HIPOGONADYZM MĘSKI - WYTYCZNE EUROPEJSKIEGO TOWARZYSTWA UROLOGICZNEGO (2/2)

<h1 style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 30px; font-stretch: inherit; font-weight: 500; line-height: 30px; margin: 0px 0px 20px 80px; outline: 0px; padding: 0px; position: relative; text-rendering: optimizeLegibility; vertical-align: baseline;"> <span class="list" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; display: inline-block; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px 0px 0px -80px; outline: 0px; padding: 0px; vertical-align: baseline; width: 80px;"><span style="margin: 0px; padding: 0px;">5.</span></span><span style="margin: 0px; padding: 0px;"> ZARZĄDZANIE CHOROBA</span></h1> <h2 style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 17px; font-stretch: inherit; font-weight: 500; line-height: 20px; margin: 0px 0px 0px 80px; outline: 0px; padding: 0px; position: relative; text-rendering: optimizeLegibility; vertical-align: baseline;"> <span style="border: 0px; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; padding: 0px; vertical-align: baseline;"><a href="https://www.blogger.com/null" name="5_1" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"></a><span class="list" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; display: inline-block; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px 0px 0px -80px; outline: 0px; padding: 0px; vertical-align: baseline; width: 80px;"><span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;">5.1.</span></span></span><span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;"> Wskazania i przeciwwskazania do leczenia</span></span></span></h2> <div class="separator" style="background-color: white; border: 0px; clear: both; color: #585858; font-family: Helvetica, Arial, sans-serif; font-size: 16px; font-stretch: inherit; line-height: 28px; margin: 0px; padding: 0px; text-align: center; vertical-align: baseline;"> <a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEibSvDGV4NH5ziV33v5Xa2CfORjbCXdgzMku-FnPaQM6Yep3SGud8OEtO7DgS09b8a7nWaNWKcizIGvTVaGnyFL0yj9xUNwG6zffFuIhYxcrER7Z3v74VC9zQHt6F3j3fh3YeRfs9e0ttA/s1600/a.png" imageanchor="1" style="border: 0px; clear: left; color: #333333; float: left; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px 1em 1em 0px; outline: none; padding: 0px; text-decoration: none; transition: all 0.25s; vertical-align: baseline;"><img border="0" height="200" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEibSvDGV4NH5ziV33v5Xa2CfORjbCXdgzMku-FnPaQM6Yep3SGud8OEtO7DgS09b8a7nWaNWKcizIGvTVaGnyFL0yj9xUNwG6zffFuIhYxcrER7Z3v74VC9zQHt6F3j3fh3YeRfs9e0ttA/s200/a.png" style="border: 0px none; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; height: auto; line-height: inherit; margin: 0px; max-width: 100%; outline: none; padding: 0px; position: relative; vertical-align: baseline;" width="115" /></a></div> <div class="bodytekst" style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; line-height: 18px; margin: 0px; outline: 0px; padding: 0px 0px 20px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;">Leczenie Testosteron ma na celu przywrócenie poziomu testosteronu w zakresie fizjologicznym u mężczyzn ze stale niskim poziomem testosteronu w surowicy krwi i związanych z tym objawów niedoboru androgenów. </span><span style="margin: 0px; padding: 0px;">Celem jest poprawa QoL, poczucie dobrego samopoczucia, funkcji seksualnych, siłę mięśni i gęstości mineralnej kości. </span><span style="margin: 0px; padding: 0px;">Tabela 5. podkreśla główne wskazania do leczenia testosteronem. </span><span style="margin: 0px; padding: 0px;">Tabela 6 wymienia główne przeciwwskazania do terapii testosteronem.</span></span></div> <div class="bodytekst_bold" style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; font-weight: 700; line-height: 18px; margin: 0px; outline: 0px; padding: 0px 0px 20px; vertical-align: baseline;"> <br style="margin: 0px; padding: 0px;" /></div> <div class="bodytekst_bold" style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; font-weight: 700; line-height: 18px; margin: 0px; outline: 0px; padding: 0px 0px 20px; vertical-align: baseline;"> <br style="margin: 0px; padding: 0px;" /></div> <div class="bodytekst_bold" style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; font-weight: 700; line-height: 18px; margin: 0px; outline: 0px; padding: 0px 0px 20px; vertical-align: baseline;"> <br style="margin: 0px; padding: 0px;" /></div> <div class="bodytekst_bold" style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; font-weight: 700; line-height: 18px; margin: 0px; outline: 0px; padding: 0px 0px 20px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">Tabela 5: Wskazania do leczenia testosteronem</span></div> <table class="tabel_zwart-wit" style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border-collapse: collapse; border-spacing: 0px; border: 1px solid rgb(102, 102, 102); box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; line-height: 18px; margin: 0px 0px 20px; max-width: 100%; outline: 0px; padding: 0px; table-layout: auto; vertical-align: baseline; width: 693px;"><tbody style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <tr style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><td class="Celstijl_1" style="-webkit-font-smoothing: antialiased; background: rgb(255, 255, 255); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="100%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">Opóźnione dojrzewanie płciowe (idiopatyczna, zespół kallmanna)</span></div> </td></tr> <tr style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><td class="Celstijl_1" style="-webkit-font-smoothing: antialiased; background: rgb(255, 255, 255); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="100%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">Zespół Klinefeltera z hipogonadyzmu</span></div> </td></tr> <tr style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><td class="Celstijl_1" style="-webkit-font-smoothing: antialiased; background: rgb(255, 255, 255); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="100%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">Zaburzenia seksualne i niski testosteron</span></div> </td></tr> <tr style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><td class="Celstijl_1" style="-webkit-font-smoothing: antialiased; background: rgb(255, 255, 255); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="100%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">Niska masa kostna w hipogonadyzmu</span></div> </td></tr> <tr style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><td class="Celstijl_1" style="-webkit-font-smoothing: antialiased; background: rgb(255, 255, 255); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="100%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">Dorosłych mężczyzn z niskim testosteronem i spójne, a korzystnie wielu oznak i objawów hipogonadyzmu następujące nieudanym leczeniu otyłości i chorób współistniejących (wymienionych w tabeli 4)</span></div> </td></tr> <tr style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><td class="Celstijl_1" style="-webkit-font-smoothing: antialiased; background: rgb(255, 255, 255); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="100%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">niedoczynność przysadki</span></div> </td></tr> <tr style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><td class="Celstijl_1" style="-webkit-font-smoothing: antialiased; background: rgb(255, 255, 255); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="100%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">Jąder gonad i hipogonadyzm</span></div> </td></tr> <tr style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><td class="Celstijl_1" style="-webkit-font-smoothing: antialiased; background: rgb(255, 255, 255); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="100%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">Cukrzyca typu 2 z hipogonadyzmu</span></div> </td></tr> </tbody></table> <div class="bodytekst_bold" style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; font-weight: 700; line-height: 18px; margin: 0px; outline: 0px; padding: 0px 0px 20px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">Tabela 6: Przeciwwskazania leczenia testosteronem</span></div> <table class="tabel_zwart-wit" style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border-collapse: collapse; border-spacing: 0px; border: 1px solid rgb(102, 102, 102); box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; line-height: 18px; margin: 0px 0px 20px; max-width: 100%; outline: 0px; padding: 0px; table-layout: auto; vertical-align: baseline; width: 693px;"><tbody style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <tr style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><td class="Celstijl_1" style="-webkit-font-smoothing: antialiased; background: rgb(255, 255, 255); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="100%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">Rak prostaty</span></div> </td></tr> <tr style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><td class="Celstijl_1" style="-webkit-font-smoothing: antialiased; background: rgb(255, 255, 255); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="100%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">Mężczyzna raka piersi</span></div> </td></tr> <tr style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><td class="Celstijl_1" style="-webkit-font-smoothing: antialiased; background: rgb(255, 255, 255); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="100%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">Ciężki bezdech senny</span></div> </td></tr> <tr style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><td class="Celstijl_1" style="-webkit-font-smoothing: antialiased; background: rgb(255, 255, 255); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="100%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">Niepłodność męska czynne chęć posiadania dzieci</span></div> </td></tr> <tr style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><td class="Celstijl_1" style="-webkit-font-smoothing: antialiased; background: rgb(255, 255, 255); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="100%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">Hematokryt> 0,54%</span></div> </td></tr> <tr style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><td class="Celstijl_1" style="-webkit-font-smoothing: antialiased; background: rgb(255, 255, 255); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="100%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">Ciężkie objawy dolnych dróg moczowych z powodu łagodnego rozrostu stercza</span></div> </td></tr> <tr style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><td class="Celstijl_1" style="-webkit-font-smoothing: antialiased; background: rgb(255, 255, 255); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="100%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">Ciężka przewlekła niewydolność serca / New York Heart Association klasy IV</span></div> </td></tr> </tbody></table> <h2 style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 17px; font-stretch: inherit; font-weight: 500; line-height: 20px; margin: 0px 0px 0px 80px; outline: 0px; padding: 0px; position: relative; text-rendering: optimizeLegibility; vertical-align: baseline;"> <span style="border: 0px; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; padding: 0px; vertical-align: baseline;"><a href="https://www.blogger.com/null" name="5_2" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"></a><span class="list" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; display: inline-block; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px 0px 0px -80px; outline: 0px; padding: 0px; vertical-align: baseline; width: 80px;"><span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;">5.2.