- Email: [email protected]
Re: Testosterone Treatment and Coronary Artery Plaque Volume in Older Men with Low Testosterone
Urological Survey 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57
Male and Female Sexual Function and Dysfunction; Andrology Re: Statin, Testosterone and Phosphodiesterase 5-Inhibitor Treatments and Age Related Mortality in Diabetes G. Hackett, P. W. Jones, R. C. Strange and S. Ramachandran Department of Urology, University of Bedfordshire, Bedfordshire, United Kingdom World J Diabetes 2017; 8: 104e111. doi: 10.4239/wjd.v8.i3.104
Abstract available at http://www.ncbi.nlm.nih.gov/pubmed/28344753 Editorial Comment: The authors wished to determine how statins, testosterone (T) replacement therapy and phosphodiesterase 5 inhibitors (PDE5Is) influence age related mortality in men with diabetes. They studied 857 diabetic men screened for the BLAST (Birmingham, Lichfield, Atherstone, Sutton Coldfield and Tamworth) study. Mean followup was 3.8 years, and patients were stratified into 1) normal T levels/untreated (total T greater than 12 nmol/l and free T greater than 0.25 nmol/l), low T/untreated and low T/treated, 2) PDE5I/untreated and PDE5I/treated, and 3) statin/untreated and statin/treated groups. When all factors were considered, those associated with lower mortality included age (OR 1.08, 95% CI 1.06 to 1.11, p <0.001), low T/treated (OR 0.38, 95% CI 0.15 to 0.92, p ¼ 0.033), PDE5I/treated (OR 0.17, 95% CI 0.053 to 0.56, p ¼ 0.004) and statin/treated (OR 0.59, 95% CI 0.36 to 0.97, p ¼ 0.038). These are interesting data. Perhaps the T replacement and PDE5I use were relegated to men with better performance status. Another possibility is that PDE5Is or T replacement improved the outcomes of these men. Very provocative data. Allen D. Seftel, MD
Suggested Reading Zhang LT, Shin YS, Kim JY et al: Could testosterone replacement therapy in hypogonadal men ameliorate anemia, a cardiovascular risk factor? An observational, 54-week cumulative registry study. J Urol 2016; 195: 1057.
Re: Testosterone Treatment and Coronary Artery Plaque Volume in Older Men with Low Testosterone M. J. Budoff, S. S. Ellenberg, C. E. Lewis, E. R. Mohler, III, N. K. Wenger, S. Bhasin, E. Barrett-Connor, R. S. Swerdloff, A. Stephens-Shields, J. A. Cauley, J. P. Crandall, G. R. Cunningham, K. E. Ensrud, T. M. Gill, A. M. Matsumoto, M. E. Molitch, R. Nakanishi, N. Nezarat, S. Matsumoto, X. Hou, S. Basaria, S. J. Diem, C. Wang, D. Cifelli and P. J. Snyder Divisions of Cardiology and Endocrinology, Los Angeles Biomedical Research Institute, Harbor-UCLA Medical Center, Torrance and Division of Epidemiology, Department of Family and Preventive Medicine, University of California, San Diego School of Medicine, La Jolla, California, Department of Biostatistics and Epidemiology, Section of Vascular Medicine, Division of Cardiovascular Disease and Division of Endocrinology, Diabetes, and Metabolism, Perelman School of Medicine, University of Pennsylvania, Philadelphia and Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, Division of Preventive Medicine, University of Alabama at Birmingham, Birmingham, Alabama, Division of Cardiology, Department of Medicine, Emory Heart and Vascular Center, Emory University School of Medicine, Atlanta, Georgia, Research Program in Men’s Health: Aging and Metabolism, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts, Divisions of Endocrinology and Geriatrics, Albert Einstein College of Medicine, Bronx, New York, Division of Diabetes, Endocrinology and Metabolism, Department of Medicine, and Department of Molecular and Cell Biology, Baylor College of Medicine and Baylor St. Luke’s Medical Center, Houston, Texas, Division of Epidemiology and Community Health, Department of Medicine, University of Minnesota and VA Health Care System, Minneapolis, Minnesota, Division of Geriatric Medicine, Yale School of Medicine, New Haven, Connecticut, Geriatric Research, Education and Clinical Center, VA Puget Sound
0022-5347/17/1984-0001/0 THE JOURNAL OF UROLOGY® Ó 2017 by AMERICAN UROLOGICAL ASSOCIATION EDUCATION
AND
RESEARCH, INC.
http://dx.doi.org/10.1016/j.juro.2017.07.056 Vol. 198, 1-3, October 2017 Printed in U.S.A.
