English (United Kingdom)

https://curated-unify.zendy.io/wp-json/zendy-region/v1/featured_content/oa?rat=en

https://curated-unify.zendy.io/wp-json/zendy-region/v1/highlighted_journal/

Global: Zendy Plus annual

Presents the access of premium content as premium feature

Premium Content

Presents the keyphrase highlighting as premium feature

Keyphrase Highlighting

Presents the summarisation as premium feature

Summarisation

Insights

Presents the pdf analysis as premium feature

PDF Analysis

Presents the zaia usage as premium feature

ZAIA

Global: Zendy Tools annual

Global: Zendy Free Plan

Global: Zendy Tools monthly

Global: Zendy Plus monthly

Testosterone Replacement Therapy (TRT) was – during the last 7 to 8 decades associated with triggering or worsening of a prostate cancer. A meta-analysis in 2005 of 19 randomized controlled trials showed no statistically significant difference in the diagnosis of prostate cancer in men using TRT or placebo (1). A pooled-analysis of 18 population-based longitudinal studies comprising 3886 men with prostate cancer (PCa) and 6438 matched controls showed no association between endogenous androgen levels and the risk of developing PCa (2). However, more controversial is the use of TRT in men after the treatment of a prostate cancer. But, during the last years more and more studies are showing that we can use – at least in a selected group – TRT after radical prostatectomy (RP) in symptomatic hypogonadal men with no impact in the oncologic outcomes. We conducted a Medline search to find publications on TRT after RP and we summarized what we have found in literature. Early in 2004, Kaufman and Graydon (3) reported 7 men under TRT after curative radical prostatectomy for PCa (6 men with Gleason 6 and 1 with Gleason 7). No biochemical recurrence (BCR) as defined by consecutive increasing PSAs and patient referral for salvage radiotherapy occurred after a follow up period of 19 months. In 1 patient, TRT was initiated in the early postoperative period due to hot flashes and low energy. There was no pattern of time of initiating TRT after RP in that series. In 2005, Agarwal and Oefelein (4) treated 10 hypogonadal symptomatic men after RP Gleason 6 in 2 patients, Gleason 7 in 7 patients and Gleason 8 in 1 patient also with no biochemical recurrence after a mean follow-up of 19 months. All patients initiated TRT at least after one year of RP. In 2008, Nabulsi et al. (5) reported 22 men under TRT after PCa – 13 with Gleason 6, 7 with Gleason 7 and 2 with Gleason 8. One patient had BCR (Gleason 8) after 12 months on TRT. Mean follow up was 24 months. Mean time after RP to initiate TRT was 11 months (range 2.5 to 118). Also in 2008, Davila et al. (6) reported a series of 14 men after RP (mean Gleason score 6.2) receiving testosterone with a mean follow-up period of 12 months with no biochemical recurrence. No mention on the time after RP when TRT was initiated. In 2009, Khera et al. (7) presented a study in which 57 symptomatic hypogonadal men were submitted to TRT after RP. The mean Gleason score was 6.57. TRT was initiated with an average of 36 months (range 1 to 136 months) after RP. In a mean follow up of 13 months DIffERENCE Of OpINION Vol. 44 (1): 4-7, January February, 2018

international braz j urol

Do we have enough evidences that make you safe to treat a man with hypogonadism one year after a radical prostatectomy for prostate cancer? | Opinion: YES