ABSTRACT
A 41-year-old male with the chief complaint of infertility was referred to our hospital. He presented withmild erectile dysfunction and reduced shaving frequency. Semen analysis indicated a decreased semen volume in addition to a low sperm count and motility. Hormone evaluation revealed the following details : follicle stimulating hormone (FSH) 1.7 mIU/ml (range 2.0-8.3 mIU/ml), luteinizing hormone (LH) 0.9 mIU/ml (range 0.8-5.7 mIU/ml), testosterone 86.6 ng/dl (range 225.0-1,039 ng/dl), and prolactin (PRL) 242.0 ng/ml (range 3.6-12.8 ng/ml). Magnetic resonance imaging (MRI) of the patient's head showed empty sella turcica. He was diagnosed with acquired hypogonadotropic hypogonadism due to hyperprolactinemia. We suspected that the hyperprolactinemia was due to the pituitary lesion, although the possibility of coexisting pituitary microadenoma could not be discarded. Based on the diagnosis, cabergoline therapy was started. Four months after initiation of cabergoline therapy, the patient's hormone levels and semen parameters normalized, followed by improvement in his clinical symptoms. Furthermore, his wife spontaneously conceived.
Subject(s)
Empty Sella Syndrome , Hyperprolactinemia , Hypogonadism , Infertility, Male , Adult , Empty Sella Syndrome/complications , Humans , Hyperprolactinemia/complications , Infertility, Male/etiology , Luteinizing Hormone , Male , TestosteroneABSTRACT
INTRODUCTION: We examined the tolerability of dosage methods of naftopidil in the treatment of male lower urinary tract symptoms associated with benign prostatic hyperplasia (BPH/male LUTS). PATIENTS AND METHODS: A total of 80 patients with BPH/male LUTS who had an International Prostate Symptom Score (IPSS) >or=8 and IPSS quality of life (QoL) >or=2 were enrolled and randomly administered naftopidil for 8 weeks at either 75 mg once daily (OD) in the evening (group O; n = 41) or 25 mg thrice daily (TID) in the morning, afternoon and evening (group T; n = 39). RESULTS: IPSS total score, IPSS-QoL and BPH impact index (BII) were significantly improved for both groups at 8 weeks after starting treatment compared to baseline. IPSS total score and daytime and 24-hour voiding frequencies were significantly improved at 8 weeks after starting treatment for group O in comparison to group T. Group O showed a significantly better degree of change in BII in comparison to group T. CONCLUSIONS: Naftopidil 75 mg OD in the evening was better tolerated than naftopidil 25 mg TID for the objective parameter and BII.