</span></span></span><span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;"> Korzyści z leczenia</span></span></span></h2> <div class="bodytekst" style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; line-height: 18px; margin: 0px; outline: 0px; padding: 0px 0px 20px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;">W leczeniu wrodzonej hypogondotrophic hipogonadyzm jest zwykle wskazane. </span><span style="margin: 0px; padding: 0px;">U tych pacjentów hormonalnej stymulacji hCG i FSH lub alternatywnie pulsacyjnego leczenia GnRH może indukować dojrzewania, przywracania płodności w większości przypadków i normalizacji mineralizację kości [ </span></span><a href="https://uroweb.org/guideline/male-hypogonadism/#note_29" style="-webkit-font-smoothing: antialiased; -webkit-tap-highlight-color: rgb(0, 160, 227); background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">29</span></a><span style="margin: 0px; padding: 0px;"> , </span><a href="https://uroweb.org/guideline/male-hypogonadism/#note_30" style="-webkit-font-smoothing: antialiased; -webkit-tap-highlight-color: rgb(0, 160, 227); background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">30</span></a><span style="margin: 0px; padding: 0px;"> ].</span></div> <div class="bodytekst" style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; line-height: 18px; margin: 0px; outline: 0px; padding: 0px 0px 20px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">Zamiennik hipogonadyzm Testosteron wystąpił w wieku dorosłym Therapy (TRT) może złagodzić objawy, ale wiele hipogonadyzmem ludzie są chorzy i / lub otyłość, a redukcja masy ciała, zmiana stylu życia i dobre leczenie chorób współistniejących są ważniejsze niż tylko TRT.</span></div> <div class="bodytekst" style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; line-height: 18px; margin: 0px; outline: 0px; padding: 0px 0px 20px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;">TRT może przedstawić kilka zalet dotyczących składu ciała, kontroli metabolicznej, psychologicznych i parametrach seksualnych. </span><span style="margin: 0px; padding: 0px;">Randomizowane badania wykazują związek między odrestaurowanych fizjologicznych poziomów testosteronu, masy mięśniowej i siły mierzona jako siła nóg prasy i czworogłowego objętości mięśni [ </span></span><a href="https://uroweb.org/guideline/male-hypogonadism/#note_36" style="-webkit-font-smoothing: antialiased; -webkit-tap-highlight-color: rgb(0, 160, 227); background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">36</span></a><span style="margin: 0px; padding: 0px;"> , </span><a href="https://uroweb.org/guideline/male-hypogonadism/#note_48-50" style="-webkit-font-smoothing: antialiased; -webkit-tap-highlight-color: rgb(0, 160, 227); background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">48-50</span></a><span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;"> ].</span><span style="margin: 0px; padding: 0px;">Podobne pozytywne wyniki przedstawiono w meta-analizy ukierunkowanych na wartość roli egzogennego testosteronu w gęstości mineralnej kości: jest oczywiste, jak leczenie testosteronem zwiększa gęstość mineralną lędźwiowego kręgosłupa produkcji zmniejszenie markerów resorpcji kości. </span><span style="margin: 0px; padding: 0px;">Dostępne testy nie wskazują na podobne działanie w szyjce kości udowej [ </span></span><a href="https://uroweb.org/guideline/male-hypogonadism/#note_49" style="-webkit-font-smoothing: antialiased; -webkit-tap-highlight-color: rgb(0, 160, 227); background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">49</span></a><span style="margin: 0px; padding: 0px;"> , </span><a href="https://uroweb.org/guideline/male-hypogonadism/#note_51" style="-webkit-font-smoothing: antialiased; -webkit-tap-highlight-color: rgb(0, 160, 227); background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">51</span></a><span style="margin: 0px; padding: 0px;"> , </span><a href="https://uroweb.org/guideline/male-hypogonadism/#note_52" style="-webkit-font-smoothing: antialiased; -webkit-tap-highlight-color: rgb(0, 160, 227); background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">​​52</span></a><span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;"> ]. </span><span style="margin: 0px; padding: 0px;">Kompozycja korpusu jest pod wpływem leczenia testosteronu u mężczyzn z hipogonadyzmem, co w konsekwencji zmniejszenie masy tłuszczu i zwiększenie beztłuszczowej masy ciała [ </span></span><a href="https://uroweb.org/guideline/male-hypogonadism/#note_49" style="-webkit-font-smoothing: antialiased; -webkit-tap-highlight-color: rgb(0, 160, 227); background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">49</span></a><span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;"> ].</span><span style="margin: 0px; padding: 0px;">Liczne badania na podstawie undekanian testosteronu, wykazują znaczne zmniejszenie zawartości tłuszczu w pniu i talii z wyraźnym zmniejszeniem talii [ </span></span><a href="https://uroweb.org/guideline/male-hypogonadism/#note_53" style="-webkit-font-smoothing: antialiased; -webkit-tap-highlight-color: rgb(0, 160, 227); background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">53</span></a><span style="margin: 0px; padding: 0px;"> , </span><a href="https://uroweb.org/guideline/male-hypogonadism/#note_54" style="-webkit-font-smoothing: antialiased; -webkit-tap-highlight-color: rgb(0, 160, 227); background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">54</span></a><span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;"> ]. </span><span style="margin: 0px; padding: 0px;">W tych samych procesach, undekanian testosteronu podawanie wykazało poprawę wagi ciała, wskaźnik masy ciała i profil lipidowy po 3 miesiącach terapii [ </span></span><a href="https://uroweb.org/guideline/male-hypogonadism/#note_53" style="-webkit-font-smoothing: antialiased; -webkit-tap-highlight-color: rgb(0, 160, 227); background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">53</span></a><span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;"> ]. </span><span style="margin: 0px; padding: 0px;">TRT przedstawia pozytywny wpływ na kontrolę glikemii i lipidów, odporność na insulinę i otyłość trzewną u hipogonadalnych mężczyzn z upośledzoną tolerancją glukozy i profil lipidowy, z konsekwentnie zmniejszeniu śmiertelności [ </span></span><a href="https://uroweb.org/guideline/male-hypogonadism/#note_55" style="-webkit-font-smoothing: antialiased; -webkit-tap-highlight-color: rgb(0, 160, 227); background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">55</span></a><span style="margin: 0px; padding: 0px;"> , </span><a href="https://uroweb.org/guideline/male-hypogonadism/#note_56" style="-webkit-font-smoothing: antialiased; -webkit-tap-highlight-color: rgb(0, 160, 227); background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">56</span></a><span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;"> ]. </span><span style="margin: 0px; padding: 0px;">Silna korelacja pomiędzy spadkiem poziomu testosteronu i zwiększona śmiertelność sercowo-naczyniowych odnotowano w meta-analiz i badań retrospektywnych pokazujących, że łączna testosteronu i wolnego testosteronu w normalnym zakresie związane są ponadto do zmniejszenia śmiertelności całkowitej [ </span></span><a href="https://uroweb.org/guideline/male-hypogonadism/#note_57-61" style="-webkit-font-smoothing: antialiased; -webkit-tap-highlight-color: rgb(0, 160, 227); background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">57-61</span></a><span style="margin: 0px; padding: 0px;"> ].</span></div> <div class="bodytekst" style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; line-height: 18px; margin: 0px; outline: 0px; padding: 0px 0px 20px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">Korzyści na libido, erekcji i ejakulacji opisywano u mężczyzn z hipogonadyzmem w kilku badaniach retrospektywnych i opisy przypadków: Małe poprawa satysfakcji z erekcji i umiarkowanej poprawy libido wykazano przez metaanalizie 17 badań placebo kontrolnej [ </span><a href="https://uroweb.org/guideline/male-hypogonadism/#note_49" style="-webkit-font-smoothing: antialiased; -webkit-tap-highlight-color: rgb(0, 160, 227); background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">49</span></a><span style="margin: 0px; padding: 0px;"> , </span><a href="https://uroweb.org/guideline/male-hypogonadism/#note_62-64" style="-webkit-font-smoothing: antialiased; -webkit-tap-highlight-color: rgb(0, 160, 227); background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">62-64</span></a><span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;"> ]. </span><span style="margin: 0px; padding: 0px;">W niedawnym badaniu wieloośrodkowym prospektywnym znaczny wzrost IIEF (International Index of Erectile Function) w zakresie popędu płciowego, stosunek satysfakcji i ogólnego zadowolenia odnotowano rozpoczynając 6 tygodni od rozpoczęcia leczenia [ </span></span><a href="https://uroweb.org/guideline/male-hypogonadism/#note_63" style="-webkit-font-smoothing: antialiased; -webkit-tap-highlight-color: rgb(0, 160, 227); background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">63</span></a><span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;"> ]. </span><span style="margin: 0px; padding: 0px;">TRT wykazały obiecujące wyniki w kilku badaniach, w których zadowalający stosunek seksualny został zgłoszony przez co najmniej trzy miesiące po indukcji terapii w hipogonadyzmem mężczyzn cierpiących na zaburzenia erekcji [ </span></span><a href="https://uroweb.org/guideline/male-hypogonadism/#note_49" style="-webkit-font-smoothing: antialiased; -webkit-tap-highlight-color: rgb(0, 160, 227); background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">49</span></a><span style="margin: 0px; padding: 0px;"> , </span><a href="https://uroweb.org/guideline/male-hypogonadism/#note_64" style="-webkit-font-smoothing: antialiased; -webkit-tap-highlight-color: rgb(0, 160, 227); background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">64</span></a><span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;"> ]. </span><span style="margin: 0px; padding: 0px;">Poprawa objawów seksualnych będzie w dużej mierze zależy od etiologii dysfunkcji: TRT u mężczyzn z prawidłowym poziomem testosteronu wydaje się mało skuteczne, ale może przyczynić się do poprawy TRT odpowiedź fosfodiesterazy typu 5 (PDE5) w hipogonadyzmem mężczyzn [ </span></span><a href="https://uroweb.org/guideline/male-hypogonadism/#note_65" style="-webkit-font-smoothing: antialiased; -webkit-tap-highlight-color: rgb(0, 160, 227); background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">65</span></a><span style="margin: 0px; padding: 0px;"> ].</span></div> <div class="bodytekst" style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; line-height: 18px; margin: 0px; outline: 0px; padding: 0px 0px 20px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">Znacząca poprawa objawów depresyjnych u mężczyzn leczonych testosteronem undecylanu odnotowano w niedawnym badaniu z randomizacją [ </span><a href="https://uroweb.org/guideline/male-hypogonadism/#note_66" style="-webkit-font-smoothing: antialiased; -webkit-tap-highlight-color: rgb(0, 160, 227); background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">66</span></a><span style="margin: 0px; padding: 0px;"> ], jak również korzyści w widmie poznawczych [ </span><a href="https://uroweb.org/guideline/male-hypogonadism/#note_67" style="-webkit-font-smoothing: antialiased; -webkit-tap-highlight-color: rgb(0, 160, 227); background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">67</span></a><span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;"> ]. </span><span style="margin: 0px; padding: 0px;">Metaanaliza danych z badań randomizowanych, kontrolowanych placebo wykazało znaczący pozytywny wpływ testosteronu na nastrój [ </span></span><a href="https://uroweb.org/guideline/male-hypogonadism/#note_68" style="-webkit-font-smoothing: antialiased; -webkit-tap-highlight-color: rgb(0, 160, 227); background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">68</span></a><span style="margin: 0px; padding: 0px;"> ].