TITLE:
Diagnosis of Male Hypogonadism: Experience of a Subsaharan African Endocrinology Department: Transversal Study from January 1st, 2020 to July 31st, 2022
AUTHORS:
Nafy Ndiaye, Ngone Diaba Diack, Yakham Mohamed Leye, Mouhamed Mbar Niang, Amadou Lamine Cisse, Yousra Benani, Abdoulaye Leye
KEYWORDS:
Diagnostic, Hypogonadism, Male, Senegal
JOURNAL NAME:
Open Journal of Endocrine and Metabolic Diseases,
Vol.13 No.11,
November
29,
2023
ABSTRACT: Introduction: Hypogonadism should be suspected in a man who has symptoms and signs of
testosterone deficiency. Clinical manifestations depend on the severity and
duration of testosterone deficiency, whether the testicular deficit is
concerning only androgen synthesis, spermatogenesis, or both. The objective of
our study was to evaluate the clinical and aetiological characteristics of male
hypogonadism in Dakar’s suburb. Patients and methods: We conducted a
transversal study from January 1st, 2020 to July 31st,
2022. We included all male patients aged at least 14 years old with
hypogonadism confirmed by a low level of early-morning free testosterone based
on two different dosages. For all patients included, sociodemographic and
diagnostic parameters were collected by using a pre-established registration
form. Results: In total, 20 patients were selected. The average age was 36.3 years old
[14 - 62 years old]. Half of the patients were overweight. Five patients had an
abdominal circumference greater than 94 cm (37 inches). The other comorbidities
found in our patients were type 2 diabetes (n = 1), hypertension (n = 1) and
primary hypercholesterolemia in 2 patients. The functional signs reported by
the patients were: couple’s infertility in 17 patients, decreased libido in 14
patients, erectile dysfunction in 13 patients, premature ejaculation in 2
patients and anejaculation in 4 patients. The physical examination revealed a
bilateral testicular atrophy in 17 patients and a unilateral testicular atrophy
in 2 patients; no patient had varicocele or urethral meatus abnormalities. Ten
patients presented a micropenis. A eunuchoid morphotype was present in 6
patients and a short stature was noted in 2 patients. It was peripheral
hypogonadism (HH) in 18 patients and hypogonadotropic hypogonadism (Hh) in 2
patients. The hypogonadotropic hypogonadism was isolated in both cases. The
testicular echography confirmed testicular atrophy and showed cryptorchidism in
5 patients. The pituitary MRI performed in 2 patients with Hh showed an aspect
of empty sella turcica in one patient and was normal in the second patient. Conclusion: In our practice, the diagnosis of male hypogonadism is most often made in
adulthood. The most usual clinical presentation is failure of pubertal sexual
development associated or not with a eunuchoid morphotype. The anomalies of
spermatogenesis are found in most patients. Infertility is the primary motive
for consultation.