Modulation of Erectile Function With Long-Acting Testosterone Injection i.m. in Hypogonadal Patients.

Modulation of Erectile Function With Long-Acting Testosterone Injection i.m. in Hypogonadal Patients, Aksam A. Yassin, Clinic of Urology/Andrology, Segeberger Kliniken, Germany, and Gulf Medical College School of Medicine, UAE; Farid Saad, Schering AG, Germany, and Gulf Medical College School of Medicine, UAE

We assessed and evaluated the impact and efficacy of long-acting testosterone injection alone to restore the erectile function in hypogonadal men. A total of 17 hypogonadal men (mean age: 58) with erectile dysfunction (ED) were prospectively evaluated for a mean of 14 weeks under long-acting testosterone (Nebido[TM]) i.m. Blood tests included total testosterone, DHT, lipid profile, blood sugar, and HBAlc, as well as prostate-specific antigen. Time average for ED was 3.8 years. Physical and sonographic examinations for prostate were performed. Sexual function assessment was performed using the International Index of Erectile Function (IIEF) in the baseline and after 12 weeks. Patients received i.m. long-acting testosterone at day 1, after six weeks, and thereafter planned to receive the same therapy at an average of 12 weeks. Eleven patients reported of significant improvement in the sexual desire domain (main value 4.5 to 8.4). Erectile function domain rose from 12 to 25 following treatment for 9-12 weeks. No patient was excluded from study in this period of time. No patient reported irritation or pains in the gluteal injection areas or any other adverse events. The remaining 6 patients who suffered from ED longer than 7 years reported improvement of sexual desire but no significant improvement in the erectile function domain, although they showed normalized values of total testosterone. These men are still under follow-up. No change in PSA or prostate gland occurred so far. These encouraging results suggest that a testosterone therapy alone could have restored the erectile function in the majority of the hypogonadal patients of this group. Further evaluation of the group or additional subjects will enlighten the influence of testosterone alone in the follow-up reports. In case of ED patients in a rush, combination therapy with PDE-5 inhibitors is recommended.