Endocrine Abstracts

Aim: Re-Analysing (study starting in 2007) the effect of injectable testosterone undecanoat depot (TUD) in hypogonadic patients.

Material-method: A. Patients: at onset 278 men with hypogonadism (median: 61 y).

B. Distribution: by decade (starting with 20y); no =6, 17, 25, 70, 86, 55, 18, 1.

C. TUD (Nebido^R-Bayer) 1000 mg injected one/3 months i.m.

D. Prostate volume (PV) appreciated by per-abdominal ultrasound: 3,5-5 MHz probe, elliptical/3D (cm³).

E. Analysis in time: before starting testosterone (T0=279), after ½ month (T1=279), 3m (T2=220), 6m (T3=170), 1y (T4=143), 2y (T5=104), 3y (T6=72), 4y (T7=60), 5y (T8=54), 6y (T9=42), 7y (T10=35), 8y (T11=27), 9y (T12=16), 10 y (T13=9), 11y (T14=5).

F. Maximum increment from T0 noted Δ M %. Average increment noted Δ A %.

G. Statistical analysis: Student test.

Results: I. A. Mean prostatic volume (cm³) before testosterone by decade (and significance) increased: 13.17; 16.85 (0.2,NS); 23.96 (P=0.01); 29.88 (P=0.0002); 36.75 (P=0.000001); 41.90 (P=0.0000001); 46.97 (P=0.00001); 32.00 (ND). B. All average prostatic volume post testosterone by decade and time were tabulated (see pdf).

II. Maximum increment post testosterone (Δ M %) per decade: 45.95; 44.44; 56.41; 56.60; 48.72; 68.18; 54.55; 20.00.

III. The moment of Δ M % - per decade: T4; T5; T8; T6; T3; T7; T5; T2.

IV. Average increment (Δ A %) per decade: +5.43; −11.42; −18.04; −4.54; −10.89; −51.71;+13.64,+12.94.

V. Considering all observations, TUD did not increase PV significantly. A. The average of increment (%) in all patients was negative: −8.08%. B. Per decade (significance): 5.43 (P>0.05); −11.42 (decreased); −18.04 (decreased); −4.54 (decreased); −10.89 (decreased); ! −51.71 (decreased); 13.64 (P>0.05 !); 12.94.

VI. In many patients, especially from 30 to 79 years, TUD could decrease slightly prostatic volume.

Comments. After 1 month, many patients give up treatment. At 1 year, around half patients withdraw. However, comparing with 2017 (Lisbon) data, patient number increased by 15%. 18 patients were operated before starting testosterone, two patients were operated during treatment. 5 patients received the diagnosis of prostatic cancer. To them, TUD was administrated when PSA < 1, usually after 3 years anticancer treatment.

Conclusions: Considering the risk for prostate (in elderly), testosterone undecanoat 1000 mg depot injectable is a safe treatment, even after 11 years of administration. Precautions should be accorded to men over 80 y old, after the 5^th year of administration. Under strict control, TUD could be administrated also in prostatic cancer.