Gupta Nikhil, Carvajal Maria, Jurewicz Michael, Gilbert Bruce R
Hofstra-Northwell School of Medicine, Smith Institute for Urology, New Hyde Park, NY, USA.
Asian J Urol. 2017 Jan;4(1):3-9. doi: 10.1016/j.ajur.2016.11.002. Epub 2016 Nov 28.
Late-onset hypogonadism, or androgen deficiency in the aging male, is a significant cause of morbidity in older men. Many men in the low normal or equivocal range for low testosterone level exhibit signs and symptoms of hypogonadism. Serum testosterone is an imperfect maker for hypogonadism as symptoms vary greatly within the low to low normal range in addition to variations among testosterone assays. Perineal ultrasound can be effectively used to examine the bulbocavernosus muscle (BCM), an androgenized tissue that may be impacted by androgen receptor activity.
This study was a retrospective analysis of men who underwent perineal ultrasound for hypogonadism. The ultrasound data were used to calculate the area of the BCM and correlate it with indices of hypogonadismin symptomatic men including free and total testosterone and dual-energy X-ray absorptiometry (DEXA).
The results demonstrate that there is a significant correlation between total and free testosterone and BCM area in hypogonadal patients. Comparison between BCM area and total testosterone showed = 0.061 and = 0.0187 and comparison between BCM area and free testosterone showed = 0.0957 and = 0.0034. In addition, low BCM was also correlated with DEXA results showing osteoporosis and osteopenia ( = 0.2239, = 0.0027).
There has been recent controversy over the safety of testosterone replacement therapy. This might be particularly important in men with hypogonadal symptoms but a low normal testosterone level. Our study investigated the use of perineal ultrasound to measure BCM as a surrogate marker for poor androgenized men presenting with hypogonadism.
迟发性性腺功能减退，即老年男性雄激素缺乏，是老年男性发病的重要原因。许多睾酮水平处于低正常范围或临界范围的男性表现出性腺功能减退的体征和症状。血清睾酮作为性腺功能减退的指标并不理想，因为在低至低正常范围内症状差异很大，而且不同的睾酮检测方法之间也存在差异。会阴超声可有效用于检查球海绵体肌（BCM），这是一种可能受雄激素受体活性影响的雄激素化组织。
本研究是对因性腺功能减退接受会阴超声检查的男性进行的回顾性分析。超声数据用于计算BCM的面积，并将其与有症状男性的性腺功能减退指标相关联，这些指标包括游离睾酮、总睾酮和双能X线吸收法（DEXA）。
结果表明，性腺功能减退患者的总睾酮、游离睾酮与BCM面积之间存在显著相关性。BCM面积与总睾酮的比较显示r = 0.061，P = 0.0187；BCM面积与游离睾酮的比较显示r = 0.0957，P = 0.0034。此外，低BCM也与显示骨质疏松和骨质减少的DEXA结果相关（r = 0.2239，P = 0.0027）。
最近关于睾酮替代疗法的安全性存在争议。这对有性腺功能减退症状但睾酮水平处于低正常范围的男性可能尤为重要。我们的研究调查了使用会阴超声测量BCM作为性腺功能减退的雄激素化不良男性的替代标志物。