</span></div> <div class="bodytekst_geen_witregel" style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; line-height: 18px; margin: -20px 0px 20px; outline: 0px; padding: 0px 0px 20px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">Korzyści w stosunku do spektrum poznawczych odnotowano w badaniach z niższym uderzenia.</span></div> <table class="tabel_zwart-wit" style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border-collapse: collapse; border-spacing: 0px; border: 1px solid rgb(102, 102, 102); box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; line-height: 18px; margin: 0px 0px 20px; max-width: 100%; outline: 0px; padding: 0px; table-layout: auto; vertical-align: baseline; width: 693px;"><thead style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <tr style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><th class="Celstijl_1" style="-webkit-font-smoothing: antialiased; background: rgb(240, 240, 240); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 1.2rem; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: 500; line-height: 1.4667rem; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="93%"><div class="tabel_bodytekstbold_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: 16px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: 700; line-height: 18px; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">Podsumowanie dowodów</span></div> </th><th class="Celstijl_1" style="-webkit-font-smoothing: antialiased; background: rgb(240, 240, 240); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 1.2rem; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: 500; line-height: 1.4667rem; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="7%"><div class="tabel_bodytekstbold_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: 16px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: 700; line-height: 18px; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">LE</span></div> </th></tr> </thead><tbody style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <tr style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><td class="Celstijl_1" style="-webkit-font-smoothing: antialiased; background: rgb(255, 255, 255); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="93%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">terapia zastępcza testosteronem (TRT) może złagodzić objawy, ale wiele hipogonadyzmem mężczyźni mają choroby przewlekłe i są otyłe: zmniejszenie masy ciała, zmiana stylu życia i dobre leczenie chorób współistniejących jest ważniejsza niż tylko TRT.</span></div> </td><td class="Celstijl_1" style="-webkit-font-smoothing: antialiased; background: rgb(255, 255, 255); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="7%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> 2</div> </td></tr> <tr style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><td class="Celstijl_1" style="-webkit-font-smoothing: antialiased; background: rgb(255, 255, 255); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="93%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">Testosteron leczenie zastępcza może poprawić skład ciała, mineralizację kości, objawy zespołu metabolicznego i męskich problemów seksualnych.</span></div> </td><td class="Celstijl_1" style="-webkit-font-smoothing: antialiased; background: rgb(255, 255, 255); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="7%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> 3</div> </td></tr> <tr style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><td class="Celstijl_1" style="-webkit-font-smoothing: antialiased; background: rgb(255, 255, 255); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="93%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">Zmniejszenie BMI i obwód pasa, poprawa kontroli glikemii i profilu lipidowego są obserwowane u mężczyzn z hipogonadyzmem otrzymujących TRT.</span></div> </td><td class="Celstijl_1" style="-webkit-font-smoothing: antialiased; background: rgb(255, 255, 255); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="7%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">2a</span></div> </td></tr> </tbody></table> <h2 style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 17px; font-stretch: inherit; font-weight: 500; line-height: 20px; margin: 0px 0px 0px 80px; outline: 0px; padding: 0px; position: relative; text-rendering: optimizeLegibility; vertical-align: baseline;"> <span style="border: 0px; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; padding: 0px; vertical-align: baseline;"><a href="https://www.blogger.com/null" name="5_3" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"></a><span class="list" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; display: inline-block; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px 0px 0px -80px; outline: 0px; padding: 0px; vertical-align: baseline; width: 80px;"><span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;">5.3.</span></span></span><span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;"> Wybór leczenia</span></span></span></h2> <div class="bodytekst" style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; line-height: 18px; margin: 0px; outline: 0px; padding: 0px 0px 20px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">Celem TRT jest przywrócenie fizjologicznych poziom testosteronu u mężczyzn z hipogonadyzmem [ </span><a href="https://uroweb.org/guideline/male-hypogonadism/#note_69" style="-webkit-font-smoothing: antialiased; -webkit-tap-highlight-color: rgb(0, 160, 227); background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">69</span></a><span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;"> ]. </span><span style="margin: 0px; padding: 0px;">Kilka preparaty są dostępne, które różnią się od drogi podawania, farmakokinetyki i zdarzeń niepożądanych, a wybór powinien być wspólna decyzja zarówno przez pacjenta, jak i lekarza [ </span></span><a href="https://uroweb.org/guideline/male-hypogonadism/#note_70" style="-webkit-font-smoothing: antialiased; -webkit-tap-highlight-color: rgb(0, 160, 227); background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">70</span></a><span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;"> ]. </span><span style="margin: 0px; padding: 0px;">Preparaty o krótkim działaniu są korzystne do długo działającego podawania depot w fazie początkowej obróbki, tak, że wszystkie zdarzenia niepożądane, które mogą rozwijać zaobserwować można wczesne i leczenie można przerwać w razie potrzeby [ </span></span><a href="https://uroweb.org/guideline/male-hypogonadism/#note_71" style="-webkit-font-smoothing: antialiased; -webkit-tap-highlight-color: rgb(0, 160, 227); background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">71</span></a><span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;"> ]. </span><span style="margin: 0px; padding: 0px;">Dostępne środki są preparaty doustne, iniekcje domięśniowe i żel transdermalny i poprawek.</span></span></div> <h3 style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; font-style: italic; font-weight: 400; line-height: 30px; margin: 0px 0px 0px 80px; outline: 0px; padding: 0px; position: relative; text-rendering: optimizeLegibility; vertical-align: baseline;"> <span class="kop3_bolditalic" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: 700; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><a href="https://www.blogger.com/null" name="5_3_1" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"></a><span class="list" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; display: inline-block; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: 400; line-height: inherit; margin: 0px 0px 0px -80px; outline: 0px; padding: 0px; vertical-align: baseline; width: 80px;"><span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;">5.3.1.</span></span></span><span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;"> Przygotowania</span></span></span></h3> <h4 style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; font-style: italic; font-weight: 400; line-height: 20px; margin: 0px 0px 0px 80px; outline: 0px; padding: 0px; position: relative; text-rendering: optimizeLegibility; vertical-align: baseline;"> <a href="https://www.blogger.com/null" name="5_3_1_1" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"></a><span class="list" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; display: inline-block; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px 0px 0px -80px; outline: 0px; padding: 0px; vertical-align: baseline; width: 80px;"><span style="margin: 0px; padding: 0px;">5.3.1.1.</span></span><span style="margin: 0px; padding: 0px;"> Testosteron Undekanian</span></h4> <div class="bodytekst" style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; line-height: 18px; margin: 0px; outline: 0px; padding: 0px 0px 20px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;">Undekanian testosteronu jest najbardziej powszechnie stosowane i najbezpieczniejszy system dostarczania ustnej.</span><span style="margin: 0px; padding: 0px;">Rzadko powoduje wzrost poziomu testosteronu powyżej mid-range i dlatego jest często związane ze skutkami ubocznymi [ </span></span><a href="https://uroweb.org/guideline/male-hypogonadism/#note_69" style="-webkit-font-smoothing: antialiased; -webkit-tap-highlight-color: rgb(0, 160, 227); background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">69</span></a><span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;"> ]. </span><span style="margin: 0px; padding: 0px;">Przy podawaniu doustnym resorpcji zależy jednoczesnym przyjmowaniem pożywienia tłuszczowego.</span><span style="margin: 0px; padding: 0px;">Undekanian testosteronu jest również dostępny jako długo działających iniekcji domięśniowych (z przerwami aż do trzech miesięcy). </span><span style="margin: 0px; padding: 0px;">Ten długi okres działania gwarantuje normalne stężenie testosteronu w surowicy dla całego okresu, ale stosunkowo długi okres wash-out może powodować problemy, jeśli pojawiają się powikłania [ </span></span><a href="https://uroweb.org/guideline/male-hypogonadism/#note_72" style="-webkit-font-smoothing: antialiased; -webkit-tap-highlight-color: rgb(0, 160, 227); background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">72</span></a><span style="margin: 0px; padding: 0px;"> ].</span></div> <h4 style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; font-style: italic; font-weight: 400; line-height: 20px; margin: 0px 0px 0px 80px; outline: 0px; padding: 0px; position: relative; text-rendering: optimizeLegibility; vertical-align: baseline;"> <a href="https://www.blogger.com/null" name="5_3_1_2" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"></a><span class="list" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; display: inline-block; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px 0px 0px -80px; outline: 0px; padding: 0px; vertical-align: baseline; width: 80px;"><span style="margin: 0px; padding: 0px;">5.3.1.2.