Endocrine Abstracts

Aim

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

Material-method

A. Patients: at onset 333 men with hypogonadism (median: 62 y).

B. Distribution: by decade (starting with 20y->90y); no = 6, 18, 35, 80, 104, 67, 21, 2.

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

D. Prostate volume (PV) by per-abdominal ultrasound: 3.5–5 MHz probe, elliptical/3D (cm³).

E. Analysis in time: before testosterone (T0 = 333), after ½ month (T1 = 332), 3m (T2 = 273), 6m (T3 = 212), 1y (T4 = 175), 2y (T5 = 121), 3y (T6 = 84), 4y (T7 = 66), 5y (T8 = 59), 6y (T9 = 50), 7y (T10 = 43), 8y (T11 = 34), 9y (T12 = 26), 10 y (T13 = 19), 11y (T14 = 11), 12y (T15 = 5), 13y (T16 = 3).

F. Maximum increment percent from T0 noted ΔM%. Average increment percent noted ΔA%.

G. Statistical analysis: Student test.

Results

I. A. Mean prostatic volume before testosterone increased by decade (significance vs 20y): 13.17; 16.83 (0.24, NS); 22.25 (P = 0.016); 29.54 (P = 0.0003); 36.19 (P = 0.000004); 40.53 (P = 0.0000002); 44.67 (P = 0.000003); 33.75 (P = 0.001). B. All average prostatic volume post testosterone by decade and time were tabulated (see pdf).

II. Maximum increment post testosterone (Δ M %) per decade: 54.76; 44.44; 56.41; 68.92; 53.85; 68.18; 54.55; 29.00.

III. The moment of ΔM% – per decade: T10; T5; T8; T8; T3; T7; T5; T2.

IV. Average increment (ΔA%) per decade: +4.69; -12.02; -14.75; -1.48; -13.33; -45.29; +14.69; +14.63.

V. Considering all observations, TUD did not increase PV significantly. A. The average of increment (%) in all patients was negative: -6.61%. B. Per decade significance vs beginning TUD was P = : 0.34; 0.12; 0.67; 0.29; 0.77; 0.98; 0.28; 0.17.

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

Comments

After 3 month, many patients give up treatment. At 1 year, around half patients withdraw. However, comparing with 2019 (Lyon) data, patient number increased by 16.22%. 19 patients were operated before starting testosterone, 4 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. Surprisingly, 16 patients died after withdrawing TUD at 2–3 years.

Conclusions

Considering the risk for prostate (in elderly), testosterone undecanoat 1000 mg depot injectable is a safe treatment, even after 13 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.