The impact of sexual activity on serum hormone levels after penile prosthesis implantation

Abstract

Objectives: Penile prosthesis implantation is the final treatment option for patients who have erectile dysfunction. Most of the patients use their penile prosthesis successfully and frequently for penile-vaginal intercourse. Previous literature showed that decrease in sexual activity resulted in decreased serum testosterone levels and vice versa. The aim of this study was to examine the impact of sexual activity on serum sex hormone levels after penile prosthesis usage. Material and methods: In this study, we examined sixtyseven patients for their sex hormone changes who had penile prosthesis surgery 2.7 ± 1.5 years ago. Results: Patients were using their penile prosthesis for sexual activity with a mean of 9.9 ± 5.7 times per month. Dehydroepiandrosterone sulfate was significantly higher compared to pre-surgery results (5.3 ± 2.6 vs 4.5 ± 2.9; p = 0.031). Mean serum total testosterone levels of patients before and after penile prosthesis usage were clinically significant 15.78 ± 4.8 nmol/L and 16.5 ± 6.1 nmol/L, respectively. Mean serum luteinizing hormone levels of patients before and after penile prosthesis usage were 3.98 ± 2.16 IU/L and 5.47 ± 4.76 IU/L, respectively. No statistical significance difference was observed in the mean total and free testosterone, estradiol and luteinizing hormone levels between pre-and post-surgery. Conclusion: This study results demonstrated that sexual activity changed sex hormone levels positively among those men who were implanted penile prosthesis because of erectile dysfunction. healthy men (1, 2). Testosterone, which has androgenic and anabolic effects on human body, decline gradually with aging in males. Major benefits of testosterone on sexual function, mood, and strength are well known from the ancient times. Currently, evidence supports the concept that normal testosterone levels reduce cardiovascular disease risk, decrease fat, decrease total cholesterol, increase muscular body mass, and display good glycemic control (3). Moreover, epidemiological studies imply that many important disease states and related comorbidities are linked to low testosterone levels (4). Although there are mixed results from animal studies (5), male testosterone concentrations before and after sexual activity were shown as increased in human studies (6, 7). Insertion of a penile prosthesis (PP) for men who cannot use or fail to respond to first and second line treatments is the final treatment option for ED. Actually PP provides a satisfactory, definitive solution for ED. In different patient satisfaction studies it was shown that, of the PP implanted men more than 90% stated they were still using the PP for sexual intercourse with an average frequency of coitus of 5 times monthly (8-10). A recent study conducted by Escasa et al. supported previous studies and confirmed that sexual activity increases testosterone level which was more prominent in participants who had sexual intercourse (7). The aim of this study is to examine the influence of sexual activity on serum sex hormone levels af...