</span></span><span style="margin: 0px; padding: 0px;"> Testosteron cypionate i enanthate</span></h4> <div class="bodytekst" style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; line-height: 18px; margin: 0px; outline: 0px; padding: 0px 0px 20px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;">Testosteron cypionate i enanthate dostępne są krótko działające systemy dostarczania domięśniowych (w odstępach 2-3 tygodni) i stanowią bezpieczne i prawidłowe przygotowania. </span><span style="margin: 0px; padding: 0px;">Jednak preparaty te mogą powodować wahania stężenia testosteronu z wysokich poziomów do poziomów poniżej normy, a co za tym idzie są one związane z okresami dobrego samopoczucia na przemian z okresami niezadowalającej odpowiedzi klinicznej [ </span></span><a href="https://uroweb.org/guideline/male-hypogonadism/#note_73" style="-webkit-font-smoothing: antialiased; -webkit-tap-highlight-color: rgb(0, 160, 227); background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">73</span></a><span style="margin: 0px; padding: 0px;"> , </span><a href="https://uroweb.org/guideline/male-hypogonadism/#note_74" style="-webkit-font-smoothing: antialiased; -webkit-tap-highlight-color: rgb(0, 160, 227); background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">74</span></a><span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;"> ]. </span><span style="margin: 0px; padding: 0px;">Są one również związane z częstszym występowaniem erytrocytosis.</span></span></div> <h4 style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; font-style: italic; font-weight: 400; line-height: 20px; margin: 0px 0px 0px 80px; outline: 0px; padding: 0px; position: relative; text-rendering: optimizeLegibility; vertical-align: baseline;"> <a href="https://www.blogger.com/null" name="5_3_1_3" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"></a><span class="list" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; display: inline-block; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px 0px 0px -80px; outline: 0px; padding: 0px; vertical-align: baseline; width: 80px;"><span style="margin: 0px; padding: 0px;">5.3.1.3.</span></span><span style="margin: 0px; padding: 0px;"> Przezskórne testosteron</span></h4> <div class="bodytekst" style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; line-height: 18px; margin: 0px; outline: 0px; padding: 0px 0px 20px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;">Preparaty przezskórnego testosteronu dostępne są plastry skórne lub żelu. </span><span style="margin: 0px; padding: 0px;">Zapewniają one jednolite i normalny poziom testosteronu w surowicy przez 24 godziny na dobę (przedział). </span><span style="margin: 0px; padding: 0px;">Najczęstsze skutki uboczne składają się z podrażnieniem skóry w miejscu stosowania (plastrów) i ryzyko przeniesienia interpersonalnej, jeśli nie zostaną podjęte odpowiednie środki ostrożności (żel) [ </span></span><a href="https://uroweb.org/guideline/male-hypogonadism/#note_75" style="-webkit-font-smoothing: antialiased; -webkit-tap-highlight-color: rgb(0, 160, 227); background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">75</span></a><span style="margin: 0px; padding: 0px;"> , </span><a href="https://uroweb.org/guideline/male-hypogonadism/#note_76" style="-webkit-font-smoothing: antialiased; -webkit-tap-highlight-color: rgb(0, 160, 227); background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">76</span></a><span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;"> ]. </span><span style="margin: 0px; padding: 0px;">Miejscowe stosowanie testosteronu 2% do pachach jest ostatnio zyskuje coraz większą popularność: wykazano, aby mieć bezpieczny i skuteczny profil w międzynarodowym otwartym badaniu klinicznym i został zatwierdzony w Stanach Zjednoczonych i Europie [ </span></span><a href="https://uroweb.org/guideline/male-hypogonadism/#note_77-79" style="-webkit-font-smoothing: antialiased; -webkit-tap-highlight-color: rgb(0, 160, 227); background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">77-79</span></a><span style="margin: 0px; padding: 0px;"> ] ,</span></div> <h4 style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; font-style: italic; font-weight: 400; line-height: 20px; margin: 0px 0px 0px 80px; outline: 0px; padding: 0px; position: relative; text-rendering: optimizeLegibility; vertical-align: baseline;"> <a href="https://www.blogger.com/null" name="5_3_1_4" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"></a><span class="list" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; display: inline-block; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px 0px 0px -80px; outline: 0px; padding: 0px; vertical-align: baseline; width: 80px;"><span style="margin: 0px; padding: 0px;">5.3.1.4.</span></span><span style="margin: 0px; padding: 0px;"> Podjęzykowa i policzkową testosteron</span></h4> <div class="bodytekst" style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; line-height: 18px; margin: 0px; outline: 0px; padding: 0px 0px 20px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">Tabletki podjęzykowe i policzkowe testosteronu są skuteczne i dobrze tolerowane systemy dostarczania, które mogą zapewnić szybką i jednolitą realizację fizjologicznego poziomu testosteronu z codziennej administracji [ </span><a href="https://uroweb.org/guideline/male-hypogonadism/#note_80" style="-webkit-font-smoothing: antialiased; -webkit-tap-highlight-color: rgb(0, 160, 227); background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">80</span></a><span style="margin: 0px; padding: 0px;"> , </span><a href="https://uroweb.org/guideline/male-hypogonadism/#note_81" style="-webkit-font-smoothing: antialiased; -webkit-tap-highlight-color: rgb(0, 160, 227); background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">81</span></a><span style="margin: 0px; padding: 0px;"> ].</span></div> <h4 style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; font-style: italic; font-weight: 400; line-height: 20px; margin: 0px 0px 0px 80px; outline: 0px; padding: 0px; position: relative; text-rendering: optimizeLegibility; vertical-align: baseline;"> <a href="https://www.blogger.com/null" name="5_3_1_5" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"></a><span class="list" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; display: inline-block; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px 0px 0px -80px; outline: 0px; padding: 0px; vertical-align: baseline; width: 80px;"><span style="margin: 0px; padding: 0px;">5.3.1.5.</span></span><span style="margin: 0px; padding: 0px;"> Podskórne składy</span></h4> <div class="bodytekst" style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; line-height: 18px; margin: 0px; outline: 0px; padding: 0px 0px 20px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;">Podskórne składy muszą być wszczepione co ​​pięć do siedmiu miesięcy i oferują długi okres działania bez istotnych wahań w surowicy poziomu testosteronu. </span><span style="margin: 0px; padding: 0px;">Ryzyko z tego rodzaju system dostarczania tkwi w infekcji i profili, które mogą występować nawet u 10% chorych [ </span></span><a href="https://uroweb.org/guideline/male-hypogonadism/#note_69" style="-webkit-font-smoothing: antialiased; -webkit-tap-highlight-color: rgb(0, 160, 227); background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">69</span></a><span style="margin: 0px; padding: 0px;"> , </span><a href="https://uroweb.org/guideline/male-hypogonadism/#note_82" style="-webkit-font-smoothing: antialiased; -webkit-tap-highlight-color: rgb(0, 160, 227); background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">82</span></a><span style="margin: 0px; padding: 0px;"> , </span><a href="https://uroweb.org/guideline/male-hypogonadism/#note_83" style="-webkit-font-smoothing: antialiased; -webkit-tap-highlight-color: rgb(0, 160, 227); background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">83</span></a><span style="margin: 0px; padding: 0px;"> ].</span></div> <h2 style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 17px; font-stretch: inherit; font-weight: 500; line-height: 20px; margin: 0px 0px 0px 80px; outline: 0px; padding: 0px; position: relative; text-rendering: optimizeLegibility; vertical-align: baseline;"> <span style="border: 0px; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; padding: 0px; vertical-align: baseline;"><a href="https://www.blogger.com/null" name="5_4" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"></a><span class="list" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; display: inline-block; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px 0px 0px -80px; outline: 0px; padding: 0px; vertical-align: baseline; width: 80px;"><span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;">5.4.</span></span></span><span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;"> Zagadnienia hipogonadyzmu i płodność</span></span></span></h2> <div class="bodytekst" style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; line-height: 18px; margin: 0px; outline: 0px; padding: 0px 0px 20px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;">Egzogenne testosteronu zmniejsza endogenną produkcję testosteronu ujemnego sprzężenia zwrotnego na osi podwzgórze-przysadka-gonad. </span><span style="margin: 0px; padding: 0px;">Jeśli wtórny hipogonadyzm zbiega się z problemami z płodnością, leczenie hCG należy rozważyć, szczególnie u mężczyzn z niskim gonadotropin. </span><span style="margin: 0px; padding: 0px;">hCG stymuluje produkcję testosteronu w komórkach Leydiga. </span><span style="margin: 0px; padding: 0px;">Jej podawanie powinno być ograniczone do pacjentów z wtórną hipogonadyzmu, czy problemy z płodnością są ważne. </span><span style="margin: 0px; padding: 0px;">Normalnych fizjologicznych poziomów w osoczu można osiągnąć przy użyciu standardowej dawce 1,500-5,000 jm domięśniowo lub podskórnie dwa razy w tygodniu. </span><span style="margin: 0px; padding: 0px;">U pacjentów z wtórną hipogonadyzmu, leczenie hCG jest połączone ze stosowaniem FSH (zwykle 150 jm trzy razy tygodniowego domięśniowo lub podskórnie) w celu wywołania spermatogenezy u pacjentów, którzy mają problemy z płodnością i hipogonadyzmem wtórnym. </span><span style="margin: 0px; padding: 0px;">Leczenie gonadotropiny kosmówkowej ludzka ma wyższe koszty niż leczenie testosteronem. </span><span style="margin: 0px; padding: 0px;">Nie ma wystarczających informacji na temat leczniczych i niepożądanych skutków długotrwałego leczenia hCG. </span><span style="margin: 0px; padding: 0px;">Ten rodzaj leczenia nie może być zatem zalecane dla hipogonadyzmu męskiego, z wyjątkiem pacjentów, u których leczenie płodności jest problemem.