The article presents original experience with use of undecanoate (
nebido, BayerHealthcare
Pharmaceuticals, Germany) in androgenic testosteron replacement
therapy in males with
hypogonadism. Prospective studies of
nebido efficacy were made in males with vein-occlusive
erectile dysfunction (n = 20), chronic
pelvic pain syndrome (n = 77),
metabolic syndrome (n = 170). Retrospective studies assessed efficacy of
nebido monotherapy in patients with
erectile dysfunction and
hypogonadism (n = 34), hematological and urological safety of the
drug (n = 40). Laboratory monitoring was performed in all the studies according to ISSAM recommendations. The patients were not included in
contraindications to androgenic
therapy.
Nebido treatment significantly improved libido and erectile function, efficacy of
phosphodiesterase of type 5 inhibiors used in moderate and severe
erectile dysfunction. Depressive, asthenic,
pain symptoms declined in males with chronic
pelvic pain. Body fat reduced in
metabolic syndrome with alleviation of its other components. Insignificant rise of
hemoglobin level and packed cell volume was observed in some patients while a PSA level increase was clinically significant in 10% patients who had initial PSA > 2.5 ng/ml and acromegalia. Also,
nebido depressed production of
gonadotropins and spermatogenesis. Thus,
nebido is highly effective in sexual dysfunction and other somatic disorders caused by
hypogonadism.
Nebido does not induce severe side effects, but clinically significant rise of PSA level requires treatment discontinuation and more careful urological examination. In view of
nebido ability to suppress spermatogenesis, the
drug should not be used in reproductively active men.