Introduction: Clinical experience shows that many men experience low TT levels after RO for TC. The literature cites a prevalence of up to 20%. The aim of this study is to define prevalence and predictors of low TT in this population.
Methods: Patients who had (i) unilateral RO for TC (ii) had two, early morning TT levels post-RO (iii) which was measured using LCMS constituted the study population. Chemo/radiation therapy pre or post-RO T therapy were exclusions. Demographics, comorbidity and endocrine profile pre and post-RO were recorded. We describe the prevalence of low TT ( <300 ng/dl) pre and post RO as well as changes in TT level after RO, including the proportion of men who dropped < 300 ng/dL and = 100 ng/dL. We performed multivariable analysis to evaluate predictors of low TT as well of a significant drop (= 100 ng/dL) after RO.
Results: 152 men were analyzed. Mean age was 44 ± 16 years. Mean TT level pre-RO was 403 ± 253. 34% of these men had T levels =300 ng/dL. 5% had diabetes, 13% had OSA. Median time between RO and postoperative TT measurement was 2 (1-6) months. Mean TT level post-RO were 403 ± 253 and 54 ± 49 ng/dL. Representing a median -67 ng/dL drop in TT levels. Post-RO, 51% had low TT levels, 40% with normal TT levels pre-RO had low TT post-RO, and 41% dropped = 100 ng/dL in TT. After multivariable assessment, only age at RO was predictive of low post-RO TT or dropping TT = 100 ng/dL after RO (pre-RO age, per 10 years increase, OR 1.44, 95%CI 1.12-1.85, p value 0.005).
Conclusions: In our cohort of men with TC and RO, approximately half of the men with TC had low TT levels and 40% dropped = 100 ng/dL in TT levels post-surgery. Older age at the time of the RO increased the likelihood of low TT or a decrease of = 100 ng/dL in TT levels post-RO.
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