The role of an endocrine specialist nurse in a nurse led testosterone implant clinic
Maria OConnor, Neil Walker, Niki Karavataki & John Wass
Introduction: In our centre prior to 2003, testosterone implantation was undertaken by rotational junior medical staff. A specialist nurse role in testosterone implantation was developed within the Oxford Department of Endocrinology over a nine month period.
Aim: To assess the adverse effects and the complications from testosterone implants offered by a specialist nurse committed to this task.
Method: Since 2003, 200 implants have been undertaken in 14 males (mean age of 52.8 years [range 2079 years]). Implants were undertaken every three months with 12 men receiving 600 mg and 2 800 mg of testosterone on each occasion. Routine bloods were taken for FBC, Lipids (non-fasting), Testosterone (trough) and PSA following each procedure.
Results: Testosterone trough level: mean 13.13 nmol/l (range 6.631.2 nmol/l [reference 8.428.7 nmol/l]). Patients have all been within the normal testosterone range before each three month implant. PSA level: mean 1.26 ug/l (range <0.014.3 ug/l [reference 04 ug/l]). One patient had a continually high PSA; prostate cancer has been excluded. Haemoglobin levels: mean 13.76 g/dl (range 12.518.3 g/dl). One patient had polycythaemia prior to starting on implants which persisted. The infection rate was nil and out of 200 implants 0.5% had exclusion problems. No patient has been lost to follow-up.
Conclusion: Despite more modern methods testosterone implants remain the preferred method in a small number of males. An Endocrine Specialist Nurse performing testosterone implantation provides an effective and safe means of service offering testosterone replacement.