The Journal of Urology | 2019
PD16-03\u2003CARDIOVASCULAR DISEASE (CVD), HYPOGONADISM & ED: POSITIVE EFFECTS UNDER LONG-TERM TREATMENT WITH TESTOSTERONE UNDECANOATE INJECTIONS (TU)
Abstract
INTRODUCTION AND OBJECTIVES: ED is a predictive risk factor for CVD. We monitored effectiveness and safety of long-term Testosterone Therapy (TTh) in hypogonadal men with a history of CVD. METHODS: Two observational registry studies of 622 hypogonadal men from two urological centers: 77 men with a previous diagnosis of coronary artery disease (CAD; n[48) and/or a myocardial infarction (MI; n[40) and/or stroke (n[7) received TU for up to 14 years. RESULTS: Mean age was 60.65 4.98 years, mean followup time was 7.29 1.20 years. Testosterone (T) levels rose from 9.78 1.56 nmol/L to trough levels (measured prior to the following injection) between 16 and 18 nmol/L. IIEF-EF (maximum score: 30) increased from 19.64 6.34 to 24.49 4.69 with a change from baseline of 5.37 0.36, this improvement was statistically significant for the first three years and remained statistically significant vs baseline throughout the observation time and stable compared to previous years. Weight decreased progressively from 114.47 13.41 to 90.42 8.77 by 23.6 0.6 kg, proportion of weight loss: 19.62 5.71%. Waist circumference decreased from 111.78 8.22 to 99.24 6.48 by 12.51 0.37 cm. The waist:height ratio improved from 0.64 0.05 to 0.57 0.04 (p<0.0001 for all). Blood pressure (BP, mmHg): Systolic BP decreased from 164.45 14.4 to 132.96 8.71, diastolic BP from 99.48 11.37 to 76.39 4.89, pulse pressure from 64.97 6.48 to 56.57 8.02 (p<0.0001 for all). Lipid pattern and glycaemic control improved significantly and sustainably. C-reactive protein (CRP) declined from 3.69 4.51 to 0.25 0.28 mg/dl. In no patient was testosterone therapy discontinued or interrupted. No cardiovascular events were reported during the observation time. CONCLUSIONS: In hypogonadal men with a history of CVD, T therapy may improve and preserve erectile function for a prolonged period of time. No cardiologic or urologic events observed during entire period of T therapy. TTh appears to be well-tolerated and safe.