Age-Related Androgen Deficiency in the Urology Department of the Gabriel Touré University Hospital Centre

Objective: To study age-related androgen deficiency (ARAD) in the urology department of Gabriel Touré University Hospital.

Patients and Methods: This was a prospective descriptive study of cases of (ARAD) in the urology department of Gabriel TOURE Hospital in Bamako, Mali. The study was conducted over a period of one year, from 1 January 2020 to 31 December 2020.

Results: During the study period, we received 1,951 patients for consultation at the urology department of the Gabriel Touré University Hospital, including 31 cases of ARAD, representing a frequency of 1.58%. The average age was 65 years. Married men were the most common, representing 77.4% of cases. Nearly half of the patients were businesspeople, representing 45.2% of cases. ARAD appeared gradually in 64.5% of patients. Nearly half of the patients had consulted for sexual asthenia (41.9%), followed by 35.5% for decreased libido. Most patients had sexual intercourse twice a week (45.2%) before the onset of the disorder. Nearly half of the patients had suffered from the disorder for several years (51.6% of cases). Most patients reported unchanged libido in 58.1% of cases. The majority of our patients were hypertensive in 38.7% of cases. Fasting blood glucose was normal in almost all non-diabetic patients, i.e. 48.39% of cases. Testosterone levels were decreased in 100% of cases. Prolactin levels were normal in more than 51.6% of patients. Serum FSH levels were normal in almost all patients, 74.2%. TSH levels were normal in the majority of patients, 71%. Nearly half of the patients had resorted to self-medication several months before their first consultation at the urology department, 58.1%. All our patients had undergone medical treatment. Most of our patients, 71%, showed progressive improvement in their health. In our series, androgen deficiency was observed in 67.7% of cases. According to the IIEF5 score, the following were normal in 38.7% of cases, mild in 22.6% of cases, slightly moderate in 12.9% of cases, and severe in 9.7% of cases. According to the AMS score, the following were normal in 32.3% of cases, mild in 32.3% of cases, moderate in 22.6% of cases, and severe in 12.9% of cases.

Conclusion: ARAD seriously impairs clinical and biochemical signs and overall quality of life in older adults. Knowledge is incomplete and sometimes unclear, and some aspects of androgen replacement therapy remain controversial.

Keywords: Testosterone, Deficiency, Aging.