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Patient Satisfaction with Testosterone Replacement Therapies: The Reasons Behind the Choices

Authors

  • Jason R. Kovac MD, PhD, FRCSC,

    Corresponding author
    1. Scott Department of Urology and the Center for Reproductive Medicine, Baylor College of Medicine, Houston, TX, USA
    • Corresponding Author: Jason R. Kovac, MD, PhD, FRCSC, Urology, Baylor College of Medicine, One Baylor Plaza, Houston, TX 77030, USA. Tel: 713-798-7265; Fax: 713-798-1891; E-mail: Kovac@bcm.edu

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  • Saneal Rajanahally MD,

    1. Scott Department of Urology and the Center for Reproductive Medicine, Baylor College of Medicine, Houston, TX, USA
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  • Ryan P. Smith MD,

    1. Scott Department of Urology and the Center for Reproductive Medicine, Baylor College of Medicine, Houston, TX, USA
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  • Robert M. Coward MD,

    1. Scott Department of Urology and the Center for Reproductive Medicine, Baylor College of Medicine, Houston, TX, USA
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  • Dolores J. Lamb PhD,

    1. Scott Department of Urology and the Center for Reproductive Medicine, Baylor College of Medicine, Houston, TX, USA
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  • Larry I. Lipshultz MD

    1. Scott Department of Urology and the Center for Reproductive Medicine, Baylor College of Medicine, Houston, TX, USA
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Abstract

Introduction

Testosterone replacement therapy (TRT) for male hypogonadism is rapidly gaining popularity and acceptance. Options include gels, injections, and implantable subcutaneous pellets.

Aims

The aim of this study was to determine rates of patient satisfaction and reasons for patient preferences in hypogonadal men on TRT.

Methods

An anonymous, prospective survey was distributed to men presenting for TRT at an academic urology clinic. The survey was organized into multiple domains including patient satisfaction and treatment motivation.

Main Outcome Measures

Patient satisfaction responses obtained via anonymous survey.

Results

Average patient age was 49 ± 0.7 years (n = 382). Injectable testosterone was chosen by 53%, gel-based regimens by 31%, and pellets by 17%. Overall, 70% of patients were satisfied with their TRT and 14% reported dissatisfaction. Satisfaction rates were similar between gels (68%), injections (73%), and implantable pellets (70%). Doctor recommendation was the sole significant reason for patients preferring gel-based TRT (66% vs. 37% injection users vs. 31% pellet users). Injectable TRT was favored because of lower cost (35% vs. 21% gel users vs. 19% pellet users). Pellets were favored for ease of use (64% vs. 44% injection users vs. 43% gel users) and convenience (58% vs. 26% injection users vs. 19% gel users). Pellets had increased rates of satisfaction within the first 12 months. Improvements in concentration and mood occurred at higher percentages in satisfied patients.

Conclusions

Patients are satisfied with TRT. Lower costs are important to patients on injections. Convenience and ease of use are central in choosing pellet therapy. Men on TRT should be questioned about mood and concentration because these factors exhibited the greatest improvements in satisfied patients. Kovac JR, Rajanahally S, Smith RP, Coward RM, Lamb DJ, and Lipshultz LI. Patient satisfaction with testosterone replacement therapies: The reasons behind the choices. J Sex Med 2014;11:553–562.

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