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Testosterone Replacement Therapy

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Andrology and Sexual Medicine

Part of the book series: Management of Urology ((MU))

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Abstract

The aim of testosterone replacement therapy (TRT) is to provide the development of and maintain the secondary sex characteristics and to improve the symptoms and signs due to testosterone deficiency in patients with androgen deficiency. Testosterone replacement should be applied in patients with hypogonadism who have symptoms and signs of androgen deficiency associated with low testosterone levels. TRT has positive effects on secondary sex characteristics, sexual functions, muscle strength, physical functions, mood and bone density. Several testosterone preparations such as oral preparations, parenteral testosterone esters, transdermal testosterone patch, testosterone gels and transdermal testosterone tablets are available for the treatment of male hypogonadism. The adequacy of testosterone therapy is assessed according to the clinical response and serum testosterone levels. The biochemical goal in treatment is to keep testosterone levels at mid-normal range. After starting TRT, serum testosterone, hematocrit and PSA levels should be measured periodically, and digital rectal examination should be performed in the follow-up. TRT is contraindicated in patients with metastatic prostate and breast cancers. Before starting TRT, men with a history of prostate cancer or are at high risk for developing prostate cancer should be identified. Testosterone therapy is also not recommended in patients with increased hematocrit values, patients with obstructive sleep apnea, uncontrolled heart failure and lower urinary tract symptoms.

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Authors and Affiliations

  1. Department of Endocrinology and Metabolism, University of Health Sciences Gulhane Faculty of Medicine, Ankara, Turkey

    Cem Haymana & Alper Sonmez

Authors
  1. Cem Haymana
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  2. Alper Sonmez
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Correspondence to Alper Sonmez .

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Editors and Affiliations

  1. Department of Urology, Gulhane Research and Training Hospital University of Health Sciences, Ankara, Turkey

    Selcuk Sarikaya

  2. Department of Urology, University of Catania, Catania, Italy

    Giorgio Ivan Russo

  3. Department of Urology, University College London Hospitals, London, UK

    David Ralph

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Haymana, C., Sonmez, A. (2022). Testosterone Replacement Therapy. In: Sarikaya, S., Russo, G.I., Ralph, D. (eds) Andrology and Sexual Medicine . Management of Urology. Springer, Cham. https://doi.org/10.1007/978-3-031-12049-7_20

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  • DOI: https://doi.org/10.1007/978-3-031-12049-7_20

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