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Testosterone, level of the lesion and age are independently associated with prostate volume in men with chronic spinal cord injury.

Authors
  • D'Andrea, S1, 2
  • Castellini, C1
  • Minaldi, E1
  • Totaro, M1
  • Felzani, G2
  • Francavilla, S1
  • Francavilla, F1
  • Barbonetti, A3
  • 1 Andrology Unit, Department of Life, Health and Environmental Sciences, University of L'Aquila, Piazzale Tommasi 1, 67100, L'Aquila, Italy. , (Italy)
  • 2 Spinal Unit, San Raffaele Institute of Sulmona, Sulmona, Italy. , (Italy)
  • 3 Andrology Unit, Department of Life, Health and Environmental Sciences, University of L'Aquila, Piazzale Tommasi 1, 67100, L'Aquila, Italy. [email protected] , (Italy)
Type
Published Article
Journal
Journal of Endocrinological Investigation
Publisher
Springer-Verlag
Publication Date
Nov 01, 2020
Volume
43
Issue
11
Pages
1599–1606
Identifiers
DOI: 10.1007/s40618-020-01243-3
PMID: 32248510
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

Although men with spinal cord injury (SCI) exhibit a prostate volume significantly smaller compared to age-matched able-bodied men, the independent association of lower prostate volume with its putative determinants has never been analyzed in this population. This study was designed to identify variables independently associated with prostate volume in men with chronic SCI. In this cross-sectional study, prostate volume of 138 men with chronic (> 1 years) SCI, aged 54.5 (25th-75th percentile: 36.0-66.0) years, was evaluated with trans-rectal ultrasonography. All patients underwent a complete neurological exam, as well as biochemical and hormonal assessment, including total testosterone (TT) levels. Free testosterone levels were calculated (cFT) by the Vermeulen formula. The median prostate volume was 23.4 mL. At the univariate analysis, a larger prostate volume was associated with higher TT (p = 0.00001) and cFT (p = 0.001), SCI level below T12 (p = 0.007), more advanced age (p = 0.04), lower body mass index (p = 0.04), higher functional independence score (p = 0.06), higher values of prostate-specific antigen (p = 0.12) and shorter duration of the injury (p = 0.21). However, at the multiple regression analyses, an independent and positive association only persisted between the prostate volume with either TT or cFT levels, and, to a lesser extent, with age and a level of spinal lesion below T12. A prostate volume below the median value was observed in 91.4% (32/35) of patients with both androgen deficiency (TT < 264 ng/dL) and spinal lesion level ≥ T12, but only in 16.5% (2/12) of patients with both normal androgen levels and spinal lesion level below T12 (p < 0.001). Our data indicate that lower testosterone levels and, to a lesser extent, a younger age and a spinal lesion level ≥ T12 represent the only variables exhibiting an independent association with a smaller prostate volume in men with SCI.

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