İzole hipogonadotropik hipogonadizmli hastalarda testislerin shear wave elastografi ile değerlendirilmesi

Abstract

Amaç: Bu çalışmanın amacı, izole hipogonadotropik hipogonadizm (IHH) hastalarında testis sertliğini shear wave elastografi (SWE) ile değerlendirmek ve sağlıklı kontrollerle karşılaştırmaktı. Gereç ve Yöntem: Bu prospektif çalışmada IHH'li 35 hasta (grup 1) ve 40 sağlıklı kontrol (grup 2) değerlendirildi. Bu iki grup yaş, testis hacmi ve SWE değerleri açısından karşılaştırıldı. Daha sonra yapılan bir analizde IHH hastaları, yeni teşhis konulan ve herhangi bir tedavi almayanlar (A grubu), testosteron replasmanı uygulananlar (B grubu) ve human koryonik gonadotropin alfa (hCG) alanlar (C grubu) şeklinde üç gruba ayrıldı. Testis hacimleri ve SWE değerleri de bu alt gruplar arasında karşılaştırıldı. Bulgular: Testis hacimleri grup 1'de grup 2'ye göre anlamlı derecede düşüktü (p<.001). Grup 1'deki olguların testiküler SWE değerleri grup 2'ye göre anlamlı olarak yüksekti (p<.001). Grup 1'deki olgularda testis sertliği ortalama değeri ile testis hacmi arasında da negatif korelasyon vardı (sağ testis için r=-0.555, p=.001, sol testis için r=-0.403, p=.016). Tedavi durumuna göre elde edilen analiz sonuçları, C grubundaki hastaların testis hacimlerinde önemli ölçüde artış olduğunu gösterdi. Ayrıca C grubundaki olgular, A ve B gruplarına göre daha düşük SWE değerlerine sahip olma eğilimindeydiler. Sonuç: SWE değerleri IHH hastalarında sağlıklı kontrollere göre anlamlı olarak yüksekti. Kısa süreli hCG replasmanı alan hastalarda bile SWE değerlerinde önemli düzelmeler bulduk. IHH hastalarının bazal SWE değerlerinin IHH'li hastalarda fertiliteyi öngörüp göremeyeceği konusunda daha fazla araştırmaya ihtiyaç vardır.

Keywords

• izole hipogonadotropik hipogonadizm
• elastografi
• testiküler sertlik
• erkek infertilitesi

The Evaluation of Testes by Shear Wave Elastography in Patients with Isolated Hypogonadotropic Hypogonadism

Abstract

Aim: The aim of this study was to evaluate testicular stiffness by shear wave elastography (SWE) in patients with isolated hypogonadotropic hypogonadism (IHH) and to compare it with healthy controls. Methods: In this prospective study, 35 patients with IHH (group 1) and 40 healthy controls (group 2) were evaluated. These two groups were compared in terms of age, testicular volume, and SWE values. In a subsequent analysis, IHH patients were divided into 3 groups: those who were newly diagnosed and did not receive any treatment (group A), those who received testosterone replacement (group B), and those who received human chorionic gonadotrophin alpha (hCG) (group C). Testicular volumes and SWE values were also compared between these subgroups. Results: Testicular volumes were significantly lower in group 1 than in group 2 (p<.001). Group 1 had significantly higher testicular SWE values than group 2 (p<.001). There was also a negative correlation between the mean value of testicular stiffness and testicular volume in group 1 (r=-0.555, p=.001 for right testes, r=-0.403, p=.016 for left testes). Results of subsequent analysis by treatment status showed that patients in group C had significantly increased testicular volumes. In addition, they tended to have lower SWE values, when compared to groups A and B. Conclusions: SWE values were significantly higher in IHH patients compared to healthy controls. We found significant improvements in SWE values even in patients receiving short-term hCG replacement. Further research is needed on whether basal SWE values of IHH patients can predict fertility in patients with IHH.

Keywords

• isolated hypogonadotropic hypogonadism
• testicular stiffness
• male infertility
• Shear Wave Elastography

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