Practical recommendations for the management of testosterone deficiency

被引:6
作者
Burte, C. [1 ]
Lejeune, H. [2 ]
Faix, A. [3 ]
Desvaux, P. [4 ]
Almont, T. [5 ]
Cuzin, B. [6 ]
Huyghe, E. [7 ,8 ]
机构
[1] Cabinet Med Sexuelle, 4 Rue Etats Unis, Cannes, France
[2] HCL, Serv Med Reprod, Hop Femme Mere Enfant, Bron, France
[3] Cabinet Urol, 265 Ave Etats Du Languedoc, Montpellier, France
[4] Cabinet Med Sexuelle, 11 Rue Magellan, F-75008 Paris, France
[5] CHU Martinique, Serv Oncol, Fort De France, Martinique, France
[6] CHU Lyon, Hop Edouard Herriot, Chirurg Transplantat, Serv Urol, Lyon, France
[7] CHU Toulouse, Med Reprod, Site Paule de Viguier, Toulouse, France
[8] CHU Toulouse, Hop Rangueil, Dept Urol Transplantat Renale & Androl, Toulouse, France
来源
PROGRES EN UROLOGIE | 2021年 / 31卷 / 8-9期
关键词
Testosterone deficiency; Libido; Erectile dysfunction; Prostate cancer; Hormone treatment; LATE-ONSET HYPOGONADISM; URINARY-TRACT SYMPTOMS; LOW SERUM TESTOSTERONE; AGING-MALE ISSAM; REPLACEMENT THERAPY; MYOCARDIAL-INFARCTION; INTERNATIONAL-SOCIETY; ANDROGEN DEFICIENCY; METABOLIC SYNDROME; PROSTATE-CANCER;
D O I
10.1016/j.purol.2020.09.026
中图分类号
R5 [内科学]; R69 [泌尿科学(泌尿生殖系疾病)];
学科分类号
1002 ; 100201 ;
摘要
Objectives. - The Francophone Society of Sexual Medicine (SFMS) and the Andrology and Sexual Medicine Committee (CAMS) of the French Association of Urology (AFU) have brought together a panel of experts to develop French recommendations for the management of testosterone deficiency (TD). Methods. - Systematic review of the literature between 01/2000 and 07/2019. Use of the method of recommendations for clinical practice (RPC) and the AGREE II grid. Results. - TD is defined as the association of clinical signs and symptoms suggestive of TD with a decrease in testosterone levels or serum androgen activity. Diagnosis requires a T tower than the reference values in young men on 2 successive assays. Sexual disorders are often at the forefront, and concern the whole male sexual function (desire, arousal, pleasure and orgasm). The most evocative symptoms are: decrease in sexual desire, disappearance of nocturnal erections, fatigue, toss of muscle strength. Overweight, depressed mood, anxiety, irritability and malaise are also frequently found. TD is more common in cases of metabolic, cardiovascular, chronic, andrological diseases, and in cases of corticosteroid, opioid, antipsychotic, anticonvutsant, antiretroviral, or cancer treatment. Since SHBG is frequently abnormal, we recommend that free or bioavaitable T is preferred over total T. The treatment of TD requires a prior clinical (DRE, breast examination) and biological (PSA, CBC) assessment. Contraindications to T treatment are: progressive prostate or breast cancer, severe heart failure or recent cardiovascular event, polycytemia, complicated BPH, paternity project. It is possible in cases of sleep apnea syndrome, psychiatric history, stable heart disease, prostate cancer under active surveillance and after one year of complete remission of a low or intermediate risk localized prostate cancer treated in a curative manner. It includes long-term testosterone supplementation and life-style counseling. Treatment is monitored at 3, 6, 12 months and annually thereafter. It is clinical (annual DRE) and biological (total T, PSA, CBC), the most frequent side effect being polyglobulia. Conclusion. - These recommendations should help improve the management of TD. (C) 2020 Published by Elsevier Masson SAS.
引用
收藏
页码:458 / 476
页数:19
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