</span></span></div> <div class="bodytekst_bold" style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; font-weight: 700; line-height: 18px; margin: 0px; outline: 0px; padding: 0px 0px 20px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">Tabela 7: Przygotowania do testosteronu terapii zastępczej</span></div> <table class="tabel_blauw-wit" style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border-collapse: collapse; border-spacing: 0px; border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; line-height: 18px; margin: 0px 0px 20px; max-width: 100%; outline: 0px; padding: 0px; table-layout: auto; vertical-align: baseline; width: 693px;"><thead style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <tr style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><th class="Celstijl_1_tint_PMS" style="-webkit-font-smoothing: antialiased; background: rgb(255, 255, 255); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 1.2rem; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: 500; line-height: 1.4667rem; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="23%"><div class="tabel_bodytekstbold_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: 16px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: 700; line-height: 18px; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">Sformułowanie</span></div> </th><th class="Celstijl_1" style="-webkit-font-smoothing: antialiased; background: rgb(255, 255, 255); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 1.2rem; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: 500; line-height: 1.4667rem; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="23%"><div class="tabel_bodytekstbold_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: 16px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: 700; line-height: 18px; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">Administracja</span></div> </th><th class="Celstijl_1" style="-webkit-font-smoothing: antialiased; background: rgb(255, 255, 255); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 1.2rem; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: 500; line-height: 1.4667rem; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="23%"><div class="tabel_bodytekstbold_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: 16px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: 700; line-height: 18px; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">Zalety</span></div> </th><th class="Celstijl_1" style="-webkit-font-smoothing: antialiased; background: rgb(255, 255, 255); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 1.2rem; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: 500; line-height: 1.4667rem; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="30%"><div class="tabel_bodytekstbold_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: 16px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: 700; line-height: 18px; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">Niedogodności</span></div> </th></tr> </thead><tbody style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <tr style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><td class="Celstijl_1_tint_PMS" style="-webkit-font-smoothing: antialiased; background: rgb(197, 218, 241); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="23%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">testosteron undekanian</span></div> </td><td class="Celstijl_1" style="-webkit-font-smoothing: antialiased; background: rgb(255, 255, 255); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="23%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;">Doustny; </span><span style="margin: 0px; padding: 0px;">2-6 cps co 6 godzin</span></span></div> </td><td class="Celstijl_1" style="-webkit-font-smoothing: antialiased; background: rgb(255, 255, 255); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="23%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">Wchłaniana przez układ limfatyczny, a w konsekwencji zmniejszenie udziału wątroby.</span></div> </td><td class="Celstijl_1" style="-webkit-font-smoothing: antialiased; background: rgb(255, 255, 255); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="30%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">Zmienny poziom testosteronu powyżej i poniżej średniej klasy [</span><a href="https://uroweb.org/guideline/male-hypogonadism/#note_69" style="-webkit-font-smoothing: antialiased; -webkit-tap-highlight-color: rgb(0, 160, 227); background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">69</span></a><span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;"> ]. </span><span style="margin: 0px; padding: 0px;">Potrzeba kilka dawek dziennie z przyjmowaniem pożywienia tłuszczowego.</span></span></div> </td></tr> <tr style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><td class="Celstijl_1_tint_PMS" style="-webkit-font-smoothing: antialiased; background: rgb(197, 218, 241); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="23%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">testosteron cypionate</span></div> </td><td class="Celstijl_1" style="-webkit-font-smoothing: antialiased; background: rgb(255, 255, 255); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="23%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;">Domięśniowy; </span><span style="margin: 0px; padding: 0px;">jeden zastrzyk co dwa do trzech tygodni</span></span></div> </td><td class="Celstijl_1" style="-webkit-font-smoothing: antialiased; background: rgb(255, 255, 255); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="23%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">Krótko działającego preparat, który umożliwia wycofanie leku w przypadku wystąpienia niepożądanych skutków ubocznych.</span></div> </td><td class="Celstijl_1" style="-webkit-font-smoothing: antialiased; background: rgb(255, 255, 255); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="30%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">Ewentualne wahania poziomu testosteronu [ </span><a href="https://uroweb.org/guideline/male-hypogonadism/#note_73" style="-webkit-font-smoothing: antialiased; -webkit-tap-highlight-color: rgb(0, 160, 227); background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">73</span></a><span style="margin: 0px; padding: 0px;"> ].</span></div> </td></tr> <tr style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><td class="Celstijl_1_tint_PMS" style="-webkit-font-smoothing: antialiased; background: rgb(197, 218, 241); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="23%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">testosteron enanthate</span></div> </td><td class="Celstijl_1" style="-webkit-font-smoothing: antialiased; background: rgb(255, 255, 255); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="23%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;">Domięśniowy; </span><span style="margin: 0px; padding: 0px;">jeden zastrzyk co dwa do trzech tygodni</span></span></div> </td><td class="Celstijl_1" style="-webkit-font-smoothing: antialiased; background: rgb(255, 255, 255); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="23%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">Krótko działającego preparat, który umożliwia wycofanie leku w przypadku wystąpienia niepożądanych skutków ubocznych.</span></div> </td><td class="Celstijl_1" style="-webkit-font-smoothing: antialiased; background: rgb(255, 255, 255); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="30%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">Wahania poziomu testosteronu [</span><a href="https://uroweb.org/guideline/male-hypogonadism/#note_72" style="-webkit-font-smoothing: antialiased; -webkit-tap-highlight-color: rgb(0, 160, 227); background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">72</span></a><span style="margin: 0px; padding: 0px;"> , </span><a href="https://uroweb.org/guideline/male-hypogonadism/#note_73" style="-webkit-font-smoothing: antialiased; -webkit-tap-highlight-color: rgb(0, 160, 227); background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">73</span></a><span style="margin: 0px; padding: 0px;"> ].</span></div> </td></tr> <tr style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><td class="Celstijl_1_tint_PMS" style="-webkit-font-smoothing: antialiased; background: rgb(197, 218, 241); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="23%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">testosteron undekanian</span></div> </td><td class="Celstijl_1" style="-webkit-font-smoothing: antialiased; background: rgb(255, 255, 255); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="23%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;">Domięśniowy; </span><span style="margin: 0px; padding: 0px;">jeden zastrzyk co 10-14 tygodni</span></span></div> </td><td class="Celstijl_1" style="-webkit-font-smoothing: antialiased; background: rgb(255, 255, 255); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="23%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">W stanie stacjonarnym poziom testosteronu bez wahania.</span></div> </td><td class="Celstijl_1" style="-webkit-font-smoothing: antialiased; background: rgb(255, 255, 255); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="30%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">Preparat długo działającego, które nie mogą umożliwić wycofanie leku w przypadku wystąpienia efektów ubocznych [ </span><a href="https://uroweb.org/guideline/male-hypogonadism/#note_74" style="-webkit-font-smoothing: antialiased; -webkit-tap-highlight-color: rgb(0, 160, 227); background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">74</span></a><span style="margin: 0px; padding: 0px;"> ].</span></div> </td></tr> <tr style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><td class="Celstijl_1_tint_PMS" style="-webkit-font-smoothing: antialiased; background: rgb(197, 218, 241); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="23%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">transdermalny testosteronu</span></div> </td><td class="Celstijl_1" style="-webkit-font-smoothing: antialiased; background: rgb(255, 255, 255); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="23%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;">Żel lub plastry skórne;</span><span style="margin: 0px; padding: 0px;">codziennie aplikacji</span></span></div> </td><td class="Celstijl_1" style="-webkit-font-smoothing: antialiased; background: rgb(255, 255, 255); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="23%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">Poziom testosteronu w stanie stacjonarnym, bez wahania.</span></div> </td><td class="Celstijl_1" style="-webkit-font-smoothing: antialiased; background: rgb(255, 255, 255); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="30%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">Podrażnienie skóry w miejscu zastosowania i ryzyko przeniesienia interpersonalnej [ </span><a href="https://uroweb.org/guideline/male-hypogonadism/#note_75" style="-webkit-font-smoothing: antialiased; -webkit-tap-highlight-color: rgb(0, 160, 227); background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">75</span></a><span style="margin: 0px; padding: 0px;">, </span><a href="https://uroweb.org/guideline/male-hypogonadism/#note_76" style="-webkit-font-smoothing: antialiased; -webkit-tap-highlight-color: rgb(0, 160, 227); background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">76</span></a><span style="margin: 0px; padding: 0px;"> ].</span></div> </td></tr> <tr style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><td class="Celstijl_1_tint_PMS" style="-webkit-font-smoothing: antialiased; background: rgb(197, 218, 241); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="23%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">podjęzykowa testosteron</span></div> </td><td class="Celstijl_1" style="-webkit-font-smoothing: antialiased; background: rgb(255, 255, 255); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="23%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;">Podjęzykowy; </span><span style="margin: 0px; padding: 0px;">dawki dzienne</span></span></div> </td><td class="Celstijl_1" style="-webkit-font-smoothing: antialiased; background: rgb(255, 255, 255); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="23%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">Szybkie wchłanianie i osiągnięcie poziomu testosteronu w surowicy fizjologicznej.</span></div> </td><td class="Celstijl_1" style="-webkit-font-smoothing: antialiased; background: rgb(255, 255, 255); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="30%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">Miejscowe podrażnienie [ </span><a href="https://uroweb.org/guideline/male-hypogonadism/#note_80" style="-webkit-font-smoothing: antialiased; -webkit-tap-highlight-color: rgb(0, 160, 227); background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">80</span></a><span style="margin: 0px; padding: 0px;"> , </span><a href="https://uroweb.org/guideline/male-hypogonadism/#note_81" style="-webkit-font-smoothing: antialiased; -webkit-tap-highlight-color: rgb(0, 160, 227); background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">81</span></a><span style="margin: 0px; padding: 0px;">].