The first look at EAU23-an overview of popular drugs in andrology

Effects of long-term testosterone therapy on quality of life and lower urinary tract symptoms in men with functional hypogonadism

Summary number: A0221

Speaker: Dr. A. (Ahmad) Haider

Reporting time: 15:30-17:00 on 11 March

There has been controversy about whether testosterone therapy (TTh) should be used for male functional hypogonadism rather than primary and secondary hypogonadism caused by organ injury. The purpose of this study was to evaluate the effect of TTh on quality of life (QoL) and lower urinary tract symptoms (LUTS) in patients with functional hypogonadism.

Of the 898 male patients with hypogonadism, 481 patients in the trial group received TTh (1000 mg, intramuscular injection, once in the first 6 weeks, and then once in the 12 weeks), and 417 patients who did not receive TTh served as the control group. The differences of baseline and 14-year data between the two groups were investigated and compared. the main outcome indicators were LUTS-related international prostate symptom (IPSS) score and urodynamic parameters, and QoL assessed by the middle-aged and elderly male symptom scale (AMS).

The baseline age of patients in the test group was 56.5 ±8.0 years old, while that in the control group was 62.7 ±5.3 years old. The average follow-up time was 11.0 ±3.2 years in the test group and 11.1 ±3.3 years in the control group. The median follow-up time of both groups was 12 years. The baseline medication conditions of the test group and the control group were as follows: Alpha-receptor blocker (36.6% vs 50.2% Magneto pamphltsman 0.0001); 5 α-reductase inhibitor (2.1% vs 8.6% Personltinct 0.0001); PDE5 inhibitor (26.4% vs 22.1% cognac 0.1308). The baseline IPSS score of the experimental group decreased from 6.4 ±3.7 to 1.5 ±0.7 after 14 years. The baseline IPSS score of the control group was 4.9 ±1.9 and increased to 11.4 ±5.1 after 14 years, and the difference between the two groups was-11.0 after adjustment. Fourteen years later, the bladder residual urine volume (RBV) of the test group decreased by 39.3 ±1.4 ml, while the RBV of the control group increased by 58.8 ±1.5 ml. After adjustment, the difference between the two groups was-94.4 (95%CI-98.2). After 14 years, the AMS scores of the experimental group were improved from 53.09.8 (severe symptoms) to 17.2 ±0.4 (asymptomatic), while the AMS scores of patients in the control group increased from 40.4 ±5.6 (moderate symptoms) to 66.7 ±5.2 (severe symptoms). After adjustment, the difference between the two groups was-52.3 (95%CI-53.4).

The voiding function and quality of life of patients with functional hypogonadism who received long-term TTh were significantly improved, while the voiding function and quality of life of patients in the control group who did not receive TTh gradually deteriorated over time.

Preliminary results of a first in human clinical trial of ADAM^®, a nonhormonal hydrogel-based male contraceptive

Summary number: A0681

Speaker: Mr. P. (Paul) Anderson

Report time: 15:45-17:15 on 12 March

Since the introduction of modern contraception in 1960, women have more choices of contraception than men. Here we report the preliminary results of the first human clinical trial of ADAM, a non-hormonal, non-permanent, hydrogel-based contraceptive.

ADAM is a highly biocompatible, non-permanent hydrogel for intraductal injection. Its preliminary safety and efficacy were evaluated in this open-label, single-arm, prospective, multicenter, dose-range clinical trial. The subjects were 30 men with normal semen parameters, aged from 25 to 65 years old. After institutional review and approval by the Ethics Committee, 4 men have been implanted with ADAM under general anesthesia (initial dose 120 ul, speed 800 ul/min). The researchers used non-scalpel vasectomy (NSV) to identify and display the vas deferens, and then injected ADAM using a 24g catheter needle and an automatic injection device. Another 26 subjects will receive different doses of hydrogel injection. Subjects will undergo semen parameters testing and adverse event assessment for up to 36 months until the average sperm concentration is less than 15 million / ml twice.

The average age of the four subjects who received ADAM injection was 36.3 ±11.1 years old. The baseline semen parameters were: semen volume 2.15 ±0.81 ml,pH 8.14 ±0.13, sperm concentration 78.45 ±28.12 (10).^six/ ml), sperm motility 56.8 ±7.5%, percentage of normal morphological sperm 13.5 ±3.7%, total number of motile sperm 70.0 ±15.7 (10)^six). No serious adverse events occurred within 3 weeks after implantation, and the characteristics of postoperative recovery were similar to those of male vasectomy. no adverse events occurred in all subjects 3 weeks after implantation. About 2 weeks after operation, the semen volume of the four subjects was 1.9 ±1.0 ml,pH 8.3 ±0.2, and the sperm concentration was 1.1 ±1.2 (10).^six/ ml), sperm motility 0. 0 ±0. 0%, total motility sperm 0. 5 ±0. 6 (10)^sixThe sperm concentration decreased by 98.9% compared with the baseline, and 2 subjects showed similar azoospermia. On the 21st day after operation, the sperm concentration of the subjects decreased by 99.5% compared with the baseline, and the subjects with 3 stroke 4 showed similar azoospermia.

The preliminary results show that injecting ADAM into male vas deferens is a safe and effective method of contraception. After that, there will be more research data to further verify the long-term safety, effectiveness and feasibility of ADAM as a male contraceptive.