Show simple item record

dc.contributor.advisorDu Plessis, J.M.
dc.contributor.advisorJulyan, M.
dc.contributor.authorBester, Hermanus Lambertus
dc.date.accessioned2020-07-23T09:00:24Z
dc.date.available2020-07-23T09:00:24Z
dc.date.issued2019
dc.identifier.urihttps://orcid.org/0000-0001-8960-5572
dc.identifier.urihttp://hdl.handle.net/10394/35285
dc.descriptionMPharm (Advanced Clinical Pharmacy), North-West University, Potchefstroom Campusen_US
dc.description.abstractLate-onset hypogonadism (LOH) is a clinical and biochemical syndrome which affect one of the biochemical processes in the human body, and then present with a set of associated symptoms, e.g. age-related testosterone deficiency. This age-related testosterone deficiency, as seen in LOH is then associated with a cluster of symptoms which mostly include loss of libido, erectile dysfunction, fatigue, depression and loss of body hair. Testosterone is the only evidence-based treatment for LOH. Benefits of treatment include: favourable effects on cognitive function, sexual parameters, body composition and quality of life with demonstrated decreased mortality rates. Testosterone replacement therapy (TRT) is known to induce changes in certain blood parameters that stimulate haematopoiesis, which might well result in polycythaemia, also known as erythrocytosis (an excessive increase in the number of red blood cells). The blood parameter changes observed pre- and post-treatment are expressed as haematocrit (Hct) percentages. Supra-physiological Hct values can be expected in the LOH patient during the first few weeks to months following treatment initiation and should reach a plateau within the first 12 months of therapy. Therefore, emphasis should be placed on frequent patient monitoring during these times that assesses signs and symptoms associated with polycythaemia to prevent testosterone-induced complications. Even though thrombosis, strokes and cardiovascular events are known complications of polycythaemia, factors such as diet, disease state and socioeconomic factors may also influence the haematopoietic process. Sufficient high-powered large cohort studies are still needed to fully explain the implication of Hct changes in the LOH patient. The primary aim of this study was to investigate the effect of TRT on total-testosterone (TT) levels and Hct, with the focus on polycythaemia that occurred in LOH treatment-naïve patients. The study took place in a private urology practice in Emalahleni, formerly known asWitbank. This was a retrospective, observational, descriptive study. Data collected were TT levels (n = 49) and Hct (n = 50) values at the point of diagnosis (day zero) and at three months’ post-treatment initiation. The risk for polycythaemia was determined by the probability of polycythaemia in the study population. The change between the two-time points was determined by the dependent t-test. Cohen’s d-value was then used to evaluate the practical significance of the results (with d ≥ 0.8 defined as a large effect with practical significance). The prevalence of polycythaemia was 34% (n = 50). The mean change in Hct over the study period was 3.49% (standard deviation [SD (4.46%)]). The mean increase in TT levels over the study period was 4.21 nmol/L (SD 6.47). The rise in Hct was statistically significant, p-value < 0.001. The practical effect size was 0.73, suggestive of a practically significant impact. The increase of TT was statistically significant (p-value < 0.001). The practically significant effect was 0.68, suggestive of a larger effect size. A negative correlation between Hct and TT was noted after the study period. The prevalence of polycythaemia is higher for the South African population than for their international counter parts, and the practical implication of the statistical findings is not yet fully explained. Monitoring for changes in Hct values, especially during the treatment initiation phase, and then annually, is therefore suggested.en_US
dc.language.isoenen_US
dc.publisherNorth-West University (South-Africa)en_US
dc.subjectLate-onset hypogonadism (LOH)en_US
dc.subjectHaematocrit (Hct)en_US
dc.subjectTestosterone replacement therapy (TRT)en_US
dc.subjectDepot-testosterone undecanoateen_US
dc.titleTestosterone undecanoate associated polycythaemia in males with late-onset hypogonadism : private practice Emalahlenien_US
dc.typeThesisen_US
dc.description.thesistypeMastersen_US
dc.contributor.researchID20984634 - Du Plessis, Jesslee Melinda (Supervisor)
dc.contributor.researchID12861081 - Julyan, Marlene (Supervisor)


Files in this item

Thumbnail

This item appears in the following Collection(s)

Show simple item record