Testosterone, level of the lesion and age are independently associated with prostate volume in men with chronic spinal c
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ORIGINAL ARTICLE
Testosterone, level of the lesion and age are independently associated with prostate volume in men with chronic spinal cord injury S. D’Andrea1,2 · C. Castellini1 · E. Minaldi1 · M. Totaro1 · G. Felzani2 · S. Francavilla1 · F. Francavilla1 · A. Barbonetti1 Received: 16 December 2019 / Accepted: 29 March 2020 © Italian Society of Endocrinology (SIE) 2020
Abstract Purpose Although men with spinal cord injury (SCI) exhibit a prostate volume significantly smaller compared to agematched able-bodied men, the independent association of lower prostate volume with its putative determinants has never been analyzed in this population. This study was designed to identify variables independently associated with prostate volume in men with chronic SCI. Methods In this cross-sectional study, prostate volume of 138 men with chronic (> 1 years) SCI, aged 54.5 (25th–75th percentile: 36.0–66.0) years, was evaluated with trans-rectal ultrasonography. All patients underwent a complete neurological exam, as well as biochemical and hormonal assessment, including total testosterone (TT) levels. Free testosterone levels were calculated (cFT) by the Vermeulen formula. Results The median prostate volume was 23.4 mL. At the univariate analysis, a larger prostate volume was associated with higher TT (p = 0.00001) and cFT (p = 0.001), SCI level below T12 (p = 0.007), more advanced age (p = 0.04), lower body mass index (p = 0.04), higher functional independence score (p = 0.06), higher values of prostate-specific antigen (p = 0.12) and shorter duration of the injury (p = 0.21). However, at the multiple regression analyses, an independent and positive association only persisted between the prostate volume with either TT or cFT levels, and, to a lesser extent, with age and a level of spinal lesion below T12. A prostate volume below the median value was observed in 91.4% (32/35) of patients with both androgen deficiency (TT
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