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abstract

abstract

097

In obese hypogonadal men, long-term testosterone therapy improves erectile function, quality of life and body weight – real-life evidence from a registry study

Saad, F1Haider, A2; Haider, KS2; Doros, G3; Traish, A4

1: Bayer AG, Germany; 2: Private Urology Practice, Germany; 3: Boston University School of Public Health, USA; 4: Boston University School of Medicine, USA

Objectives: Obesity has negative effects on erectile function. We investigated effects of long-term testosterone therapy (TTh) in a registry in a urology office in comparison to an untreated hypogonadal control group.

Material and Methods: Of 776 hypogonadal men in the registry, 441 (59%) were obese. 267 obese men with testosterone ≤12.1 nmol/L and symptoms of hypogonadism received testosterone undecanoate 1000 mg every 3 months following an initial 6-week interval for up to 10 years (T-group). 174 hypogonadal men decided against testosterone therapy (CTRL). Erectile function was assessed by IIEF-EF (5+1 questions, maximal score: 30). Differences between groups were estimated and adjusted for age, waist circumference, BMI, blood pressure, lipids, and quality of life to account for baseline differences between groups.

Results: Mean age: T-group: 60±6, CTRL: 64±5. IIEF-EF increased from 19.1±5.2 to 27.1±1.6 at 10 years in the T-group. The improvement was statistically significant compared to previous year for the first 5 years. In CTRL, IIEF-EF decreased from 19.4±3.6 to 9±2 with statistical significance vs. previous year for the first 9 years. The estimated adjusted between-group difference was +19.2 (p<0.0001 for all). Quality of life (QoL), measured by the Aging Males’ Symptoms scale, improved in the T-group from 52.2±10 to 17.1±0.2 and declined in CTRL from 39.8±5.6 to 58±2, estimated adjusted between-group difference: 40.4 (p<0.0001 for all). Waist circumference decreased from 110±7 to 98±6 cm in the T-group (p<0.0001) and from 118±11 to 114±10 in CTRL (NS), estimated difference between groups: -14 cm (p<0.0001). Weight decreased from 113±11 to 89±8 kg in the T-group (p<0.0001) and from 104±9 to 100±9 in CTRL (NS), between-group difference: -23 kg (p<0.0001). The per cent weight change at 10 years was -21.3±4.9% in the T-group (p<0.0001) vs +0.3±5.1% in CTRL (p<0.01), between-group difference: -21.3% (p<0.0001). Medication adherence in the T-group was 100 per cent as all injections were performed in the office and documented.

Conclusions: Erectile function improved with long-term TTh but worsened in CTRL. Weight and waist circumference decreased sustainably in the T-group and remained largely stable in CTRL. Weight loss as a result of TTh in obese hypogonadal men may have contributed to improving sexual function. Changes in erectile function and body weight were accompanied by changes in quality of life.

Disclosure:

Work supported by industry: yes, by Bayer AG (industry funding only - investigator initiated and executed study).

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