Characteristics and outcomes of men with erectile dysfunction as the presenting symptom due to a lactotroph adenoma
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Le résumé fourni par la source
PURPOSE: Erectile dysfunction (ED) is frequently underreported in men suffering from prolactinomas and can be challenging to manage. Both dopamine agonists (DAs) and transsphenoidal surgery (TSS) correct hyperprolactinemia and restore gonadal function. However, there is scarce data regarding their effectiveness in correcting ED over the long term. METHODS: This study is a retrospective single-center comparative cohort study analyzing men diagnosed with prolactinomas, both with and without confirmed erectile dysfunction (ED) at diagnosis. Independent risk factors for persistent ED over the long term were examined using multivariate logistic regression. RESULTS: Among the 39 men with lactotroph adenomas, ED was one of the presenting symptoms in 22 (56%). The mean age at diagnosis was 45 ± 12 years. Surgery was the primary treatment in 6 (27%) ED patients and 8 (47%) non-ED patients. After a mean follow-up of 74 ± 48 months, remission from hyperprolactinemia was achieved in the majority (76%) of men: 71% in the non-ED cohort and 81% in the ED group (p = 0.70), regardless of the primary treatment strategy (surgical 84% versus medical 72%, p = 0.46). Long-term remission of ED was noted in 16 (73%) patients. Interestingly, high baseline BMI levels emerged as potential risk factors for persistent ED over the long term (OR 1.4, 95%CI 1.0-1.9; p = 0.04), while neither the initial adenoma size nor the primary treatment strategy (i.e., TSS vs. DAs) reached statistical significance. CONCLUSIONS: Correcting hyperprolactinemia and its associated hypogonadism significantly improves ED in the majority of men with prolactinomas over the long term, regardless of the primary treatment strategy employed. In addition to addressing endocrine deficiencies, the early initiation of weight control programs may be considered for men with lactotroph adenomas and ED. Although our study suggests an association between BMI and the risk of persistent ED, further research is needed to establish any causal relationships.
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Le contrôle bibliographique ouvert
DOI retrouvé dans Crossref DOI retrouvé ; titre concordant.
- Titre Crossref
- Characteristics and outcomes of men with erectile dysfunction as the presenting symptom due to a lactotroph adenoma
- Date Crossref
- 31/07/2024
- Éditeur
- Springer Science and Business Media LLC
- Type
- journal-article
Ce recoupement confirme des métadonnées liées au DOI. Il ne confirme ni la méthode ni les conclusions de l’étude, et il ne compte pas comme une seconde source scientifique indépendante.
Où se fait cette recherche
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University of Bern pays non établi dans la noticeUniversité ou école supérieure
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Bern University of Applied Sciences pays non établi dans la noticeUniversité ou école supérieure
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Kantonsspital Aarau pays non établi dans la noticeÉtablissement de santé
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RWTH Aachen University Deptartment of Neurosurgery pays non établi dans la noticeUniversité ou école supérieure
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Luzerner Kantonsspital pays non établi dans la noticeÉtablissement de santé
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Kantonsspital St. Gallen pays non établi dans la noticeÉtablissement de santé
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University Hospital of Bern pays non établi dans la noticeÉtablissement de santé
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University of Basel pays non établi dans la noticeUniversité ou école supérieure
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University Hospital of Basel Department of Neurosurgery pays non établi dans la noticeÉtablissement de santé
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University of Freiburg Department of Neurosurgery pays non établi dans la noticeUniversité ou école supérieure
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University Medical Center Freiburg pays non établi dans la noticeÉtablissement de santé
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Department of Neurosurgery pays non établi dans la noticeInstitution
University of Bern, Bern University of Applied Sciences et Kantonsspital Aarau, avec 9 autres affiliations.
Une affiliation ne permet pas de déduire la nationalité d’un auteur.