www.jurology.com Dochead: Urological Survey
LIT 5.5.0 DTD JURO14874_proof 18 July 2017 2:04 am EO:
j
58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80 81 82 83 84 85 86 87 88 89 90 91 92 93 94 95 96 97 98 99 100 101 102 103 104 105 106 107 108 109 110 111 112 1 113 114
2
115 116 117 118 119 120 121 122 123 124 125 126 127 128 129 130 131 132 133 134 135 136 137 138 139 140 141 142 143 144 145 146 147 148 149 150 151 152 153 154 155 156 157 158 159 160 161 162 163 164 165 166 167 168 169 170 171
MALE AND FEMALE SEXUAL FUNCTION AND DYSFUNCTION; ANDROLOGY
Health System, and Division of Gerontology and Geriatric Medicine, Department of Internal Medicine, University of Washington School of Medicine, Seattle, Washington, and Division of Endocrinology, Metabolism and Molecular Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois JAMA 2017; 317: 708e716. doi: 10.1001/jama.2016.21043
Abstract available at http://www.ncbi.nlm.nih.gov/pubmed/28241355 Editorial Comment: To test the hypothesis that testosterone treatment in older men with low testosterone slows progression of noncalcified coronary artery plaque volume, the authors performed a double-blind placebo controlled trial at 9 academic medical centers in the United States. The participants were 170 of 788 men 65 years old or older with an average of 2 serum testosterone levels lower than 275 ng/dl (with 82 assigned to placebo and 88 to testosterone) and symptoms suggestive of hypogonadism. All patients were enrolled in the Testosterone Trials between June 24, 2010 and June 9, 2014. Men were treated with testosterone gel with the dose adjusted to maintain testosterone level in the normal range for young men, or placebo gel for 12 months. In older men with symptomatic hypogonadism treatment with testosterone gel for 1 year compared to placebo was associated with a significantly greater increase in coronary artery noncalcified plaque volume, as measured by coronary computerized tomographic angiography. The small sample size precludes strong recommendations. These are interesting data, and further study is warranted. Allen D. Seftel, MD
Suggested Reading Rao PK, Boulet SL, Mehta A et al: Trends in testosterone replacement therapy use from 2003 to 2013 among reproductive-age men in the United States. J Urol 2017; 197: 1121.
Re: High Prevalence of Low Serum Biologically Active Testosterone in Older Male Veterans C. F. Conover, J. F. Yarrow, T. J. Garrett, F. Ye, E. P. Quinlivan, D. F. Cannady, M. D. Peterson and S. E. Borst Research Service and Geriatrics Research, Education and Clinical Center, North Florida/South Georgia Veterans Health System and Department of Pathology, Immunology and Laboratory Medicine, North Florida Foundation for Research and Education, and Department of Applied Physiology and Kinesiology, University of Florida, Gainesville, Florida, and Department of Physical Medicine and Rehabilitation, University of Michigan School of Medicine, Ann Arbor, Michigan J Am Med Dir Assoc 2017; 18: 366.e17ee24. doi: 10.1016/j.jamda.2016.12.077
Abstract available at http://www.ncbi.nlm.nih.gov/pubmed/28214238 Editorial Comment: The authors assessed the prevalence of hypogonadism in older male veterans by comparing direct measurements of total testosterone (TT) and bioavailable testosterone (BioT) vs indirect BioT values derived from existing and newly developed regression analyses. This study was conducted at the Malcom Randall VA Medical Center in Gainesville, Florida. The study cohort consisted of 203 community dwelling male veterans 60 years old or older. TT, BioT, albumin, sex hormone-binding globulin and body mass index were evaluated. In this cohort the prevalence of low TT was higher and low BioT was markedly higher than reported in the general age matched population, indicating a greater incidence of hypogonadism in older male veterans. These findings are intriguing. Allen D. Seftel, MD
Suggested Reading Rao PK, Boulet SL, Mehta A et al: Trends in testosterone replacement therapy use from 2003 to 2013 among reproductive-age men in the United States. J Urol 2017; 197: 1121.
