title: Effects of testosterone replacement therapy withdrawal and re-treatment in hypogonadal elderly men upon obesity, voiding function and prostate safety parameters.
abstract: Whether testosterone replacement therapy (TRT) is a lifelong treatment for men with hypogonadism remains unknown. We investigated long-term TRT and TRT withdrawal on obesity and prostate-related parameters. Two hundred and sixty-two hypogonadal patients (mean age 59.5) received testosterone undecanoate in 12-week intervals for a maximum of 11 years. One hundred and forty-seven men had TRT interrupted for a mean of 16.9 months and resumed thereafter (Group A). The remaining 115 patients were treated continuously (Group B). Prostate volume, prostate-specific antigen (PSA), residual voiding volume, bladder wall thickness, C-reactive protein (CRP), aging male symptoms (AMS), International Index of erectile function - erectile function (IIEF-EF) and International Prostate Symptoms Scores (IPSS) were measured over the study period with anthropometric parameters of obesity, including weight, body mass index (BMI) and waist circumference. Prior to interruption, TRT resulted in improvements in residual voiding volume, bladder wall thickness, CRP, AMS, IIEF-EF, IPSS and obesity parameters while PSA and prostate volume increased. TRT interruption reduced total testosterone to hypogonadal levels in Group A and resulted in worsening of obesity parameters, AMS, IPSS, residual voiding volume and bladder wall thickness, IIEF-EF and PSA while CRP and prostate volume were unchanged until treatment resumed whereby these effects were reversed. TRT interruption results in worsening of symptoms. Hypogonadism may require lifelong TRT.
authors.affiliation: a Institute of Urology & Andrology , Norderstedt , Germany .|b Department of Preventive Medicine, Men's Health Programme , Dresden International University , Dresden , Germany .|c Department of Urology , School of Medicine, Gulf Medical University , Ajman , UAE .
authors.forename: Aksam
authors.initials: A
authors.lastname: Yassin
authors.affiliation: d Department of Human Metabolism , University of Sheffield , Sheffield , UK .
authors.forename: Joanne E
authors.initials: JE
authors.lastname: Nettleship
authors.affiliation: e Department of Urology & Andrology , Hamad Medical Corporation , Doha , Qatar , and.
authors.forename: Raidh A
authors.initials: RA
authors.lastname: Talib
authors.affiliation: a Institute of Urology & Andrology , Norderstedt , Germany .
authors.forename: Yousef
authors.initials: Y
authors.lastname: Almehmadi
authors.affiliation: f Boston University School of Public Health , Boston , MA , USA.
authors.forename: Gheorge
authors.initials: G
authors.lastname: Doros
mesh_terms: D000368:Aged; D020249:Hormone Replacement Therapy; D006801:Humans; D007006:Hypogonadism / Q000150:complications / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications*; D011467:Prostate / Q000187:drug effects*; D013739:Testosterone / Q000627:therapeutic use*; D014554:Urination / Q000187:drug effects*
chemical_list: D013739:Testosterone
keywords: BPH; Hypogonadism; lower urinary tract symptoms; prostate; testosterone replacement therapy duration; testosterone replacement therapy interruption