在丸激素替代疗法期间的前列腺风险和监测
Shalender Bhasin1, Ian M Thompson2
1Research Program in Men's Health: Aging and Metabolism, Boston Claude D. Pepper Older Americans Independence Center, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA.
The Journal of clinical endocrinology and metabolism
|May 16, 2024
概括
替代疗法 (TRT) 对于患有阴性腺体缺陷症的男性,显示前列腺不良事件的风险较低. 精心查和监测是TRT期间前列腺安全的关键.
科学领域:
- 内分泌学 在内分泌学.
- 泌尿器科 泌尿器科 泌尿器科 泌尿器科
- 男人的健康 男人的健康
背景情况:
- 阴性双症与降低前列腺癌死亡率有关,但替代疗法 (TRT) 的前列腺安全性仍在争论中.
- 几项大型随机试验已经研究了TRT期间前列腺安全结果,而TRAVERSE试验提供了全面的数据.
研究的目的:
- 在接受TRT的男性中评估前列腺不良事件的风险.
- 评估TRT对前列腺癌发病率,下泌尿道症状和前列腺特异性抗原水平的影响.
主要方法:
- 分析来自大型,持续时间较长的TRAVERSE试验的数据,其中包括前性确定的前列腺安全数据.
- 包括经过仔细查的阴腺男性,不包括患前列腺癌高风险的男性.
- 判断前列腺事件,以确保全面的数据收集.
主要成果:
- 前列腺癌的发病率,急性尿,BPH手术,前列腺活检和新的LUTS疗法在TRT和安慰剂组之间很低和相似.
- TRT并没有加剧下尿路症状.
- 与安慰剂相比,TRT在第一年观察到前列腺特异性抗原的更大增加.
结论:
- 在精心挑选的男性中,TRT与前列腺不良事件的低风险有关.
- 治疗前对前列腺癌风险的评估和标准化的监测计划对于安全的TRT至关重要,能够早期检测高度前列腺癌,同时尽量减少不必要的活检.
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