Re: Effects of Bariatric Surgery on Female Pelvic Floor Disorders A. Leshem, M. Shimonov, H. Amir, D. Gordon and A. Groutz Lis Maternity and Women’s Hospital, Tel Aviv Sourasky Medical Center and E. Wolfson Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel Urology 2017; 105: 42e47. doi: 10.1016/j.urology.2017.03.003
Dochead: Urological Survey
LIT 5.5.0 DTD JURO14874_proof 18 July 2017 2:04 am EO:
172 173 174 175 176 177 178 179 180 181 182 183 184 185 186 187 188 189 190 191 192 193 194 195 196 197 198 199 200 201 202 203 204 205 206 207 208 209 210 211 212 213 214 215 216 217 218 219 220 221 222 223 224 225 226 227 228
Male and Female Sexual Function and Dysfunction; Andrology Re: Statin, Testosterone and Phosphodiesterase 5-Inhibitor Treatments and Age Related Mortality in Diabetes G. Hackett, P. W. Jones, R. C. Strange and S. Ramachandran Department of Urology, University of Bedfordshire, Bedfordshire, United Kingdom World J Diabetes 2017; 8: 104e111. doi: 10.4239/wjd.v8.i3.104
Abstract available at http://www.ncbi.nlm.nih.gov/pubmed/28344753 Editorial Comment: The authors wished to determine how statins, testosterone (T) replacement therapy and phosphodiesterase 5 inhibitors (PDE5Is) influence age related mortality in men with diabetes. They studied 857 diabetic men screened for the BLAST (Birmingham, Lichfield, Atherstone, Sutton Coldfield and Tamworth) study. Mean followup was 3.8 years, and patients were stratified into 1) normal T levels/untreated (total T greater than 12 nmol/l and free T greater than 0.25 nmol/l), low T/untreated and low T/treated, 2) PDE5I/untreated and PDE5I/treated, and 3) statin/untreated and statin/treated groups. When all factors were considered, those associated with lower mortality included age (OR 1.08, 95% CI 1.06 to 1.11, p <0.001), low T/treated (OR 0.38, 95% CI 0.15 to 0.92, p ¼ 0.033), PDE5I/treated (OR 0.17, 95% CI 0.053 to 0.56, p ¼ 0.004) and statin/treated (OR 0.59, 95% CI 0.36 to 0.97, p ¼ 0.038). These are interesting data. Perhaps the T replacement and PDE5I use were relegated to men with better performance status. Another possibility is that PDE5Is or T replacement improved the outcomes of these men. Very provocative data. Allen D. Seftel, MD
Suggested Reading Zhang LT, Shin YS, Kim JY et al: Could testosterone replacement therapy in hypogonadal men ameliorate anemia, a cardiovascular risk factor? An observational, 54-week cumulative registry study. J Urol 2016; 195: 1057.
Re: Testosterone Treatment and Coronary Artery Plaque Volume in Older Men with Low Testosterone M. J. Budoff, S. S. Ellenberg, C. E. Lewis, E. R. Mohler, III, N. K. Wenger, S. Bhasin, E. Barrett-Connor, R. S. Swerdloff, A. Stephens-Shields, J. A. Cauley, J. P. Crandall, G. R. Cunningham, K. E. Ensrud, T. M. Gill, A. M. Matsumoto, M. E. Molitch, R. Nakanishi, N. Nezarat, S. Matsumoto, X. Hou, S. Basaria, S. J. Diem, C. Wang, D. Cifelli and P. J. Snyder Divisions of Cardiology and Endocrinology, Los Angeles Biomedical Research Institute, Harbor-UCLA Medical Center, Torrance and Division of Epidemiology, Department of Family and Preventive Medicine, University of California, San Diego School of Medicine, La Jolla, California, Department of Biostatistics and Epidemiology, Section of Vascular Medicine, Division of Cardiovascular Disease and Division of Endocrinology, Diabetes, and Metabolism, Perelman School of Medicine, University of Pennsylvania, Philadelphia and Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, Division of Preventive Medicine, University of Alabama at Birmingham, Birmingham, Alabama, Division of Cardiology, Department of Medicine, Emory Heart and Vascular Center, Emory University School of Medicine, Atlanta, Georgia, Research Program in Men’s Health: Aging and Metabolism, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts, Divisions of Endocrinology and Geriatrics, Albert Einstein College of Medicine, Bronx, New York, Division of Diabetes, Endocrinology and Metabolism, Department of Medicine, and Department of Molecular and Cell Biology, Baylor College of Medicine and Baylor St. Luke’s Medical Center, Houston, Texas, Division of Epidemiology and Community Health, Department of Medicine, University of Minnesota and VA Health Care System, Minneapolis, Minnesota, Division of Geriatric Medicine, Yale School of Medicine, New Haven, Connecticut, Geriatric Research, Education and Clinical Center, VA Puget Sound
0022-5347/17/1984-0001/0 THE JOURNAL OF UROLOGY® Ó 2017 by AMERICAN UROLOGICAL ASSOCIATION EDUCATION
AND
RESEARCH, INC.
http://dx.doi.org/10.1016/j.juro.2017.07.056 Vol. 198, 1-3, October 2017 Printed in U.S.A.
