The Prostate as an Endocrine Organ
Aside from nonmelanoma skin cancer, prostate cancer is the most common cancer among men in the United States, and benign prostatic hyperplasia is the most common benign tumor found in men. Until recently, its endocrine functions and possible influence on the hypothalamic-pituitary axis have been relatively understudied. This review summarizes the current understanding of the potential endocrine functions of prostate cancer and benign prostate tissue. (Source: Urologic Clinics of North America)
Source: Urologic Clinics of North America - October 6, 2022 Category: Urology & Nephrology Authors: Kevin R. Loughlin Source Type: research
Current Management and Controversies Surrounding Andropause
Andropause is a condition surrounded by controversies, whether it be through its diagnosis or management. As we learn more about the pathophysiology of hypogonadism, our perspectives on the risks and benefits of testosterone therapy have shifted. We attempt to discuss the most modern and relevant points of controversy currently affecting the field. Throughout this review, we discuss the art of diagnosing hypogonadism as well as the association or lack thereof between testosterone replacement therapy and cardiovascular disease, prostate cancer, thrombosis, antiaging effects, exogenous steroid abuse, and diabetes mellitus. (...
Source: Urologic Clinics of North America - October 6, 2022 Category: Urology & Nephrology Authors: Abrar H. Mian, David Y. Yang, Tobias S. Kohler Source Type: research
Molecular Mechanisms of Castrate-Resistant Prostate Cancer
Despite newer therapies for castrate-resistant prostate cancer (CRPC), many patients do not experience a treatment response, and most eventually experience secondary resistance. Various androgen-receptor-related and alternative mechanisms of resistance in CRPC have been identified. This focus on understanding the molecular basis of therapeutic resistance, including lineage plasticity, neuroendocrine transformation, and a range of other implicated genomic alterations will hopefully inform decision-making in the care of this lethal cancer. (Source: Urologic Clinics of North America)
Source: Urologic Clinics of North America - October 6, 2022 Category: Urology & Nephrology Authors: Srinath Kotamarti, Andrew J. Armstrong, Thomas J. Polascik, Judd W. Moul Source Type: research
Testosterone and Male Sexual Function
This article reviews the role of testosterone in normal male sexual anatomic development and function, the consequences of low testosterone on sexual function, and clinical standards for health care providers treating hypogonadal men with sexual dysfunction. (Source: Urologic Clinics of North America)
Source: Urologic Clinics of North America - October 6, 2022 Category: Urology & Nephrology Authors: Logan B. Galansky, Jason A. Levy, Arthur L. Burnett Source Type: research
What We Have Learned from The Testosterone Trials
As men age, their serum concentration of total testosterone decreases only slightly, but because the concentration of sex hormone binding globulin increases, the concentration of free testosterone decreases to a greater degree. The testosterone trials demonstrated that testosterone treatment of elderly men who have low serum testosterone levels increases their sexual function, hemoglobin, and bone mineral density to moderate degrees, and their walking, vitality, and mood slightly. Testosterone treatment increases coronary artery noncalcified plaque volume. However, the trials were not large enough or long enough to know if...
Source: Urologic Clinics of North America - October 6, 2022 Category: Urology & Nephrology Authors: Peter J. Snyder Source Type: research
Testosterone Assays
Challenges to the accurate and precise measurement of testosterone include deficiencies in standardization, variable reference ranges, expenses related to gold standard equipment, and other challenges. Total testosterone remains the most accessible for standard laboratories, while free testosterone and bioavailable testosterone may be useful adjuncts, particularly in men with low borderline testosterone values. Mass spectrometry is the gold standard measurement modality for total testosterone, while equilibrium dialysis followed by direct assessment with a trusted method is the gold standard technique for measuring free te...
