Efficacy of androgen replacement therapy in patients with coexistence of  hipogonadism and venoocclusive erectile dysfunction

Ufuk Öztürk; Nevzat Can Şener; HN Göksel Göktuğ; Alper Dilli; Hasan Bakırtaş; M Abdürrahim İmamoğlu

doi:10.5455/GMJ-30-2012-114

Authors

Ufuk Öztürk Dışkapı Yıldırım Beyazıt Eğitim ve Araştırma Hastanesi 4. Üroloji Kliniği, Ankara
Nevzat Can Şener Dışkapı Yıldırım Beyazıt Eğitim ve Araştırma Hastanesi 4. Üroloji Kliniği, Ankara
HN Göksel Göktuğ Dışkapı Yıldırım Beyazıt Eğitim ve Araştırma Hastanesi 4. Üroloji Kliniği, Ankara
Alper Dilli Dışkapı Yıldırım Beyazıt Eğitim ve Araştırma Hastanesi Radyoloji Kliniği, Ankara
Hasan Bakırtaş Dışkapı Yıldırım Beyazıt Eğitim ve Araştırma Hastanesi 4. Üroloji Kliniği, Ankara
M Abdürrahim İmamoğlu Dışkapı Yıldırım Beyazıt Eğitim ve Araştırma Hastanesi 4. Üroloji Kliniği, Ankara

DOI:

https://doi.org/10.5455/GMJ-30-2012-114

Keywords:

Erectile dysfunction, hypogonadism, testosterone

Abstract

Decreases in plasma testosterone levels cause not only fatigue, depression, but also sexual symptoms such as decrease in libido or erectile dysfunction (ED). Low testosterone levels can cause venoocclusive dysfunction. In this study, we aimed to show that ED could be treated by testosterone replacement in patients with venoocclusive dysfunction and hipogonadism. Data of 500 patients applied to our clinic with ED between January 2009- March 2012 were examined retrospectively for coexistence of erectile dysfunction, hipogonadism and venoocclusive dysfunction. International Index of Erectile Disfuncion (IIEF-5) scores and plasma testosterone levels of the patients were evaluated. Venoocclusive dysfunction was determined by penile color Doppler ultrasound. After excluding other causes that can cause ED, 37 patients administered testosterone replacement therapy for hipogonadism and venoocclusive erectile dysfunction, were enrolled in the study. After 6 months, IIEF-5 scores and plasma testosterone levels of the patients were reevaluated. After treatment, 29 of 37 patients (78%) were found to improve for ED. Patients with ED, hipogonadism and venous leakage should be kept in mind. We believe this condition could be treated by testosterone replacement therapy.

Metrics

Metrics Loading ...

References

Yassin AA, Saad F. Testosterone and erectile dysfunction. J Androl 2008;29(6):593-604.

Cunningham GR, Hirshkowitz M, Korenman SG, Karacan I. Testosterone replacement therapy and sleep-related erections in hypogonadal men. J Clin Endocrinol Metab 1990;70(3):792-7.

Rakic Z, Starcevic V, Starcevic VP, Marinkovic J. Testosterone treatment in men with erectile disorder and low levels of totaltestosterone in serum. Arch Sex Behav 1997;26(5):495-504.

Hwang TI, Chen HE, Tsai TF, Lin YC. Combined use of androgen and sildenafil for hypogonadal patients unresponsive to sildenafil alone. Int J Impot Res 2006;18(4):400-4.

Traish AM, Goldstein I, Kim NN. Testosterone and erectile function: from basic research to a new clinical paradigm for managing men with androgen insufficiency and erectile dysfunction. Eur Urol 2007;52(1):54-70.

Carani C, Scuteri A, Marrama P, Bancroft J. The effects of testosterone administration and visual erotic stimuli on nocturnal penile tumescence in normal men. Horm Behav 1990;24(3):435-41.

Schiavi RC, White D, Mandeli J, Schreiner-Engel P. Hormones and nocturnal penile tumescence in healthy aging men. Arch Sex Behav 1993;22(3):207-15.

Nehra A, Azadzoi KM, Moreland RB, Pabby A, Siroky MB, Krane RJ, et al. Cavernosal expandability is an erectile tissue mechanical property which predicts trabecular histology in an animal model of vasculogenic erectile dysfunction. J Urol 1998;159(6):2229 -36.

Nehra A, Goldstein I, Pabby A, Nugent M, Huang YH, de las Morenas A, et al. Mechanisms of venous leakage: a prospective clincopathologic correlation of corporal function and structure. J Urol 1996;156(4):1320-9.

Moreland RB. Is there a role for hypoxemia in penile fibrosis? Int J Impot Res 1998;10(2):113-20.

Rogers RS, Graziottin TM, Lin CS, Kan YW, Lue TF. Intracavernosal vascular endothelial growth factor (VEGF) injection and adeno-assoicated virus-mediated VEGF gene therapy prevent and reverse venogenic erectile dysfunction in rats. Int J Impot Res 2003;15(1):26-37.

Traish AM, Toselli P, Jeong SJ, Kim NN. Adipocyte accumulation in penile corpus cavernosum of the orchiectomized rabbit: a potential mechanism for venoocclusive dysfunction in androgen deficiency. J Androl 2005;26(2):242-8.

Singh R, Artaza JN, Taylor WE, Gonzalez-Cadavid NF, Bhasin S. Androgens stimulate myogenic differentiation and inhibit adipogenesis in C3H 10T1/2 pluripotent cells through an androgen receptor-mediated pathway. Endocrinology 2003;144(11): 5081-8.

Burnett AL. Novel nitric oxide signaling mechanisms regulate the erectile response. Int J Impot Res 2004;16 Suppl 1:S15-9.

Shen ZJ, Zhou XL, Lu YL, Chen ZD. Effect of androgen deprivation on penile ultrastructure. Asian J Androl 2003;5(1):33-6.

Yassin AA, Saad F, Traish A. Testosterone undecanoate restores erectile function in a subset of patients with venous leakage: a series of case reports. J Sex Med 2006;3(4):727-35.

Traish AM. Androgens play a pivotal role in maintaining penile tissue architecture and erection: a review. J Androl 2009;30(4):363-9.

Chamness SL, Ricker DD, Crone JK, Dembeck CL, Maguire MP, Burnett AL, et al. The effect of androgen on nitric oxide synthase in the male reproductive tract of the rat. Fertil Steril 1995;63(5):1101-7.

McNicholas TA, Dean JD, Mulder H, Carnegie C, Jones NA. A novel testosterone gel formulation normalizes androgen levels in hypogonadal men, with improvements in body composition and sexual function. BJU Int 2003;91(1):69-74.

Chiang HS, Cho SL, Lin YC, Hwang TI. Testosterone gel monotherapy improves sexual function of hypogonadal men mainly through restoring erection: evaluation by IIEF score. Urology 2009;73(4):762-6.

Kurbatov D, Kuznetsky J, Traish A. Testosterone improves erectile function in hypogonadal patients with venous leakage. J Androl 2008;29(6):630-7.