</span></div> </td></tr> <tr style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><td class="Celstijl_1_tint_PMS" style="-webkit-font-smoothing: antialiased; background: rgb(197, 218, 241); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="23%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">policzkową testosteron</span></div> </td><td class="Celstijl_1" style="-webkit-font-smoothing: antialiased; background: rgb(255, 255, 255); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="23%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;">Policzkową tablet; </span><span style="margin: 0px; padding: 0px;">dwie dawki dziennie</span></span></div> </td><td class="Celstijl_1" style="-webkit-font-smoothing: antialiased; background: rgb(255, 255, 255); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="23%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">Szybkie wchłanianie i osiągnięcie poziomu testosteronu w surowicy fizjologicznej.</span></div> </td><td class="Celstijl_1" style="-webkit-font-smoothing: antialiased; background: rgb(255, 255, 255); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="30%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">Podrażnienie, ból w miejscu zastosowania [ </span><a href="https://uroweb.org/guideline/male-hypogonadism/#note_80" style="-webkit-font-smoothing: antialiased; -webkit-tap-highlight-color: rgb(0, 160, 227); background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">80</span></a><span style="margin: 0px; padding: 0px;"> , </span><a href="https://uroweb.org/guideline/male-hypogonadism/#note_81" style="-webkit-font-smoothing: antialiased; -webkit-tap-highlight-color: rgb(0, 160, 227); background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">81</span></a><span style="margin: 0px; padding: 0px;"> ].</span></div> </td></tr> <tr style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><td class="Celstijl_1_tint_PMS" style="-webkit-font-smoothing: antialiased; background: rgb(197, 218, 241); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="23%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">podskórne składy</span></div> </td><td class="Celstijl_1" style="-webkit-font-smoothing: antialiased; background: rgb(255, 255, 255); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="23%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">Podskórne implanty co pięć do siedmiu miesięcy</span></div> </td><td class="Celstijl_1" style="-webkit-font-smoothing: antialiased; background: rgb(255, 255, 255); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="23%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">Długi czas trwania i stały poziom testosteronu w surowicy.</span></div> </td><td class="Celstijl_1" style="-webkit-font-smoothing: antialiased; background: rgb(255, 255, 255); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="30%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">Ryzyka infekcji i wytłaczania implantów [ </span><a href="https://uroweb.org/guideline/male-hypogonadism/#note_69" style="-webkit-font-smoothing: antialiased; -webkit-tap-highlight-color: rgb(0, 160, 227); background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">69</span></a><span style="margin: 0px; padding: 0px;"> , </span><a href="https://uroweb.org/guideline/male-hypogonadism/#note_82" style="-webkit-font-smoothing: antialiased; -webkit-tap-highlight-color: rgb(0, 160, 227); background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">82</span></a><span style="margin: 0px; padding: 0px;"> , </span><a href="https://uroweb.org/guideline/male-hypogonadism/#note_83" style="-webkit-font-smoothing: antialiased; -webkit-tap-highlight-color: rgb(0, 160, 227); background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">83</span></a><span style="margin: 0px; padding: 0px;"> ].</span></div> </td></tr> </tbody></table> <div class="kop2_witregel" style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; line-height: 18px; margin: 0px; outline: 0px; padding: 0px 0px 20px; vertical-align: baseline;"> <a href="https://www.blogger.com/null" name="5_5" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"></a><span class="list" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">5.5.</span></span><span style="margin: 0px; padding: 0px;"> Zalecenia dla terapii zastępczej testosteronem</span></div> <table class="tabel_blauw" style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border-collapse: collapse; border-spacing: 0px; border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; line-height: 18px; margin: 0px 0px 20px; max-width: 100%; outline: 0px; padding: 0px; table-layout: auto; vertical-align: baseline; width: 693px;"><thead style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <tr style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><th class="Celstijl_1_tint_PMS" style="-webkit-font-smoothing: antialiased; background: rgb(197, 218, 241); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 1.2rem; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: 500; line-height: 1.4667rem; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="87%"><div class="tabel_bodytekstbold_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: 16px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: 700; line-height: 18px; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">zalecenia</span></div> </th><th class="Celstijl_1_tint_PMS" style="-webkit-font-smoothing: antialiased; background: rgb(197, 218, 241); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 1.2rem; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: 500; line-height: 1.4667rem; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="7%"><div class="tabel_bodytekstbold_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: 16px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: 700; line-height: 18px; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">LE</span></div> </th><th class="Celstijl_1_tint_PMS" style="-webkit-font-smoothing: antialiased; background: rgb(197, 218, 241); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 1.2rem; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: 500; line-height: 1.4667rem; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="7%"><div class="tabel_bodytekstbold_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: 16px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: 700; line-height: 18px; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">GR</span></div> </th></tr> </thead><tbody style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <tr style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><td class="Celstijl_1_tint_PMS" style="-webkit-font-smoothing: antialiased; background: rgb(197, 218, 241); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="87%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;">Całkowicie poinformować pacjenta o spodziewanych korzyści i skutków ubocznych opcji leczenia.</span><span style="margin: 0px; padding: 0px;">Wybierz preparat o wspólnej decyzji przez poinformowanego pacjenta i lekarza.</span></span></div> </td><td class="Celstijl_1_tint_PMS" style="-webkit-font-smoothing: antialiased; background: rgb(197, 218, 241); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="7%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">3</span></div> </td><td class="Celstijl_1_tint_PMS" style="-webkit-font-smoothing: antialiased; background: rgb(197, 218, 241); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="7%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">ZA</span></div> </td></tr> <tr style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><td class="Celstijl_1_tint_PMS" style="-webkit-font-smoothing: antialiased; background: rgb(197, 218, 241); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="87%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">Używać preparatów krótko działających niż długo działające podawania depot po rozpoczęciu leczenia początkowego, tak, że leczenie może być regulowana lub zatrzymana w przypadku niekorzystnych skutków ubocznych.</span></div> </td><td class="Celstijl_1_tint_PMS" style="-webkit-font-smoothing: antialiased; background: rgb(197, 218, 241); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="7%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">3</span></div> </td><td class="Celstijl_1_tint_PMS" style="-webkit-font-smoothing: antialiased; background: rgb(197, 218, 241); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="7%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">b</span></div> </td></tr> <tr style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><td class="Celstijl_1_tint_PMS" style="-webkit-font-smoothing: antialiased; background: rgb(197, 218, 241); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="87%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">Nie stosować terapię testosteronem u pacjentów z męskiej niepłodności i aktywnego dziecka życzenia, ponieważ może on tłumić spermatogenensis.</span></div> </td><td class="Celstijl_1_tint_PMS" style="-webkit-font-smoothing: antialiased; background: rgb(197, 218, 241); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="7%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">1b</span></div> </td><td class="Celstijl_1_tint_PMS" style="-webkit-font-smoothing: antialiased; background: rgb(197, 218, 241); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="7%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">ZA</span></div> </td></tr> <tr style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><td class="Celstijl_1_tint_PMS" style="-webkit-font-smoothing: antialiased; background: rgb(197, 218, 241); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="87%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">Należy używać wyłącznie leczenie hCG na hipogonadyzm u pacjentów z hipogonadyzmem jednoczesnego leczenia bezpłodności.</span></div> </td><td class="Celstijl_1_tint_PMS" style="-webkit-font-smoothing: antialiased; background: rgb(197, 218, 241); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="7%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">1b</span></div> </td><td class="Celstijl_1_tint_PMS" style="-webkit-font-smoothing: antialiased; background: rgb(197, 218, 241); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="7%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">b</span></div> </td></tr> <tr style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><td class="Celstijl_1_tint_PMS" style="-webkit-font-smoothing: antialiased; background: rgb(197, 218, 241); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="87%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">U pacjentów z postacią hipogonadyzmu dorosły, tylko próbować leczenia testosteronem u mężczyzn z głównych objawów i jeśli utrata masy ciała, zmiana stylu życia i równowagę dobra leczenia chorób współistniejących okazały się nieskuteczne.</span></div> </td><td class="Celstijl_1_tint_PMS" style="-webkit-font-smoothing: antialiased; background: rgb(197, 218, 241); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="7%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">2</span></div> </td><td class="Celstijl_1_tint_PMS" style="-webkit-font-smoothing: antialiased; background: rgb(197, 218, 241); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="7%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">ZA</span></div> </td></tr> </tbody></table> <h2 style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 17px; font-stretch: inherit; font-weight: 500; line-height: 20px; margin: 0px 0px 0px 80px; outline: 0px; padding: 0px; position: relative; text-rendering: optimizeLegibility; vertical-align: baseline;"> <span style="border: 0px; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; padding: 0px; vertical-align: baseline;"><a href="https://www.blogger.com/null" name="5_6" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"></a><span class="list" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; display: inline-block; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px 0px 0px -80px; outline: 0px; padding: 0px; vertical-align: baseline; width: 80px;"><span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;">5.6.