WCE 2017: Effect of Testosterone Impregnated Pellet Therapy on Lower Urinary Tract Symptoms

Vancouver, Canada (UroToday.com) Dr. Ostrowski, a 4th year resident from the Mayo Clinic in Jacksonville, Florida, presented data on the effect of testosterone impregnated pellet therapy on lower urinary tract symptoms in a cohort of clinic patients. Males with hypogonadism are commonly treated with testosterone replacement therapy. As an introduction to his talk, Dr. Ostrowski explained that one of the concerns for this therapy is whether it can worsen lower urinary tract symptoms (LUTS) given that testosterone may promote prostate growth.
For this study males with hypogonadism were treated with testosterone replacement therapy, specifically a long acting subcutaneous testosterone impregnated pellet (STIP) delivery system. There were a total of 38 patients who participated in this study. All patients answered pre and post American Urological Association Symptom Index Score (AUASIS) questionnaires. These score were analyzed and Dr. Ostrowski and his team assessed whether there was a relationship between change in the AUASIS and the use of STIP for the treatment of hypogonadism.

In the AUASIS, patients responded to questions regarding elements such as incomplete emptying, frequency, intermittent stream, urgency, weak stream, straining, and nocturia on a 0-5 scale. For this comparison, baseline and post STIP responses to these questions were analyzed.

Following analysis, results showed that the mean baseline AUASIS was 9.2 (+/-6.0) while the post-STIP AUASIS was 8.8 (+/-6.2). The difference in AUA SIS scores was not significant. 45% of the 38 patients showed a less than 3-point change is AUASIS. Interestingly, the remaining 55% of patients showed a greater that 3-point improvement (29%) or worsening (25%) of AUASIS.

Dr. Ostrowski concluded that average AUASIS for both pre and post STIP are in the moderate (8-19) category of voiding dysfunction. He further added that STIP therapy successfully elevate testosterone to eugonadal levels without alteration of patient AUASIS. Lastly, he suggested that worsening LUTS should not be a concern when recommending STIP therapy for hypogonadal men.

Presented by: Andy Ostrowski

Authors: Andy Ostrowski, Robert Williams, Gregory Broderick
Affiliation: Department of Urology, Mayo Clinic Florida, Jacksonville, Florida

Written by: Renai Yoon, Department of Urology, University of California-Irvine, at 35th World Congress of Endourology– September 12-16, 2017, Vancouver, Canada.