Endocrine Abstracts

We identified 65 patients from the departmental endocrine database who had received testosterone (T) therapy. 62 records were reviewed and 7 patients excluded as they received T <6 months. We undertook a retrospective audit examining the routine monitoring of these patients. These 55 patients included; 21 patients with primary hypogonadism (PH) and 34 patients with secondary hypogonadism (SH); mean age (range) 52 (28–75) and 59 (35–91) yrs respectively. 46 (84%) patients achieved T levels within the normal range (8–30) nmol/l, which increased to 96% when poorly compliant patients were excluded. Baseline data was available for 41 patients prior to T therapy. Hb, PSA, Cholesterol and BP were measured prior to treatment in only 66, 54, 54 and 10% of patients respectively. The percentage of patients having annual measurement of these parameters was; testosterone 75%, Hb 58%, PSA 62%, cholesterol 47% and BP 56%. The overall numbers of patients receiving parenteral or topical testosterone therapy remained similar with time, however there was an increase in gel therapy and a reduction in patch therapy. 16 patients had poor compliance or failed to attend regular appointments – most of these had PH and patients with Klinefelter’s syndrome were particularly non-compliant. The mean (range) increment for these parameters during T therapy were; testosterone 20.1 (0.6–51.4) nmol/l, Hb 1.6 (0.2–4.9) g/dl, PSA 0.7 (−0.24–4.3) mcg/l and cholesterol 0.2 (−0.5–1.3) mmol/l. We conclude that annual monitoring for biochemical changes and BP during T therapy was performed in the majority of patients, but was considerably less than 100%. In particular, baseline data collection was poor. Outpatient monitoring should be more vigilant but poor compliance, attendance and outpatient cancellations make this challenging. The majority of patients did not show significant increments in these parameters. No patients underwent digital rectal examination and this remains controversial.