Hypogonadotropic Hypogonadism in Non-Functioning Pituitary Adenomas: Impact of Intervention

Abstract To determine the prevalence of hypogonadotropic hypogonadism (HH) among patients with non-functioning pituitary adenomas (NFPA) and the post-surgery outcome on pituitary gonadotropins secretion (PGS); to determine the prevalence of erectile dysfunction (ED) on male patients with NFPA, to evaluate the impact of testosterone replacement therapy (TRT) in those with HH. Retrospective evaluation of gonadal function in 109 NFPA patients (45 males), with a mean age of 51.8 years, diagnosed on the last 10 years. ED questionnaire applied to 34 male patients. Male patients with NFPA were significantly older (males 58.1±15.8 vs. females 47.4±16.94; p=0.001). Most patients had macroadenomas (67%; p=0.001) and only a minority were incidentalomas (19%; p<0.001). Prevalence of HH was 40% (60% on males, 25% on females; p<0.001). Surgery was performed in 54% of all patients (71% of males, 42% of females; p<0.003). After intervention, 14% became HH, 69% maintained previous function and 17% improved. On the questionnaire, 76% reported having ED, 54% of which had HH and 21% were under TRT. Of the patients under TRT, 79% still had ED. Median age of patients with ED was significantly higher [with ED 65 vs. without 49 years; p=0.012). There was no BMI difference between patients with or without TRT (28.0 vs. 27.4 Kg/m2). NFPA was more frequent in older rather than younger patients. Males were older, had more HH and surgery. There was no significant improvement of pituitary function with surgery (17%) and 13% became iatrogenic HH. TRT had a low efficacy to improve ED in these patients.

Download Full-text

MON-273 Retrospective Analysis of Gonadotropin-Mediated Pubertal Induction in Male Patients with Congenital Hypogonadotropic Hypogonadism (CHH)

Journal of the Endocrine Society ◽

10.1210/jendso/bvaa046.1809 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

Author(s):

Biagio Cangiano ◽

Giovanni Goggi ◽

Fabiana Guizzardi ◽

Valeria Vezzoli ◽

Paolo Duminuco ◽

...

Keyword(s):

Retrospective Analysis ◽

Multiple Regression ◽

Semen Analysis ◽

Final Height ◽

Pubertal Development ◽

Hypogonadotropic Hypogonadism ◽

Bone Age ◽

Testicular Development ◽

Testosterone Replacement Therapy ◽

Male Patients

Abstract CHH is a rare disease characterized by a failure to enter (complete forms) or to complete (partial forms) pubertal development. It has a strong genetic background and it needs a treatment to allow the puberty to complete. In male this goal could be achieved either by the classic testosterone replacement therapy or by the exogenous gonadotropins (Gn) administration which allows both the endogenous testosterone production and the testicular development. So far, only few studies have explored this latter therapeutic approach in inducing the CHH pubertal development and no internationally recognized protocols are available. Aim of this retrospective analysis is to (i) investigate clinical and biochemical predictors of testicular response to Gn-induced puberty in CHH; (ii) study the non-reproductive outcomes of this treatment (height, body proportions) and their determinants. A total of 19 CHH male patients, undergoing two years of Gn-mediated (FSH and hCG) puberty induction started between the ages of 14 and 23 years, were retrospectively evaluated. For each patient clinical history, physical examination, hormonal evaluation, and genetic analysis using Targeted Next Generation Sequencing for CHH genes was performed; 8 patients accepted to perform a semen analysis (SA) at the end of their treatment.Mann Whitney test and multiple regression analysis showed testicular volume after 24 months of Gn-mediated pubertal induction, to be significantly associated with: (i) the presence of cryptorchidism; (ii) the presence of a completely definable genetic cause for the disease; (iii) the presence of a complete CHH form. No significant association was found with the cumulative dose of hCG administered in 24 months. The statistical analyses regarding SA could not find the same associations. Multiple regression analyses investigating the eunuchoid habitus and a measure of the difference of subject’s final height from his target (deltaSDSth), showed a significant association with: (i) age at the beginning of the induction; (ii) the duration of growth during induction; (iii) and (for deltaSDSth) bone age before the induction. Duration of growth during induction resulted to be associated with previous testosterone priming and with partial CHH.In summary, our study confirms cryptorchidism and complete genetic forms of CHH as negative predictors of testicular response probably because they usually affect early phases of life with a complete GnRH deficiency. We also found that the eunuchoid habitus and deltaSDSth are associated not only with delayed treatment, but also with the duration of stature growth during the induction, apparently related to earlier androgenization.

Download Full-text

An evolution of clinical practice: the impact of changes in clinical management of non-functioning pituitary adenomas on long-term pituitary function and risk of recurrence

Endocrine Abstracts ◽

10.1530/endoabs.34.p287 ◽

2014 ◽

Author(s):

Michael O'Reilly ◽

Harriet Pearce ◽

Gabriella Bugg ◽

Rosalind Mitchell ◽

Andy Toogood ◽

...

Keyword(s):

Clinical Practice ◽

Clinical Management ◽

Pituitary Adenomas ◽

Pituitary Function ◽

Risk Of Recurrence ◽

The Impact ◽

Non Functioning Pituitary Adenomas

Download Full-text

Post-surgery Outcome Measurement of 30 Patients with Crooked Nasal Deformity using Rhinoplasty Outcome Evaluation Scale

Clinical Rhinology An International Journal ◽

10.5005/jp-journals-10013-1219 ◽

2015 ◽

Vol 8 (1) ◽

pp. 5-7 ◽

Cited By ~ 1

Author(s):

Rakesh Kumar ◽

Vishav Yadav ◽

Venkata Karthikeyan Chokkalingam ◽

Ramesh Chander Deka

Keyword(s):

Outcome Measurement ◽

Deformity Correction ◽

Outcome Evaluation ◽

Preoperative Period ◽

Nasal Deformity ◽

Patient’S Satisfaction ◽

Surgery Outcome ◽

Post Surgery ◽

A Prospective Study ◽

The Impact

ABSTRACT Objective The aim of the study was to assess the outcome of nasal deformity correction using rhinopasty outcome evaluation (ROE) scale. Materials and methods We conducted a prospective study of 30 patients with crooked nasal deformityin period 2008 to 2011 and assessed outcome with the help of ROE scale. Results Preoperative mean ROE score was 34.15 ± 15.58. All 30 patients ROE score was less than 85 in preoperative period. Postoperative mean score was 86.50 ± 7.07 with a mean gain of 52.35. 21/30 patients (70%) had postoperative score of more than 85 (excellent). Conclusion Rhinoplasty outcome evaluation scale is a useful subjective tool to assess the impact of deformity and outcome after surgery (patient's satisfaction). How to cite this article Yadav V, Kumar R, Chokkalingam VK, Deka RC, Hota A. Post-surgery Outcome Measurement of 30 Patients with Crooked Nasal Deformity using Rhinoplasty Outcome Evaluation Scale. Clin Rhinol An Int J 2015;8(1):5-7.

Download Full-text