Abstrakt

Niejednoznaczne dane dotyczące zarówno terminologii, diagnostyki, jak i leczenia niedoboru testosteronu u mężczyzn, skłoniły autorów do podjęcia próby krytycznej analizy dotychczasowej wiedzy. Aktualne wytyczne zarówno Amerykańskiego jak i Europejskiego Towarzystwa Urologicznego (EAU i AUA) określają terapię testosteronem jako skuteczną i bezpieczną. Jednak wiele doniesień wskazuje na negatywne skutki tej terapii budząc niechęć do jej stosowania przez lekarzy i potencjalnych pacjentów, głównie w obawie przed rozwojem u tych chorych raka gruczołu krokowego i incydentów sercowo-naczyniowych. Najwięcej wątpliwości zaobserwowano po opublikowaniu w 2013 i 2014 r. dwóch badań retrospektywnych, skutkiem czego było przerwanie terapii u wielu pacjentów, u których obserwowano korzystne działanie terapii testosteronem. Ponadto, u wielu mężczyzn ze wskazaniami do leczenia testosteronem, terapii tej nie zastosowano, w obawie o ich bezpieczeństwo. Najnowsze dane obaw tych jednak nie potwierdzają. W ponad 100 opublikowanych niedawno pracach naukowo- badawczych wykazano korzystny wpływ terapii testosteronem. Amerykańskie Towarzystwo Endokrynologów Klinicznych (AACE) i Amerykańskie Kolegium Endokrynologii (ACE) opracowały wspólnie własną ocenę piśmiennictwa stwierdzając, że nie ma przekonujących dowodów na to, że terapia testosteronem zwiększa ryzyko incydentów sercowo-naczyniowych. Tożsame wnioski płyną z aktualnych wytycznych EAU i AUA.

Przypisy

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