Impact of Testosterone Replacement Therapy in Patients with Hypogonadism and High-Grade Prostate Intraepithelial Neoplasia or Atypical Small Acinar Proliferation in Prostate Biopsy
Marcin Życzkowski, Krzysztof Nowakowski, Rafał Bogacki, Piotr Bryniarski, Zbigniew Kaletka, Mieczysław Fryczkowski, Andrzej Paradysz
(Department of Urology, Medical University of Silesia in Katowice, Zabrze, Poland)
Med Sci Tech 2015; 56:18-25
The aim of this study was to evaluate the influence of testosterone on high-grade prostate intraepithelial neoplasia (HG PIN) or atypical small acinar proliferation (ASAP) of the prostate in hypogonadal men.
Material and Methods: The study was conducted on 142 male patients with the diagnoses of HG PIN or ASAP and testosterone deficiency syndrome, with mean age 64.5 years, of which 78 met the inclusion criteria. The following parameters were evaluated before and after testosterone supplementation: PSA, LH, testosterone (T) levels in blood, prostate volume, IPSS scale, quality of life (QL), T/PSA ratio, and blood hemoglobin (Hb) and hematocrit (Ht). The average observation period was 15.2 months (6–34 months). The first biopsy was a sextance one, and the next repeat-biopsies were made according to the extended protocol. The results underwent statistical analysis.
Results: After 15 months of testosterone replacement therapy, there were no statistically significant differences in progression and remission between different types of prostate histopathological conditions. PSA level was raised after testosterone replacement therapy (TRT) but without statistical significance. Prostate volume, T/PSA ratio, T level, IPSS, QL, Hb, and Ht increased with statistical significance. LH level was lowered with statistical significance.
Conclusions: The level of oncological safety after 15 months of testosterone replacement therapy in males with hypogonadism in whom histopathological lesions in the prostate were diagnosed is comparable to that of eugonadal males. The highest remission was observed in patients with HG PIN (36.... read more
Keywords: Precancerous Conditions, Prostatic Neoplasms, Testosterone