Low Serum Testosterone is Present in Nearly Half of Men Undergoing Artificial Urinary Sphincter Placement

McKibben, Maxim J.; Fuentes, Jorge L.; Shakir, Nabeel; Fuchs, Joceline S.; Viers, Boyd R.; Pagliara, Travis; Hofer, M.; Scott, Jeremy; Morey, Allen F.

doi:10.1016/j.urology.2018.04.018

Cited by 13 publications

(5 citation statements)

References 25 publications

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“…Among men undergoing artificial urethral sphincter (AUS) placement post-prostatectomy, low serum testosterone was reported as a risk factor for stress UI [ 44 ]. In community-dwelling older male cancer patients, diagnoses of prostate and bladder cancers had the strongest associations with UI, compared to colorectal and lung cancers [ 43 ].…”

Section: Results/evidence Synthesismentioning

confidence: 99%

A scoping review of risk factors for urinary incontinence in older men

Olagundoye,

Odusanya,

Kung

et al. 2023

BMC Geriatr

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Background Most epidemiological studies have not systematically identified or categorized risk factors for urinary incontinence (UI) in older men, despite a higher prevalence than in younger men. Considering the burden of UI, an understanding of risk factors can inform cost-effective prevention/treatment programs. This scoping review aimed to identify and categorise risk factors for UI in older men, identify gaps in the evidence, and opportunities for future research. Methods The Joanna Briggs Institute (JBI) method for scoping reviews guided the conduct and reporting of this review alongside the Preferred Reporting Items for Systematic Reviews and Meta-analyses extension for scoping reviews checklist. JBI’s Population, Concept, and Context approach framed the inclusion criteria (all evidence sources on UI risk factors that included older men [65 +]). We employed JBI’s three-step search strategy, which included a limited initial search in Ovid MEDLINE, a detailed comprehensive database search, and a search of reference lists of included studies, Google Scholar and grey literature. There were no restrictions on language, study type, or publication date. Two independent reviewers screened, selected, and extracted eligible studies. Data were analyzed using descriptive statistics and qualitative content analysis. Results Forty-seven articles that met the inclusion criteria identified 98 risk factors across six categories. Behavioural risk factors, reported by only two studies, were the least investigated of all the categories, whereas medical factors/diseases were the most investigated. No genetic factors were documented. The top five risk factors were increasing age/advanced age (n = 12), Benign Prostatic Hyperplasia (n = 11), Diabetes Mellitus (n = 11), Detrusor overactivity (n = 10), limitation in physical function/ADL disability (n = 10), increased Body Mass Index (BMI)/overweight/obesity (n = 8), Dementia (n = 8), and Parkinson’s disease (n = 7). Conclusion There is a dearth of evidence to describe the role behavioural risk factors have in UI in older men. These factors may play a role in health promotion and disease prevention in this area. Registration A protocol detailing the methods was developed and published, and is registered in the Open Science Framework [Feb 07 2023; https://osf.io/xsrge/].

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Section: Results/evidence Synthesismentioning

confidence: 99%

A scoping review of risk factors for urinary incontinence in older men

Olagundoye,

Odusanya,

Kung

et al. 2023

BMC Geriatr

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“…11,12 Given that LT is common among men after prostate cancer treatment, both due to age and androgen deprivation therapy, the potential impact on the management of postprostatectomy incontinence is profound. 13 In this study, we sought to update and confirm our initial observation of the link between low testosterone levels and AUS cuff erosion in a large cohort of patients.…”

Section: Introductionmentioning

confidence: 88%

Most men with artificial urinary sphincter cuff erosion have low serum testosterone levels

Wolfe

Ortiz

Baumgarten

et al. 2021

Neurourology and Urodynamics

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Aims: To evaluate the relationship between serum testosterone (T) levels and artificial urinary sphincter (AUS) cuff erosion in a population of incontinent men who underwent AUS placement.Methods: A retrospective analysis of our single-surgeon AUS database was performed to identify men with T levels within 24 months of AUS placement.Men were stratified into two groups based on serum testosterone: low serum testosterone (LT) (<280 ng/dl) and normal serum testosterone (NT) (>280 ng/dl).Multivariable analysis was performed to control for risk factors. The outcome of interest was the incidence of and time to spontaneous urethral cuff erosion; other risk factors for cuff erosion were also evaluated.Results: Among 161 AUS patients with serum testosterone levels, 84 (52.2%) had LT (mean: 136.8 ng/dl, SD: 150.4 ng/dl) and 77 (47.8%) had NT (mean: 455.8 ng/dl, SD: 197.3 ng/dl). Cuff erosion was identified in 42 men (26.1%) at a median of 7.1 months postoperatively (interquartile range: 3.6-13.4 months), most of whom (30/42, 71.4%) were testosterone deficient. LT levels were less common (54/119, 45.4%) in the non-erosion cohort (p = 0.004). Men with low T were nearly three times as likely to suffer AUS erosion than men with normal T (odds ratio = 2.519, p = 0.021). LT level was the only factor associated with AUS erosion on multivariable analysis. Conclusions:LT is an independent risk factor for AUS cuff erosion. Men with LT are more likely to present with cuff erosion, but there is no difference in time to erosion.

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“…Studies showed AUS erosion will affect 90% of men with androgen deficiency ( 121 , 122 ). Also, McKibben et al demonstrated that low androgen levels are observed in approximately 50% of men who undergo AUS placement ( 123 ). In the study by Bailey et al , androgen deprivation therapy within two years before AUS placement showed no impact on the outcomes and complications ( 124 ).…”

Section: Methodsmentioning

confidence: 99%

Hypogonadism and urologic surgeries: a narrative review

Fendereski¹,

Ghaed²,

Calvert³

et al. 2022

Transl Androl Urol

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Background and Objective: Previous studies indicated that the treatment of male hypogonadism can be beneficial for intraoperative and postsurgical outcomes. In this study, we aimed to determine the impact of male hypogonadism on urologic surgeries. We provided an overview of the key studies in the field with the focus on the outcomes of urologic surgeries in hypogonadal men with/without testosterone replacement therapy (TRT).Methods: We performed a literature review in PubMed and Google Scholar databases for the most relevant articles pertaining to the outlined topics without placing any limitations on publication years or study designs. We included full-text English articles published in peer reviewed journals between January 1970 and March 2022.

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Low Serum Testosterone is Present in Nearly Half of Men Undergoing Artificial Urinary Sphincter Placement

Cited by 13 publications

References 25 publications

A scoping review of risk factors for urinary incontinence in older men

A scoping review of risk factors for urinary incontinence in older men

Most men with artificial urinary sphincter cuff erosion have low serum testosterone levels

Hypogonadism and urologic surgeries: a narrative review

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