Androgen deficiency after radical prostatectomy: a phenomenon overlooked in urological practice?

Polishchuk D.L., Kulieva Z.M., Amosov N.A., Amosova M.V., Fadeev V.V., Amosov A.V., Tsymbal A.A.

1) I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia; 2) M.F. Vladimirsky Moscow Regional Clinical Research Institute, Moscow, Russia

Androgen deficiency following radical prostatectomy (RP) is a clinically uncharacterised and conceptually undefined phenomenon. Meanwhile, millions of men undergo RP annually, and if persistent hypogonadism truly developed in at least a subset of them, series of observations, cohort studies, and clinical guidelines would already exist. The absence of such evidence may reflect either a real problem, concealed at the intersection of urology and endocrinology, or the inherent untenability of the idea itself. To clarify this issue, a critical reappraisal of the hypothesis of persistent androgen deficiency as a potential consequence of RP is required. The focus of analysis is not on isolated findings but on the logic of their interpretation – ranging from alterations in endocrine profiles to proposed pathophysiological mechanisms, from diagnostic criteria to the rationale for replacement therapy and follow-up strategies. In each section, the emphasis shifts from simple fact-gathering to reconstruction of argumentation. The question is not merely what data exist, but whether they allow one to speak of a distinct clinical category. The objective of this article is not to refute the hypothesis, but to assess its validity as a scientific model aspiring to diagnostic and therapeutic significance.

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About the Authors

Corresponding author: M.V. Amosova – M.D., Ph.D., Associate Professor of the Department of Endocrinology No. 1 of the N.V. Sklifosovsky Institute of Clinical Medicine of the I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia; e-mail: mariaamosova@mail.ru

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