</span></span></span><span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;"> Czynniki ryzyka w leczeniu testosteronem</span></span></span></h2> <div class="bodytekst" style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; line-height: 18px; margin: 0px; outline: 0px; padding: 0px 0px 20px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;">Lekarze często niechętnie oferują TRT zwłaszcza u starszych mężczyzn ze względu na potencjalne ryzyko wystąpienia tej terapii. </span><span style="margin: 0px; padding: 0px;">Do najczęstszych wątpliwości są reprezentowane przez możliwe konsekwencje dla prostaty i ryzyka sercowo-naczyniowego.</span></span></div> <h3 style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; font-style: italic; font-weight: 400; line-height: 30px; margin: 0px 0px 0px 80px; outline: 0px; padding: 0px; position: relative; text-rendering: optimizeLegibility; vertical-align: baseline;"> <span class="kop3_bolditalic" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: 700; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><a href="https://www.blogger.com/null" name="5_6_1" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"></a><span class="list" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; display: inline-block; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: 400; line-height: inherit; margin: 0px 0px 0px -80px; outline: 0px; padding: 0px; vertical-align: baseline; width: 80px;"><span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;">5.6.1.</span></span></span><span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;"> Raka piersi u mężczyzn</span></span></span></h3> <div class="bodytekst" style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; line-height: 18px; margin: 0px; outline: 0px; padding: 0px 0px 20px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">Mężczyzna rak piersi jest rzadką chorobą, z częstością mniejszą niż 1% wszystkich nowotworów męskich [ </span><a href="https://uroweb.org/guideline/male-hypogonadism/#note_84" style="-webkit-font-smoothing: antialiased; -webkit-tap-highlight-color: rgb(0, 160, 227); background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">84</span></a><span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;"> ].</span><span style="margin: 0px; padding: 0px;">Częstość występowania jest wyższa u ludzi z zespołem Klinefeltera. </span><span style="margin: 0px; padding: 0px;">Leczenie testosteronem jest przeciwwskazane u mężczyzn z historią raka sutka [ </span></span><a href="https://uroweb.org/guideline/male-hypogonadism/#note_27" style="-webkit-font-smoothing: antialiased; -webkit-tap-highlight-color: rgb(0, 160, 227); background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">27</span></a><span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;"> ]. </span><span style="margin: 0px; padding: 0px;">Związek między TRT i rozwoju raka piersi nie jest poparte silnymi dowodami choć istnieją doniesienia oparte na małych grupach pacjentów [ </span></span><a href="https://uroweb.org/guideline/male-hypogonadism/#note_85" style="-webkit-font-smoothing: antialiased; -webkit-tap-highlight-color: rgb(0, 160, 227); background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">85</span></a><span style="margin: 0px; padding: 0px;"> ].</span></div> <h3 style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; font-style: italic; font-weight: 400; line-height: 30px; margin: 0px 0px 0px 80px; outline: 0px; padding: 0px; position: relative; text-rendering: optimizeLegibility; vertical-align: baseline;"> <span class="kop3_bolditalic" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: 700; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><a href="https://www.blogger.com/null" name="5_6_2" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"></a><span class="list" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; display: inline-block; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: 400; line-height: inherit; margin: 0px 0px 0px -80px; outline: 0px; padding: 0px; vertical-align: baseline; width: 80px;"><span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;">5.6.2.</span></span></span><span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;"> Ryzyko raka prostaty</span></span></span></h3> <div class="bodytekst" style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; line-height: 18px; margin: 0px; outline: 0px; padding: 0px 0px 20px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">Wzrost raka prostaty może wpływać testosteronu, badania wykazują, że hipogonadyzm jest związany z mniejszą częstością występowania raka gruczołu krokowego, raka gruczołu krokowego, ale jeśli występuje u mężczyzn z hipogonadyzmem zwykle ma zaawansowanym stadium wyższy wynik Gleason [ </span><a href="https://uroweb.org/guideline/male-hypogonadism/#note_86" style="-webkit-font-smoothing: antialiased; -webkit-tap-highlight-color: rgb(0, 160, 227); background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">86</span></a><span style="margin: 0px; padding: 0px;"> , </span><a href="https://uroweb.org/guideline/male-hypogonadism/#note_87" style="-webkit-font-smoothing: antialiased; -webkit-tap-highlight-color: rgb(0, 160, 227); background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">87</span></a><span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;"> ]. </span><span style="margin: 0px; padding: 0px;">Krótkotrwałe randomizowanych badań wspierają hipotezę, że TRT nie powoduje zmiany w histologię prostaty ani znaczącego wzrostu intraprostatic testosteronu, DHT, i [ </span></span><a href="https://uroweb.org/guideline/male-hypogonadism/#note_88" style="-webkit-font-smoothing: antialiased; -webkit-tap-highlight-color: rgb(0, 160, 227); background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">88</span></a><span style="margin: 0px; padding: 0px;"> , </span><a href="https://uroweb.org/guideline/male-hypogonadism/#note_89" style="-webkit-font-smoothing: antialiased; -webkit-tap-highlight-color: rgb(0, 160, 227); background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">89</span></a><span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;"> ]. </span><span style="margin: 0px; padding: 0px;">Najnowsze badania wskazują, że terapia testosteronem nie zwiększa ryzyka zachorowania na raka prostaty [ </span></span><a href="https://uroweb.org/guideline/male-hypogonadism/#note_88-91" style="-webkit-font-smoothing: antialiased; -webkit-tap-highlight-color: rgb(0, 160, 227); background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">88-91</span></a><span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;"> ], ale brak jest długoterminowych danych follow-up nie są jeszcze dostępne. </span><span style="margin: 0px; padding: 0px;">Niedawna meta-analiza wykazała wyższą (ale nie istotny statystycznie) odsetek zdarzeń prostaty w średnim wieku i starszych mężczyzn na TRT, ale były one bardziej prawdopodobne, aby mieć gruczołu biopsji ze względu na pewien wzrost antygenu specyficznego dla prostaty (PSA) , co jest powszechne u mężczyzn na TRT [ </span></span><a href="https://uroweb.org/guideline/male-hypogonadism/#note_70" style="-webkit-font-smoothing: antialiased; -webkit-tap-highlight-color: rgb(0, 160, 227); background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">70</span></a><span style="margin: 0px; padding: 0px;"> ].</span></div> <div class="bodytekst" style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; line-height: 18px; margin: 0px; outline: 0px; padding: 0px 0px 20px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;">Terapia testosteronem jest wyraźnie przeciwwskazane u mężczyzn z zaawansowanym rakiem prostaty. </span><span style="margin: 0px; padding: 0px;">Temat przedmiotem dyskusji jest zastosowanie TRT u mężczyzn z hipogonadyzmem z historią raka prostaty i bez objawów aktywnej choroby. </span><span style="margin: 0px; padding: 0px;">Do tej pory tylko badania z ograniczonej liczby pacjentów i stosunkowo krótki okres obserwacji są dostępne i nie wskazują na zwiększone ryzyko raka prostaty nawrotu [ </span></span><a href="https://uroweb.org/guideline/male-hypogonadism/#note_89" style="-webkit-font-smoothing: antialiased; -webkit-tap-highlight-color: rgb(0, 160, 227); background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">89</span></a><span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;"> ]. </span><span style="margin: 0px; padding: 0px;">Według niedawnego badania retrospektywne na hipogonadyzmem mężczyzn z poprzedniej historii raka prostaty otrzymujących TRT po diagnozie raka, leczenie nie wiązało się ze zwiększoną śmiertelnością ogólną lub specyficzne dla nowotworów, ale TRT było bardziej prawdopodobne, aby być przepisywany u pacjentów poddanych radykalnej prostatektomii za dobrze zróżnicowanych nowotworów [ </span></span><a href="https://uroweb.org/guideline/male-hypogonadism/#note_92" style="-webkit-font-smoothing: antialiased; -webkit-tap-highlight-color: rgb(0, 160, 227); background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">92</span></a><span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;"> ]. </span><span style="margin: 0px; padding: 0px;">Brak randomizowanych badań kontrolowanych placebo są jeszcze dostępne w celu udokumentowania jego długoterminowego bezpieczeństwa u tych pacjentów [ </span></span><a href="https://uroweb.org/guideline/male-hypogonadism/#note_69" style="-webkit-font-smoothing: antialiased; -webkit-tap-highlight-color: rgb(0, 160, 227); background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">69</span></a><span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;"> ]. </span><span style="margin: 0px; padding: 0px;">Objawowe mężczyźni, którzy zostali hipogonadyzmem leczonych chirurgicznie zlokalizowane raka gruczołu krokowego i którzy są obecnie bez cech aktywnej choroby (tj mierzalną PSA, badanie odbytu, nienormalnym dowodów kości / przerzutów do narządów trzewnych) można ostrożnie rozważyć TRT [ </span></span><a href="https://uroweb.org/guideline/male-hypogonadism/#note_93-95" style="-webkit-font-smoothing: antialiased; -webkit-tap-highlight-color: rgb(0, 160, 227); background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">93-95</span></a><span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;"> ]. </span><span style="margin: 0px; padding: 0px;">W tych mężczyzn leczenie powinno być ograniczone do pacjentów z niskim ryzykiem wznowy raka prostaty (tj Gleasona <8 etapem="" font="" ml="" nbsp="" ng="" patologiczne="" przedoperacyjnej="" psa="" pt1-2=""><span style="margin: 0px; padding: 0px;">Leczenie nie powinno rozpocząć się przed jednym roku obserwacji po zabiegu, a pacjent powinien pozostawać bez nawrotu PSA [ </span></8></span><a href="https://uroweb.org/guideline/male-hypogonadism/#note_65" style="-webkit-font-smoothing: antialiased; -webkit-tap-highlight-color: rgb(0, 160, 227); background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">65</span></a><span style="margin: 0px; padding: 0px;"> , </span><a href="https://uroweb.org/guideline/male-hypogonadism/#note_94-96" style="-webkit-font-smoothing: antialiased; -webkit-tap-highlight-color: rgb(0, 160, 227); background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">94-96</span></a><span style="margin: 0px; padding: 0px;"> ].