McLaren Drew, Siemens D Robert, Izard Jason, Black Angela, Morales Alvaro
Department of Urology and Centre for Applied Urological Research, Kingston General Hospital, Queen's University, Kingston, ON, Canada.
BJU Int. 2008 Nov;102(9):1142-6. doi: 10.1111/j.1464-410X.2008.07811.x. Epub 2008 Jun 6.
To report on a clinical practice series of testosterone-replacement therapy (TRT) in men with testosterone deficiency syndrome (TDS), examining clinical efficacy, biochemical parameters and effects on prostate health over a 2-year period.
A retrospective review of 85 patients with symptoms of TDS and at least a 3-month trial of TRT was performed in this single-centre, clinical practice setting. Three domains of symptomatology were evaluated: libido, erectile function and energy levels. Symptoms were assessed by a combination of patient reporting, physician's assessment and validated symptom assessment scores. Total testosterone (TT), calculated bio-available testosterone (BT) and prostate-specific antigen (PSA) levels were continuously measured and effects on prostate health were examined.
Only 38 (45%) patients in this cohort remained on TRT for >2 years. The most common reason for discontinuing treatment was lack of clinical response but those remaining on TRT had continued improvement in libido, erectile function and energy levels. During treatment, the average TT and calculated BT values significantly increased compared with the baseline values at most of the evaluated time points, with no significant change in average PSA values. In all, 15% of this cohort had some degree of progression of lower urinary tract symptoms. Seven patients had eight 'for-cause' prostate biopsies either during supplementation or at any date after completion, with an only three positive for cancer.
Only 45% of men on TRT remained on treatment for >2 years in this clinical practice experience of men with TDS. Those remaining showed persistent improvement in their symptoms. The average TT and BT values increased significantly with no significant change in PSA levels.
报告男性睾酮缺乏综合征（TDS）患者睾酮替代疗法（TRT）的临床实践系列，研究2年期间的临床疗效、生化参数及对前列腺健康的影响。
在这个单中心临床实践环境中，对85例有TDS症状且至少进行了3个月TRT试验的患者进行回顾性研究。评估了三个症状领域：性欲、勃起功能和能量水平。通过患者报告、医生评估和经过验证的症状评估分数相结合的方式对症状进行评估。持续测量总睾酮（TT）、计算得出的生物可利用睾酮（BT）和前列腺特异性抗原（PSA）水平，并检查对前列腺健康的影响。
该队列中只有38例（45%）患者接受TRT治疗超过2年。停止治疗的最常见原因是缺乏临床反应，但继续接受TRT治疗的患者在性欲、勃起功能和能量水平方面持续改善。治疗期间，在大多数评估时间点，平均TT和计算得出的BT值与基线值相比显著增加，而平均PSA值无显著变化。总体而言，该队列中有15%的患者下尿路症状有一定程度的进展。7例患者在补充治疗期间或完成治疗后的任何时间进行了8次“因症”前列腺活检，其中仅3例癌症检测呈阳性。
在TDS男性患者的这一临床实践经验中，只有45%接受TRT治疗的男性持续治疗超过2年。继续治疗的患者症状持续改善。平均TT和BT值显著增加，而PSA水平无显著变化。
