Low Serum Testosterone is Present in Nearly Half of Men Undergoing Artificial Urinary Sphincter Placement

To report the prevalence of low serum testosterone (LST) in men undergoing AUS placement at a single high-volume institution METHODS: We retrospectively reviewed all men undergoing AUS procedures by a single surgeon from January 2015 to January 2018 to identify men with pretreatment total serum testosterone levels. LST was defined as less than 280 ng/dL. Patients with only post-treatment testosterone levels were excluded. Demographic characteristics and clinical outcomes were compared between men with and without LST.

Among 113 AUS patients with pretreatment serum testosterone levels drawn an average of 2.2 months before AUS surgery, 45.1% (51/113) met criteria for LST, including 18 patients on androgen deprivation therapy. The rate of primary LST was 34.7% (33/95). The median total serum testosterone level among men with LST was 118 ng/dL (IQR 6-211), and 413 mg/dL (IQR 333-550) in the normal serum testosterone (NST) group. There were no differences in patient age, history of radiation, erectile dysfunction, or other comorbidities between the groups. Body mass index (BMI) was higher in the LST group compared to NST (30 vs 27 kg/m2, p=0.001). Cuff size and rates of transcorporal cuff placement were similar between groups.

Nearly one-half of men with stress urinary incontinence undergoing AUS placement present with LST. While AUS cuff erosion appears to be more common in men with LST. Men with LST should undergo additional counseling and evaluation prior to AUS surgery.

Urology. 2018 Apr 27 [Epub ahead of print]

Maxim J McKibben, Jorge Fuentes, Nabeel Shakir, Joceline L Fuchs, Boyd R Viers, Travis Pagliara, Mattias Hofer, Jeremy Scott, Allen F Morey

Department of Urology, UT Southwestern Medical Center, Dallas, Texas., Department of Urology, UT Southwestern Medical Center, Dallas, Texas. Electronic address: .