At baseline, men had total testosterone levels ≤348 ng/dL. Of the cohort, 360 received injections of testosterone undecanoate (Aveed), 1,000 mg every 12 weeks, following an initial 6-week interval for up to 10 years. All injections were administered in a single office. Some 296 hypogonadal men who opted against testosterone therapy served as the controls. Both groups were followed for a median of 78 months.
Total testosterone levels increased quickly to 500 ng/dL in the patients who chose testosterone therapy, and remained there through the end of follow-up. There was no change in total testosterone in the controls.
Prostate volume increased by a mean of 2 mL—from 29.2 mL to 31.1 mL—in the TT group over the 8 years and was unchanged in the controls. The estimated difference in prostate volume was 2 mL (p<.05) between the TT and control groups at year 8 when adjusted for baseline age, weight, waist circumference, fasting glucose level, blood pressure, and lipid levels.
As expected, the post-void residual volume as measured by ultrasound increased in the control group, from 48.3 mL at baseline to 64.5 mL at last follow-up. In the group that received testosterone undecanoate, post-void residual declined from a mean of 47.3 mL at baseline to a mean of 13.7 mL at the final follow-up.
The estimated adjusted difference in post-void residual volume was significant in favor of the TT group starting at year 1 (10 mL difference; p<.0001) and remained significant throughout the follow-up, reaching a difference of 53 mL at year 8 (p<.0001).