www.jurology.com Dochead: Urological Survey
LIT 5.5.0 DTD JURO14874_proof 18 July 2017 2:04 am EO:
j
58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80 81 82 83 84 85 86 87 88 89 90 91 92 93 94 95 96 97 98 99 100 101 102 103 104 105 106 107 108 109 110 111 112 1 113 114
2
115 116 117 118 119 120 121 122 123 124 125 126 127 128 129 130 131 132 133 134 135 136 137 138 139 140 141 142 143 144 145 146 147 148 149 150 151 152 153 154 155 156 157 158 159 160 161 162 163 164 165 166 167 168 169 170 171
MALE AND FEMALE SEXUAL FUNCTION AND DYSFUNCTION; ANDROLOGY
Health System, and Division of Gerontology and Geriatric Medicine, Department of Internal Medicine, University of Washington School of Medicine, Seattle, Washington, and Division of Endocrinology, Metabolism and Molecular Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois JAMA 2017; 317: 708e716. doi: 10.1001/jama.2016.21043
Abstract available at http://www.ncbi.nlm.nih.gov/pubmed/28241355 Editorial Comment: To test the hypothesis that testosterone treatment in older men with low testosterone slows progression of noncalcified coronary artery plaque volume, the authors performed a double-blind placebo controlled trial at 9 academic medical centers in the United States. The participants were 170 of 788 men 65 years old or older with an average of 2 serum testosterone levels lower than 275 ng/dl (with 82 assigned to placebo and 88 to testosterone) and symptoms suggestive of hypogonadism. All patients were enrolled in the Testosterone Trials between June 24, 2010 and June 9, 2014. Men were treated with testosterone gel with the dose adjusted to maintain testosterone level in the normal range for young men, or placebo gel for 12 months. In older men with symptomatic hypogonadism treatment with testosterone gel for 1 year compared to placebo was associated with a significantly greater increase in coronary artery noncalcified plaque volume, as measured by coronary computerized tomographic angiography. The small sample size precludes strong recommendations. These are interesting data, and further study is warranted. Allen D. Seftel, MD
Suggested Reading Rao PK, Boulet SL, Mehta A et al: Trends in testosterone replacement therapy use from 2003 to 2013 among reproductive-age men in the United States. J Urol 2017; 197: 1121.
Re: High Prevalence of Low Serum Biologically Active Testosterone in Older Male Veterans C. F. Conover, J. F. Yarrow, T. J. Garrett, F. Ye, E. P. Quinlivan, D. F. Cannady, M. D. Peterson and S. E. Borst Research Service and Geriatrics Research, Education and Clinical Center, North Florida/South Georgia Veterans Health System and Department of Pathology, Immunology and Laboratory Medicine, North Florida Foundation for Research and Education, and Department of Applied Physiology and Kinesiology, University of Florida, Gainesville, Florida, and Department of Physical Medicine and Rehabilitation, University of Michigan School of Medicine, Ann Arbor, Michigan J Am Med Dir Assoc 2017; 18: 366.e17ee24. doi: 10.1016/j.jamda.2016.12.077
Abstract available at http://www.ncbi.nlm.nih.gov/pubmed/28214238 Editorial Comment: The authors assessed the prevalence of hypogonadism in older male veterans by comparing direct measurements of total testosterone (TT) and bioavailable testosterone (BioT) vs indirect BioT values derived from existing and newly developed regression analyses. This study was conducted at the Malcom Randall VA Medical Center in Gainesville, Florida. The study cohort consisted of 203 community dwelling male veterans 60 years old or older. TT, BioT, albumin, sex hormone-binding globulin and body mass index were evaluated. In this cohort the prevalence of low TT was higher and low BioT was markedly higher than reported in the general age matched population, indicating a greater incidence of hypogonadism in older male veterans. These findings are intriguing. Allen D. Seftel, MD
Suggested Reading Rao PK, Boulet SL, Mehta A et al: Trends in testosterone replacement therapy use from 2003 to 2013 among reproductive-age men in the United States. J Urol 2017; 197: 1121.
Re: Effects of Bariatric Surgery on Female Pelvic Floor Disorders A. Leshem, M. Shimonov, H. Amir, D. Gordon and A. Groutz Lis Maternity and Women’s Hospital, Tel Aviv Sourasky Medical Center and E. Wolfson Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel Urology 2017; 105: 42e47. doi: 10.1016/j.urology.2017.03.003
Dochead: Urological Survey
LIT 5.5.0 DTD JURO14874_proof 18 July 2017 2:04 am EO:
172 173 174 175 176 177 178 179 180 181 182 183 184 185 186 187 188 189 190 191 192 193 194 195 196 197 198 199 200 201 202 203 204 205 206 207 208 209 210 211 212 213 214 215 216 217 218 219 220 221 222 223 224 225 226 227 228