Beste apotheek van Nederland

Chapter 3. Results
Question 1. What is the Clinical Utility of Routine Blood Tests
(Testosterone/Prolactin/Luteinizing Hormone/Follicle-
Stimulating Hormone) in Identifying and Affecting
Therapeutic Outcomes for Treatable Causes of Erectile
Dysfunction (ED)?
Prevalence of Hormonal Abnormalities in ED Patients
Literature Search
A total of 22 studies (23 publications) were identified as eligible and were included in the
review. 20,38,56-76 One study was reported in two publications. 62,76
Overview of Trials
The prevalence of hypogonadism, hyperprolactinemia, and measurements of serum level
LH/FSH were evaluated in 21 20,38,57-75 , 10 20,38,56,58,60,61,65,67,72,73 and 8 20,61,63-65,67,69,73 studies,
respectively.
The included studies were conducted in North America, Europe (France, Greece, Spain,
Sweden, Turkey, and UK), Brazil, Australia, Egypt, Saudi Arabia, and Malaysia.
The characteristics of included studies are presented in Table 1.
Study and Reporting Quality
The quality of the 22 included studies of men with erectile dysfunction who had their serum
levels of testosterone, prolactin, luteinizing hormone (LH) and/or follicle-stimulating hormone
(FSH) measured was assessed using QUADAS. 46
The QUADAS scores for each study are presented in Table C-2 (Appendix C).
About 60 percent of the studies provided an adequate description of population
characteristics and inclusion/exclusion criteria.
Populations (Studies Reporting on Hypogonadism)
Twenty-one of the included studies measured testosterone serum levels in men with erectile
dysfunction as total testosterone (TT) serum levels. 20,38,57-75 Two studies reported free
testosterone (FT) serum levels, 59,66 two studies reported calculated free testosterone (cFT) serum
levels, 73,74 and one study 73 calculated bioavailable testosterone (BT) serum levels.
Most studies recruited primary care clinic patients. In 10 studies participants were recruited
from specialized clinics (urology, andrology, sexual dysfunction, and endocrinology clinics).
Only 11 studies reported the use of a validated questionnaire to measure erectile dysfunction.
The participants’ mean age across studies ranged from 50 to 60 years. Important comorbidities
such as hypertension, diabetes mellitus, and ischemic vascular disease were described in only 8
of the 22 studies.
Further details regarding the serum hormonal level measurements (e.g. time the serum was
collected, cut-off values for positive/negative test results) are found in Table 1.
Appendixes and Evidence Tables for this report are provided electronically at
http://www.ahrq.gov/downloads/pub/evidence/pdf/erectiledys/erecdys.pdf