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• W2108236059 abstract "No AccessJournal of UrologyAdult Urology1 Feb 2015Testosterone Recovery after Polytrauma and Scrotal Injury in Patients from Operation Enduring Freedom and Operation Iraqi Freedom Molly Williams, Inger Rosner, Yongmei Chen, Jennifer Cullen, James Jezior, and Robert Dean Molly WilliamsMolly Williams More articles by this author , Inger RosnerInger Rosner More articles by this author , Yongmei ChenYongmei Chen More articles by this author , Jennifer CullenJennifer Cullen Financial interest and/or other relationship with the Henry M. Jackson Foundation. More articles by this author , James JeziorJames Jezior More articles by this author , and Robert DeanRobert Dean Financial interest and/or other relationship with Pfizer. More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2014.08.105AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: We examined the long-term natural history of testosterone recovery in patients with complex battle injuries. Materials and Methods: We retrospectively reviewed the charts of patients who participated in Operation Enduring Freedom and Operation Iraqi Freedom, and underwent urological surgical consultation at Walter Reed Army Medical Center, Washington, D.C. or the National Naval Medical Center, Bethesda, Maryland, from 2001 to August 2011. Of the 192 patient charts reviewed 138 (72%) had testosterone values available. The study inclusion criterion of at least 2 testosterone measurements, including 1 made within 40 days of injury, was met by 84 patients (61%) with testosterone data available. Those treated with bilateral orchiectomy were not required to meet this criterion. Results: Initial patient testosterone after injury in the testosterone recovery group was inversely proportional to the degree of scrotal injury. In patients in whom testosterone recovered to at least 250 ng/dl the recovery occurred a mean of 4.5 months after injury. Patients who required testosterone replacement had lower initial testosterone (p = 0.0063) and lower testosterone velocity (p <0.0001). Conclusions: Monitoring the velocity of testosterone recovery is a viable approach in male patients who receive significant genitourinary trauma. In patients in whom testosterone recovered the recovery occurred within a mean of 5 months after injury. It is reasonable to observe patients with scrotal injuries since testosterone may recover in many of them without intervention. References 1 U.S. Casualty Status. Available at http://www.defense.gov/news/casualty.pdf. Accessed February 26, 2013. 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Google Scholar 8 : Sex hormone levels and functional outcomes: a controlled study of patients with spinal cord injury compared with healthy subjects. Am J Phys Med Rehabil2007; 86: 784. Google Scholar 9 : Sex hormones modulate distant organ injury in both a trauma/hemorrhagic shock model and a burn model. Surgery2005; 137: 56. Google Scholar 10 : Effects of exogenous testosterone on testicular function during the chronic phase of spinal cord injury: dose effects on spermatogenesis and Sertoli cell and sperm function. J Spinal Cord Med2004; 27: 55. Google Scholar 11 : Acute effects of spinal cord injury on the pituitary-testicular hormone axis and Sertoli cell functions: a time course study. J Androl1995; 16: 148. Google Scholar 12 : Relations among plasma prolactin, testosterone, and injury severity in war casualties. World J Surg1997; 21: 240. Google Scholar 13 : The effect of oxandrolone on the endocrinologic, inflammatory, and hypermetabolic responses during the acute phase postburn. Ann Surg2007; 246: 351. Google Scholar 14 : Restoration of hormonal action and muscle protein. Crit Care Med2007; 35: S630. Google Scholar 15 : The influence of sex hormones on coagulation and inflammation in the trauma patient. Shock2008; 29: 334. Google Scholar 16 : Testosterone is responsible for enhanced susceptibility of males to ischemic renal injury. J Biol Chem2004; 279: 52282. Google Scholar © 2015 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 193Issue 2February 2015Page: 618-622 Advertisement Copyright & Permissions© 2015 by American Urological Association Education and Research, Inc.Keywordstestosteronemultiple traumatestisscrotumwounds and injuriesMetricsAuthor Information Molly Williams More articles by this author Inger Rosner More articles by this author Yongmei Chen More articles by this author Jennifer Cullen Financial interest and/or other relationship with the Henry M. Jackson Foundation. More articles by this author James Jezior More articles by this author Robert Dean Financial interest and/or other relationship with Pfizer. More articles by this author Expand All Advertisement PDF downloadLoading ..." @default.
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• W2108236059 title "Testosterone Recovery after Polytrauma and Scrotal Injury in Patients from Operation Enduring Freedom and Operation Iraqi Freedom" @default.
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