Source: Urologic Clinics of North America - October 6, 2022 Category: Urology & Nephrology Authors: Brendan King, Caleb Natale, Wayne J.G. Hellstrom Source Type: research
Benefits and Risks of Testosterone Treatment of Older Men with Hypogonadism
Total and free testosterone levels decline in men with advancing age due to defects at all levels of the hypothalamic-pituitary-testicular axis. Testosterone treatment of older men with low testosterone levels is associated with improvements in sexual activity, sexual desire, and erectile function; lean body mass, muscle strength, and stair climbing power, and self-reported mobility; areal and volumetric bone mineral density, and estimated bone strength; depressive symptoms; and anemia. Long-term risks of cardiovascular events and prostate cancer during testosterone treatment remain unknown. Testosterone treatment may be o...
Source: Urologic Clinics of North America - October 6, 2022 Category: Urology & Nephrology Authors: Francesca F. Galbiati, Anna L. Goldman, Arijeet Gattu, Ezgi Caliskan Guzelce, Shalender Bhasin Source Type: research
Testosterone Therapy and Prostate Cancer
The widely accepted absolute contraindication for administration of testosterone in hypogonadal men with prostate cancer has been questioned. Although recommendations from some professional associations still adhere to the traditional concepts, there is increasing relaxation of such positions. Currently, the evidence for definitive guidelines is unavailable and the clinician has to rely on incomplete but best attainable information. Under certain circumstances (successfully treated prostate cancer or active surveillance for low risk disease), testosterone administration is warranted. For those with intermediate or high-ris...
Source: Urologic Clinics of North America - September 30, 2022 Category: Urology & Nephrology Authors: Alvaro Morales, D. Robert Siemens Source Type: research
Testosterone: The Hormone of Love, War, and Immortality
Since mankind first appeared on earth, the human psyche has been driven by love, war, and immortality. Through the years, testosterone, both endogenous and exogenous, has been purported to have multiple effects on human behavior and function. (Source: Urologic Clinics of North America)
Source: Urologic Clinics of North America - September 21, 2022 Category: Urology & Nephrology Authors: Kevin R. Loughlin Tags: Preface Source Type: research
Reconstructive Urology
is broad, expanding, and ever changing. The field is rooted in plastic surgery principles focused on tissue transfer techniques, blood supply, wound healing, flaps, and grafts and is focused on both functional and cosmetic outcomes. In this dedicated Urologic Clinics of North America, we have experts from around the world who put together state-of-the-art articles on the vast array of conditions we treat as reconstructive urologists. Topics range from common flaps and grafts used in the urinary system, anterior and posterior urethral reconstruction, neurogenic bladder management and common operative solutions, common type...
Source: Urologic Clinics of North America - August 1, 2022 Category: Urology & Nephrology Authors: Jill C. Buckley Tags: Preface Source Type: research
Reconstructive Urology: Michelangelo Buonaroti, Andreas Vesalius, and the Marriage of Surgery and Art
“I saw an angel in the marble and carved until I set him free.”1 These words were spoken by Michelangelo Buonaroti about 500 years ago. He is part of the long-shared tradition of artists and surgeons in the study of anatomy. When he was only seventeen, Michelangelo started his dissections of cad avers from the hospital of the Monastery of Santo Spirito after the death of his mentor, Lorenzo de Medici.2 (Source: Urologic Clinics of North America)
Source: Urologic Clinics of North America - August 1, 2022 Category: Urology & Nephrology Authors: Kevin R. Loughlin Tags: Foreword Source Type: research
Urologic Reconstructive Surgery
UROLOGIC CLINICS OF NORTH AMERICA (Source: Urologic Clinics of North America)
Source: Urologic Clinics of North America - August 1, 2022 Category: Urology & Nephrology Authors: Jill C. Buckley Source Type: research
Copyright
ELSEVIER (Source: Urologic Clinics of North America)
Source: Urologic Clinics of North America - August 1, 2022 Category: Urology & Nephrology Source Type: research
Contributors
KEVIN R. LOUGHLIN, MD, MBA (Source: Urologic Clinics of North America)
Source: Urologic Clinics of North America - August 1, 2022 Category: Urology & Nephrology Source Type: research
Contents
Kevin R. Loughlin (Source: Urologic Clinics of North America)
Source: Urologic Clinics of North America - August 1, 2022 Category: Urology & Nephrology Source Type: research
