sdü tıp fak derg Medical Journal of Süleyman Demirel University 2602-2109 Süleyman Demirel Üniversitesi 10.17343/sdutfd.368786 Clinical Sciences Klinik Tıp Bilimleri Erektil disfonksiyonun değerlendirilmesinde hormonal incelemenin gerekliliği Necessity of endocrine screening in men with erectile dysfunction Sarıer Mehmet Medical Park Hastanesi, Üroloji Bölümü Soylu Ahmet Özel Gözde Hastanesi, Üroloji Bölümü Baydinç Can İnönü Üniversitesi, Tıp Fakültesi, Üroloji Anabilim Dalı 12 01 2018 25 4 356 360 12 19 2017 01 01 2018 Copyright © 1994, Süleyman Demirel Üniversitesi Tıp Fakültesi Dergisi 1994 Süleyman Demirel Üniversitesi Tıp Fakültesi Dergisi

Amaçlar: ErektilDisfonksiyon nedeniyle başvuran hastada yapılacak ilk incelemede rutin hormonaldeğerlendirmenin yapılıp yapılmaması tartışmalıdır. Bu çalışmada kliniğimizebaşvuran ve hormonal inceleme yapılan hastalara bu incelemelerin katkısı araştırıldı.Yöntem ve gereçler: Pokliniğimizebaşvuran ve hormonal değerlendirme düşünülen hastalarda FSH, LH, Prolaktin veTestosteron seviyelerinden en az ikisine bakılarak incelemeler yapıldı.Hormonal bozukluk oranları tespit edilerek bu bozukluların hasta yaşı ilekorele olup olmadığına bakıldı. Ayrıca bu değerlendirmeler sonucunda tedavidefarklı bir uygulamanın yapılıp yapılmadığı tespit edildi.Bulgular: Ortalama yaşı 46,1 olan 356hastanın 227’sine (%63.8) hormonal inceleme yapıldı. FSH yüksekliği % 9.5(20/221), LH yüksekliği %7.1 (16/224), prolaktin yüksekliği %4.7 (10/211) vetestosteron düşüklüğü %3.7 (7/191) hastada tespit edildi. FSH ve LH ile yaşarasında anlamlı pozitif korelasyon, prolaktin ile yaş arasında negatifkorelasyon görülürken testesteron ile yaş arasında korelasyon tespit edilmedi.Prolaktin yüksekliği olan 10 hastanın 1 tanesi daha önceden hipofiz adenomutanısı almış ve tedavi edilmekteydi. Diğer 9 hastada prolaktin değerleri normalsınırın 2 katını geçmediğinden endokrinoloji bilim dalı tarafından ek incelemeyegerek görülmedi. Testosteron düşüklüğü olan 7 hastadan libido azalması olan 2tanesine testosteron replasmanı yapılırken diğer 5 tanesine gerek görülmedi vetüm hastalara erektil disfonksiyona yönelik tedaviler uygulandı.Sonuçlar: Bu bulgularerektil disfonksiyon nedeniyle başvuran bir hastada yapılacak ilk incelemedehormonal incelemenin tedaviye ek katkısının çok olmayacağını göstermektedir.Hormonal incelemeler iyi bir anemnez ve fizik muayeneyi takiben sadece gerekliolgularda istenmelidir.

OBJECTIVES: It is an issueof debate whether or not to perform hormonal testing as a first-lineinvestigation in patients with erectile dysfunction. This study aimed to assessthe contribution of hormonal testing to the diagnostic investigations ofpatients who present with erectile dysfunction.METHODS:Investigations were performed in patients who applied to our andrologyclinic and in whom hormonal causes were suspected, by looking at least two ofthe FSH, LH, prolactin and testosterone levels. The rates of hormonaldisturbances and their correlation with age were determined. Additionally, whetherany modification was performed or not according to the results of these testswas noted. RESULTS: Hormonal investigation was performed in 227(63.8%) of 356 patients. Theincreased levels of FSH,LH,prolactin and decreased level of testosterone wereseen in 9.5%(20/221),7.1% (16/224),4.7%(10/211) and 3.7%(7/191) of thepatients.There was a positive correlation between FSH and LH and age,a negativecorrelation between prolactin and age,and no correlation between testosteroneand age. One of the 10 patients with prolactin increase had been diagnosed andbeen receiving treatment for hypophysis adenoma. Since the level of prolactinwas not twice the normal level no further examination was requested in theremaining 9 patients by the endocrinologists. Testosterone replacement wasgiven in two of 7 patients with decreased libido. In the remaining 5 patientsno replacement was needed.CONCLUSIONS:Our findings indicate that performing the hormonal investigation as a firstline investigation in an erectile dysfunction patient does not contribute tothe treatment additionally. Hormonal investigations should be performed afterdetailed history and physical examination and only in necessary cases.

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