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1.
Urologiia ; (6): 82-7, 2014.
Article in Russian | MEDLINE | ID: mdl-25799733

ABSTRACT

The study was aimed to the optimization of conservative therapy of micropenis in hypogonadal men using combination of traction therapy and androgen replacment therapy (ART) with injections of prolonged testosterone undecanoate (Nebido) and to evaluatiom of the safety of ART in terms of the risk of prostate cancer against the background of combined treatment of micropenis by both methods within 12 months. The study included 16 men aged 22-62 years with micropenis and hypogonadism. 10 men were diagnosed with primary hypogonadism, 6 men were diagnosed with secondary hypogonadism without reserve gonadal function; therefore, all 16 patients were treated with testosterone undecanoate 1000 mg intramuscularly according to the scheme: the second injection 6 weeks after the first injection, then each injection once a 12 weeks, the course of 12 months. During the first 3 months of ART, hypogonadism in all men was eliminated, but only at 6 month of ART, the length of the penis in the flaccid state at maximum extension increased from 5.8±1.2 to 8.3±1.2 cm (p<0.05), and the length of the erect penis - from 6.8±1.1 to 11.8±0.9 (p<0,05). At the next stage, from the 6th to the 12th month of ART, traction therapy was simultaneously carried out. At the end of the treatment, the length of the penis in the flaccid state at maximum extension increased by 58% of the original length, and in a state of erection - by 114% (p<0.05). During the 12 months of treatment, prostate volume in all men increased from 3.4±1.2 to 16.3±1.2 (p<0.05), which corresponds to the size of the prostate in healthy men. Total blood PSA level increased from 0.72±0.03 to 1.4±0.05 ng/ml (p<0.05), but it was in the acceptable range of reference values for healthy men during whole period of ART in all patients. Start therapy with prolonged testosterone undecanoate for 6 months significantly increases the efficiency of traction therapy in men with hypogonadism and micropenis, but for maintenance of the effect, ART should be continued during all period of treatment.


Subject(s)
Androgens/therapeutic use , Genital Diseases, Male/therapy , Hormone Replacement Therapy/methods , Hypogonadism/therapy , Penis/abnormalities , Physical Therapy Modalities , Testosterone/analogs & derivatives , Adult , Genital Diseases, Male/blood , Genital Diseases, Male/pathology , Humans , Hypogonadism/blood , Hypogonadism/pathology , Kallikreins/blood , Male , Middle Aged , Penis/pathology , Prostate-Specific Antigen/blood , Testosterone/therapeutic use , Time Factors
2.
Urologiia ; (1): 41-4, 2008.
Article in Russian | MEDLINE | ID: mdl-18649679

ABSTRACT

In selection of patients with erectile dysfunction perspective for conservative treatment we conducted a sialis-test (oral test with tadalafil which is a vasoactive drug, inhibitor of phosphodiesterase of type 5). In sialis negative test we studied a hormonal status of the patient (testosteron level in the blood serum) and performed dopplerography of penile vessels in the course of intracavernous injection of a vasoactive drug. In 2002-2005 we treated 115 patients with erectile dysfunction suffering from plastic induration of the penis. We gave conservative treatment to 66 patients and surgical treatment - to 50 (43%) patients. All surgical patients had evident alterations of penile vessels of cavernous tissue and were not perspective for conservative treatment. Treatment policy in erectile dysfunction in Peyronie's disease is the following: in positive sialis test the patients receive conservative treatment - inhibitors of phosphodiesterase of type 5; in negative sialis test blood hormones (testosteron) should be measured and penile vessels should be studied (dopplerography). In detection of low level of testosteron and normal penile vessels the patients receive combined treatment - replacement hormonal therapy plus inhibitors of phosphodiesterase type 5. In vascular pathology verified at dopplerography and negative tadalafil test the patients receive surgical treatment.


Subject(s)
Androgens/therapeutic use , Carbolines/administration & dosage , Erectile Dysfunction/drug therapy , Hormone Replacement Therapy , Penile Induration/drug therapy , Phosphodiesterase Inhibitors/administration & dosage , Testosterone/therapeutic use , Adult , Aged , Erectile Dysfunction/blood , Erectile Dysfunction/complications , Humans , Male , Middle Aged , Penile Induration/blood , Penile Induration/complications , Retrospective Studies , Tadalafil , Testosterone/blood
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