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What problems does a low testosterone in adult males cause and how can it be treated?

Low testosterone is relatively common in men especially as they become older. The condition is also known as Hypogonadism, the Male Menopause or Andropause. Low testosterone can cause a number of problems. The most obvious is of a sexual nature with low sex drive and erectile dysfunction. It also causes more non-specific problems such as fatigue, poor sleep patterns, memory loss, depression and anxiety. The ADAM questionnaire can be useful to document to document these symptoms. Testosterone has a beneficial effect on the way the body handles some fats and sugar with low testosterone recognised as one cause of early diabetes and high cholesterol.

The condition can be detected by measuring the blood level of testosterone. This is best measured in the morning as testosterone levels vary and are at their highest in the morning. If levels are low or borderline low, especially if there are symptoms such as erectile dysfunction or low sex drive, then testosterone replacement therapy can be beneficial.

Testosterone replacement therapy can be prescribed as a gel, which is rubbed onto the skin once daily, a patch, which is stuck to the skin, or a surgically implanted pellet that slowly releases testosterone over several months. Blood levels of testosterone should be monitored to ensure that the correct dose is being used. The commonest side effect of the gel and patch is skin irritation at the site of administration. High levels of testosterone can cause aggressiveness, and may make prostate cancer worse.

Men’s Health evening

A very enjoyable and informative evening was spent on 3rd April 2012 at the Leek Golf Club discussing Men’s Health issues. About 35 members of the club joined 3 Consultants from the Staffordshire Urology Clinic and a senior Nursing Sister from the University Hospital of North Staffordshire to discuss a number of topics. The meeting was introduced and chaired by Mr Liu.

Mr Luscombe first talked about the prostate including it’s position, function and problems that it might cause, such as a poor urinary flow, prostatitis and prostate cancer. He went on to talk about appropriate tests, including the use of PSA testing, and treatments ranging from monitoring, drug therapy and surgery for each of the problems. This generated a large number of questions from a very interested and enthusiastic audience, especially concerning prostate cancer and surgery such laparoscopic radical prostatectomy and laser prostate surgery.

Mr Gommersall then talked about a number of conditions including blood in the urine, erection problems, low testosterone and testicular swellings. Questions from the audience came thick and fast, with particular interest in the effects and treatment of low testosterone.

Informal discussions before and after the formal presentation were of great interest and the Staffordshire Urology Clinic would like to thank the Chairman and members of the golf club for their invitation, interest and warm hospitality.

Education event planned for 3rd April at Leek Golf Club

The Staffordshire Urology Clinic have been invited to attend a Men’s Health education event at Leek Golf club at 7.30pm on 3rd April 2012. Issues for discussion include, prostate problems including cancer, erection problems, testicular swellings including cancer, kidney problems, blood in the urine and bladder problems including bladder cancer.

Mr Golash helps introduce Keyhole kidney surgery to Dumfries, Scotland

Mr Golash is widely recognised as an expert at (laparoscopic) keyhole kidney surgery. He has helped a number of local surgeons to introduce this type of surgery to their hospitals. His latest project is to help a surgeon in Dumfries, Scotland, where patients have to either have traditional major cutting open surgery, or travel hundreds of miles and wait months for keyhole surgery. A surgeon from Dumfries has made a number of visits to Stoke, to observe the surgery, and Mr Golash has so far made 1 trip to Scotland, to ensure that the surgery is introduced safely.

Positive margin rates after radical prostatectomy are under half the national average

Positive margin rates (PSM) after radical prostatectomy performed by Christopher Luscombe of the Staffordshire Urology Clinic have been consistently about 15% over the last 5 years. This compares with a national average of 38% reported in an article in the medical journal British Journal of Urology International last month. The article describes research carried out on the British Association of Urological Surgeons complex procedures database; a database that all Urology Consultants in the UK are encouraged to report details of operations that they perform to. PSM are associated with a much higher rate of cancer recurrence after radical prostatectomy, although many men are still cured even with a PSM, and the lower the rate the better. Our PSM results of only 15% are taken from this database and our further analysis of this database for operations performed in the last 5 years shows that a PSM rate of only 15% is the lowest in the Midlands, although reporting by many surgeons is not comprehensive.

National results from this database for 2012 have just been published (click here).

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