Outcomes of Prostate Biopsy in Men with Hypogonadism Prior or During Testosterone Replacement Therapy
Int. braz. j. urol
;
41(6): 1167-1171, Nov.-Dec. 2015. graf
Article
in English
| LILACS
| ID: lil-769772
ABSTRACT
Introduction: The relationship between Testosterone Replacement Therapy (TRT) and prostate cancer remains controversial. Most TRT studies show no change in prostate specific antigen (PSA) but some men do have PSA rise or develop an abnormal digital rectal exam (aDRE). Our objective was to examine the biopsy results of men with symptomatic hypogonadism before or during therapy. Materials and Methods: Data was extracted from our medical record on men with hypogonadism who had a prostate biopsy within the past 4 years done by 3 Urologists with guideline driven practice patterns. Results: 96 men were identified. Mean age at biopsy was 63 (range 40–85) and median PSA was 3.78ng/dL (0.5–662). Of the 61 men not on TRT, median PSA was 4.34 (0.5 to 662) and mean total testosterone 254 (191–341). There were 29 (47.5%) prostate cancers found (6 Gleason score 6, 13 Gleason score 7, 10 Gleason score 8 or 9). Of the 35 men on TRT, median PSA was 3.27 (0.5 to 13.7). The %PSA increase ranged from 2 to 251% (mean 93.5%). Mean total testosterone was 383 (146–792). Of the 14 men treated < 2 years, none had cancer. Of the 21 men treated 2 or more years 5 had cancer (2 Gleason score 6, 3 Gleason score 7). Conclusions: Men with hypogonadism and a clinical indication for biopsy often have prostate cancer, many high grade. No men with an initial PSA rise on TRT had cancer. Men on long term TRT should be monitored with PSA and DRE per guidelines.
Full text:
Available
Index:
LILACS (Americas)
Main subject:
Prostatic Neoplasms
/
Testosterone
/
Hormone Replacement Therapy
/
Eunuchism
Type of study:
Etiology study
/
Practice guideline
/
Prognostic study
/
Risk factors
Limits:
Adult
/
Aged
/
Aged80
/
Humans
/
Male
Language:
English
Journal:
Int. braz. j. urol
Journal subject:
Urology
Year:
2015
Type:
Article
Affiliation country:
United States
Institution/Affiliation country:
Glickman Urological and Kidney Institute/US
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