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- 저자 : Louis J Gooren (검색결과 2 건)
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Late Onset Hypogonadism and Lower Urinary Tract Symptoms: New Insights
Farid Saad,Louis J Gooren 대한남성과학회 2011 The World Journal of Men's Health Vol.29 No.1
Late onset hypogonadism was originally perceived as an academic topic. In the course of two decades it has become an issue impacting on everyday urology. For long time clinical conditions, such as cardiovascular disease, diabetes mellitus type 2, sexual dysfunction and urological complaints affecting the aging male, were regarded as independent clinical entities, treated by a number of medical specialists. Over the last decade their close interrelationship could be convincingly demonstrated. Declining testosterone levels in elderly appear to be central to the above pathologies. Epidemiological studies show that prostate disease occurs at an age when serum testosterone levels decline. It is now clear that erectile dysfunction is a local expression of endothelial dysfunction of the cardiovascular system. Testosterone deficiency is associated with an increased incidence of cardiovascular disease and diabetes mellitus, sequels of the metabolic syndrome. There is a relationship between the metabolic syndrome and lower urinary tract symptoms (LUTS). The pathophysiology of LUTS has much in common with the pathological substrate of erectile dysfunction with regard to vascular factors and the role of nitric oxide, explaining why phosphodiesterase type 5 inhibitors have often a beneficial effect on LUTS. It must be regarded an omission not to include testosterone measurements in the work-up of the LUTS, erectile dysfunction, cardiovascular disease and diabetes mellitus type 2. These conditions hinge on testosterone deficiency, and if testosterone deficiency can be proven, testosterone treatment can improve these conditions. There are many sites in the lower urinary tract where testosterone exerts effects.
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Farid Saad,Aksam Yassin,Ahmad Haider,Gheorghe Doros,Louis Gooren 대한비뇨의학회 2015 Investigative and Clinical Urology Vol.56 No.4
Purpose: To investigate the potential benefits of testosterone administration to elderly men (>65 years) with late-onset hypogonadism (LOH) in comparison with younger men and to assess the safety of testosterone administration to elderly men. Materials and Methods: A total of 561 hypogonadal men from two registry studies were divided into age groups of ≤65 years (group Y, n=450; range, 32–65 years) and >65 years (group O, n=111; range, 66–84 years). Following an initial 6-week interval, all men were treated with 3-month injections of parenteral testosterone undecanoate for up to 6 years. Results: Over the 6 years, there was a progressive decrease of body weight and waist circumference. Beneficial effects on lipids and other metabolic factors and on psychological and sexual functioning progressed over the first 24 to 42 months and were sustained. Rather than a deterioration, there was an improvement of urinary parameters. Prostate volume and prostate-specific antigen increased moderately. Hematocrit levels increased but remained within safe margins. Conclusions: The benefits of restoring serum testosterone in men with LOH were not significantly different between men older than 65 years of age and younger men. There were no indications that side effects were more severe in elderly men. The effects on prostate and urinary function and hematocrit were within safe margins. Age itself need not be a contraindication to testosterone treatment of elderly men with LOH.
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