Erektil disfonksiyonun değerlendirilmesinde hormonal incelemenin gerekliliği

Yıl 2018, Cilt: 25 Sayı: 4, 356 - 360, 01.12.2018

Mehmet Sarıer , Ahmet Soylu , Can Baydinç

https://doi.org/10.17343/sdutfd.368786

Cited By: 1

Öz

Amaçlar:  Erektil
Disfonksiyon nedeniyle başvuran hastada yapılacak ilk incelemede rutin hormonal
değerlendirmenin yapılıp yapılmaması tartışmalıdır. Bu çalışmada kliniğimize
başvuran ve hormonal inceleme yapılan hastalara bu incelemelerin katkısı araştırıldı.

Yöntem ve gereçler: Pokliniğimize
başvuran ve hormonal değerlendirme düşünülen hastalarda FSH, LH, Prolaktin ve
Testosteron seviyelerinden en az ikisine bakılarak incelemeler yapıldı.
Hormonal bozukluk oranları tespit edilerek bu bozukluların hasta yaşı ile
korele olup olmadığına bakıldı. Ayrıca bu değerlendirmeler sonucunda tedavide
farklı bir uygulamanın yapılıp yapılmadığı tespit edildi.

 Bulgular: Ortalama yaşı 46,1 olan 356
hastanın 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) ve
testosteron düşüklüğü %3.7 (7/191) hastada tespit edildi. FSH ve LH ile yaş
arasında anlamlı pozitif korelasyon, prolaktin ile yaş arasında negatif
korelasyon görülürken testesteron ile yaş arasında korelasyon tespit edilmedi.
Prolaktin yüksekliği olan 10 hastanın 1 tanesi daha önceden hipofiz adenomu
tanısı almış ve tedavi edilmekteydi. Diğer 9 hastada prolaktin değerleri normal
sınırın 2 katını geçmediğinden endokrinoloji bilim dalı tarafından ek incelemeye
gerek görülmedi. Testosteron düşüklüğü olan 7 hastadan libido azalması olan 2
tanesine testosteron replasmanı yapılırken diğer 5 tanesine gerek görülmedi ve
tüm hastalara erektil disfonksiyona yönelik tedaviler uygulandı. 

Sonuçlar: Bu bulgular
erektil disfonksiyon nedeniyle başvuran bir hastada yapılacak ilk incelemede
hormonal incelemenin tedaviye ek katkısının çok olmayacağını göstermektedir.
Hormonal incelemeler iyi bir anemnez ve fizik muayeneyi takiben sadece gerekli
olgularda istenmelidir. 

Anahtar Kelimeler

Erektil disfonksiyon, hormon, testosteron

Necessity of endocrine screening in men with erectile dysfunction

Öz

OBJECTIVES: It is an issue
of debate whether or not to perform hormonal testing as a first-line
investigation in patients with erectile dysfunction. This study aimed to assess
the contribution of hormonal testing to the diagnostic investigations of
patients who present with erectile dysfunction.

 METHODS:
Investigations were performed in patients who applied to our andrology
clinic and in whom hormonal causes were suspected, by looking at least two of
the FSH, LH, prolactin and testosterone levels. The rates of hormonal
disturbances and their correlation with age were determined. Additionally, whether
any modification was performed or not according to the results of these tests
was noted.

RESULTS: Hormonal investigation was performed in 227(63.8%) of 356 patients. The
increased levels of FSH,LH,prolactin and decreased level of testosterone were
seen in 9.5%(20/221),7.1% (16/224),4.7%(10/211) and 3.7%(7/191) of the
patients.There was a positive correlation between FSH and LH and age,a negative
correlation between prolactin and age,and no correlation between testosterone
and age. One of the 10 patients with prolactin increase had been diagnosed and
been receiving treatment for hypophysis adenoma. Since the level of prolactin
was not twice the normal level no further examination was requested in the
remaining 9 patients by the endocrinologists. Testosterone replacement was
given in two of 7 patients with decreased libido. In the remaining 5 patients
no replacement was needed.

 CONCLUSIONS:
Our findings indicate that performing the hormonal investigation as a first
line investigation in an erectile dysfunction patient does not contribute to
the treatment additionally. Hormonal investigations should be performed after
detailed history and physical examination and only in necessary cases.

Anahtar Kelimeler

Erectile dysfunction, hormone, testosterone

Kaynakça

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