20129

Erektil disfonksiyonun değerlendirilmesinde hormonal incelemenin gerekliliği

Amaçlar: Erektil Disfonksiyon nedeniyle başvuran hastada yapılacak ilk incelemede rutin hormonal değerlendirmenin yapılıp yapılmaması tartışmalıdır. Bu çalışmada kliniğimize başvuran ve hormonal inceleme yapılan hastalara bu incelemelerin katkısı araştırıldı.Yöntem ve gereçler: Pokliniğimize başvuran ve hormonal değerlendirme düşünülen hastalarda FSH, LH, Prolaktin ve Testosteron seviyelerinden en az ikisine bakılarak incelemeler yapıldı. Hormonal bozukluk oranları tespit edilerek bu bozukluların hasta yaşı ile korele olup olmadığına bakıldı. Ayrıca bu değerlendirmeler sonucunda tedavide farklı bir uygulamanın yapılıp yapılmadığı tespit edildi. Bulgular: Ortalama yaşı 46,1 olan 356 hastanın 227’sine (%63.8) hormonal inceleme yapıldı. FSH yüksekliği % 9.5 (20/221), LH yüksekliği %7.1 (16/224), prolaktin yüksekliği %4.7 (10/211) ve testosteron düşüklüğü %3.7 (7/191) hastada tespit edildi. FSH ve LH ile yaş arasında anlamlı pozitif korelasyon, prolaktin ile yaş arasında negatif korelasyon görülürken testesteron ile yaş arasında korelasyon tespit edilmedi. Prolaktin yüksekliği olan 10 hastanın 1 tanesi daha önceden hipofiz adenomu tanısı almış ve tedavi edilmekteydi. Diğer 9 hastada prolaktin değerleri normal sınırın 2 katını geçmediğinden endokrinoloji bilim dalı tarafından ek incelemeye gerek görülmedi. Testosteron düşüklüğü olan 7 hastadan libido azalması olan 2 tanesine testosteron replasmanı yapılırken diğer 5 tanesine gerek görülmedi ve tüm hastalara erektil disfonksiyona yönelik tedaviler uygulandı. Sonuçlar: Bu bulgular erektil disfonksiyon nedeniyle başvuran bir hastada yapılacak ilk incelemede hormonal incelemenin tedaviye ek katkısının çok olmayacağını göstermektedir. Hormonal incelemeler iyi bir anemnez ve fizik muayeneyi takiben sadece gerekli olgularda istenmelidir.

Anahtar Kelimeler:

Erektil disfonksiyon, hormon, testosteron

Necessity of endocrine screening in men with erectile dysfunction

OBJECTIVES: It is an issue of debate whether or not to perform hormonal testing as a first-line investigation in patients with erectile dysfunction. This study aimed to assess the contribution of hormonal testing to the diagnostic investigations of patients who present with erectile dysfunction. METHODS: Investigations were performed in patients who applied to our andrology clinic and in whom hormonal causes were suspected, by looking at least two of the FSH, LH, prolactin and testosterone levels. The rates of hormonal disturbances and their correlation with age were determined. Additionally, whether any modification was performed or not according to the results of these tests was noted. RESULTS: Hormonal investigation was performed in 227(63.8%) of 356 patients. The increased levels of FSH,LH,prolactin and decreased level of testosterone were seen in 9.5%(20/221),7.1% (16/224),4.7%(10/211) and 3.7%(7/191) of the patients.There was a positive correlation between FSH and LH and age,a negative correlation between prolactin and age,and no correlation between testosterone and age. One of the 10 patients with prolactin increase had been diagnosed and been receiving treatment for hypophysis adenoma. Since the level of prolactin was not twice the normal level no further examination was requested in the remaining 9 patients by the endocrinologists. Testosterone replacement was given in two of 7 patients with decreased libido. In the remaining 5 patients no replacement was needed. CONCLUSIONS: Our findings indicate that performing the hormonal investigation as a first line investigation in an erectile dysfunction patient does not contribute to the treatment additionally. Hormonal investigations should be performed after detailed history and physical examination and only in necessary cases.

Keywords:

Erectile dysfunction, hormone, testosterone,

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