</span></span></div> <div class="bodytekst" style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; line-height: 18px; margin: 0px; outline: 0px; padding: 0px 0px 20px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">Chorych poddanych brachyterapii lub zewnętrznego wiązki promieniowania (EBRT) dla niskiego ryzyka raka prostaty może być również ostrożnie rozważyć TRT w przypadku objawowego hipogonadyzmu ze ścisłego monitorowania nawrotów raka gruczołu krokowego [ </span><a href="https://uroweb.org/guideline/male-hypogonadism/#note_92" style="-webkit-font-smoothing: antialiased; -webkit-tap-highlight-color: rgb(0, 160, 227); background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">92</span></a><span style="margin: 0px; padding: 0px;"> , </span><a href="https://uroweb.org/guideline/male-hypogonadism/#note_94" style="-webkit-font-smoothing: antialiased; -webkit-tap-highlight-color: rgb(0, 160, 227); background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">94</span></a><span style="margin: 0px; padding: 0px;"> , </span><a href="https://uroweb.org/guideline/male-hypogonadism/#note_96" style="-webkit-font-smoothing: antialiased; -webkit-tap-highlight-color: rgb(0, 160, 227); background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">96</span></a><span style="margin: 0px; padding: 0px;"> , </span><a href="https://uroweb.org/guideline/male-hypogonadism/#note_97" style="-webkit-font-smoothing: antialiased; -webkit-tap-highlight-color: rgb(0, 160, 227); background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">97</span></a><span style="margin: 0px; padding: 0px;"> ], chociaż nie ma długo- dane o bezpieczeństwie Termin dostępne są u tych pacjentów.</span></div> <h3 style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; font-style: italic; font-weight: 400; line-height: 30px; margin: 0px 0px 0px 80px; outline: 0px; padding: 0px; position: relative; text-rendering: optimizeLegibility; vertical-align: baseline;"> <span class="kop3_bolditalic" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: 700; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><a href="https://www.blogger.com/null" name="5_6_3" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"></a><span class="list" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; display: inline-block; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: 400; line-height: inherit; margin: 0px 0px 0px -80px; outline: 0px; padding: 0px; vertical-align: baseline; width: 80px;"><span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;">5.6.3.</span></span></span><span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;"> Choroby układu krążenia</span></span></span></h3> <div class="bodytekst" style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; line-height: 18px; margin: 0px; outline: 0px; padding: 0px 0px 20px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">Istnieją dowody na to, że niedobór testosteronu, jak również zaburzenia erekcji są oba niezależne biomarkery, ale niekoniecznie przyczyną chorób układu krążenia, a także dla wszystkich przyczyn sercowo-naczyniowych i śmiertelności [ </span><a href="https://uroweb.org/guideline/male-hypogonadism/#note_98" style="-webkit-font-smoothing: antialiased; -webkit-tap-highlight-color: rgb(0, 160, 227); background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">98</span></a><span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;"> ]. </span><span style="margin: 0px; padding: 0px;">Endogenne poziomy testosteronu w średnim zakresie normalnej, z najmniejszym ryzykiem zgonu [</span></span><a href="https://uroweb.org/guideline/male-hypogonadism/#note_61" style="-webkit-font-smoothing: antialiased; -webkit-tap-highlight-color: rgb(0, 160, 227); background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">61</span></a><span style="margin: 0px; padding: 0px;"> ].</span></div> <div class="bodytekst" style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; line-height: 18px; margin: 0px; outline: 0px; padding: 0px 0px 20px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">Dwa badania wykazały, że mężczyźni z poziomem testosteronu w górnego kwartyla normalnego zakresu mają zmniejszoną liczbę zdarzeń sercowo-naczyniowych w porównaniu do łącznych danych z dolnego kwartyla trzech [ </span><a href="https://uroweb.org/guideline/male-hypogonadism/#note_99" style="-webkit-font-smoothing: antialiased; -webkit-tap-highlight-color: rgb(0, 160, 227); background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">99</span></a><span style="margin: 0px; padding: 0px;"> ,</span><a href="https://uroweb.org/guideline/male-hypogonadism/#note_100" style="-webkit-font-smoothing: antialiased; -webkit-tap-highlight-color: rgb(0, 160, 227); background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">100</span></a><span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;"> ]. </span><span style="margin: 0px; padding: 0px;">Świadomość, że hipogonadyzm i zaburzenia erekcji są biomarkery choroby układu sercowo-naczyniowego pokazują, że pacjenci powinni być oceniane pod kątem czynników ryzyka chorób układu krążenia oraz w stosownych przypadkach, o których mowa kardiologii. </span><span style="margin: 0px; padding: 0px;">Poszczególne czynniki ryzyka sercowo-naczyniowego (np styl życia, dieta, ćwiczenia, palenie papierosów, nadciśnienie tętnicze, cukrzyca, dyslipidemii) powinny być leczone u mężczyzn z wcześniej istniejącą chorobą sercowo-naczyniową. </span><span style="margin: 0px; padding: 0px;">Ich prewencja wtórna powinna być zoptymalizowana, najlepiej jak to możliwe.</span></span></div> <div class="bodytekst" style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; line-height: 18px; margin: 0px; outline: 0px; padding: 0px 0px 20px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">TRT również w niektórych badaniach wykazano korzystny wpływ na pewne czynniki ryzyka sercowo-naczyniowego [</span><a href="https://uroweb.org/guideline/male-hypogonadism/#note_101" style="-webkit-font-smoothing: antialiased; -webkit-tap-highlight-color: rgb(0, 160, 227); background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">101</span></a><span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;"> ]. </span><span style="margin: 0px; padding: 0px;">U mężczyzn z angiograficznie potwierdzonej choroby wieńcowej tych z niskim testosteronem są na większe ryzyko zgonu [ </span></span><a href="https://uroweb.org/guideline/male-hypogonadism/#note_102" style="-webkit-font-smoothing: antialiased; -webkit-tap-highlight-color: rgb(0, 160, 227); background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">102</span></a><span style="margin: 0px; padding: 0px;"> , </span><a href="https://uroweb.org/guideline/male-hypogonadism/#note_103" style="-webkit-font-smoothing: antialiased; -webkit-tap-highlight-color: rgb(0, 160, 227); background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">103</span></a><span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;"> ]. </span><span style="margin: 0px; padding: 0px;">Przez wiele lat, od TRT był dostępny aż do niedawna nie było żadnych badań klinicznych w literaturze medycznej, które wykazały zaniepokojenie w odniesieniu do zwiększonego ryzyka wystąpienia poważnych zdarzeń sercowo-naczyniowych (MACE) Oprócz niewydolności serca [ </span></span><a href="https://uroweb.org/guideline/male-hypogonadism/#note_104" style="-webkit-font-smoothing: antialiased; -webkit-tap-highlight-color: rgb(0, 160, 227); background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">104</span></a><span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;"> ]. </span><span style="margin: 0px; padding: 0px;">MACE definiuje się jako zgon sercowo-naczyniowych, niezakończony zgonem ostrego zawału mięśnia sercowego, ostrego zespołu wieńcowego, niewydolności serca, udaru mózgu. </span><span style="margin: 0px; padding: 0px;">Jednak trzy ostatnie badania (jedno kontrolowane placebo [ </span></span><a href="https://uroweb.org/guideline/male-hypogonadism/#note_105" style="-webkit-font-smoothing: antialiased; -webkit-tap-highlight-color: rgb(0, 160, 227); background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">105</span></a><span style="margin: 0px; padding: 0px;"> ] i dwóch badaniach obserwacyjnych [ </span><a href="https://uroweb.org/guideline/male-hypogonadism/#note_106" style="-webkit-font-smoothing: antialiased; -webkit-tap-highlight-color: rgb(0, 160, 227); background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">106</span></a><span style="margin: 0px; padding: 0px;"> , </span><a href="https://uroweb.org/guideline/male-hypogonadism/#note_107" style="-webkit-font-smoothing: antialiased; -webkit-tap-highlight-color: rgb(0, 160, 227); background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">107</span></a><span style="margin: 0px; padding: 0px;"> ] sugerowali, że TRT może wiązać się ze zwiększonym ryzykiem wystąpienia zdarzeń sercowo-naczyniowych. Badania te zostały ostatnio zweryfikowane przez FDA, który stwierdził, że, "każde z tych badań miał poważne ograniczenia, co wyklucza możliwość wyciągnięcia ostatecznych wniosków" [ </span><a href="https://uroweb.org/guideline/male-hypogonadism/#note_108" style="-webkit-font-smoothing: antialiased; -webkit-tap-highlight-color: rgb(0, 160, 227); background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">108</span></a><span style="margin: 0px; padding: 0px;"> ]. Wyniki te są obsługiwane przez listów w odpowiedzi na papierze przez Vigen  </span><span class="bodytekstitalic" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: italic; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">i wsp.</span></span><span style="margin: 0px; padding: 0px;">  [ </span><a href="https://uroweb.org/guideline/male-hypogonadism/#note_109" style="-webkit-font-smoothing: antialiased; -webkit-tap-highlight-color: rgb(0, 160, 227); background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">109</span></a><span style="margin: 0px; padding: 0px;"> ].</span></div> <div class="bodytekst" style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; line-height: 18px; margin: 0px; outline: 0px; padding: 0px 0px 20px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;">Europejska Agencja Leków (EMA) stwierdził, zwanej dalej "Grupa Koordynacyjna wzajemnego uznawania i zdecentralizowanych procedur - Human (CMDh), organ regulacyjny reprezentujących państwa członkowskie UE, wyraziła zgodę na zasadzie konsensusu, że nie ma spójne dowody na zwiększone ryzyko problemy z sercem z lekami testosteronu u mężczyzn, którzy nie mają hormon (stan znany jako hipogonadyzmu). </span><span style="margin: 0px; padding: 0px;">Jednak informacje o produktach mogą być aktualizowane zgodnie z najbardziej aktualnych dostępnych danych na temat bezpieczeństwa i ostrzeżeń, że brak testosteronu powinny być potwierdzone przez oznak i objawów oraz badań laboratoryjnych przed rozpoczęciem leczenia mężczyzn z tymi lekami.</span></span></div> <div class="bodytekst" style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; line-height: 18px; margin: 0px; outline: 0px; padding: 0px 0px 20px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">Proces TOM (Basaria  </span><span class="bodytekstitalic" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: italic; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">et al.</span></span><span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;"> ) Stosuje się dawki testosteronu dwa razy, że zaleca się rozpoczynania leczenia, więc nie odzwierciedla normalną praktykę kliniczną, oprócz badania był słaby, aby wykryć zwiększone ryzyko wystąpienia zdarzeń sercowo-naczyniowych. </span><span style="margin: 0px; padding: 0px;">Niedawny obszerny i szczegółowy metaanalizy dostępnych ocenianych randomizowanych badaniach kontrolowanych placebo, stwierdzono, że dane nie wspierają rolę przyczynową między TRT i niekorzystnych zdarzeń sercowo-naczyniowych [ </span></span><a href="https://uroweb.org/guideline/male-hypogonadism/#note_58" style="-webkit-font-smoothing: antialiased; -webkit-tap-highlight-color: rgb(0, 160, 227); background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">58</span></a><span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;"> ]. </span><span style="margin: 0px; padding: 0px;">Istnieje jednak żadne długoterminowe badania lub badań z randomizacją (RCT), że dają ostatecznej odpowiedzi. </span><span style="margin: 0px; padding: 0px;">Badania obserwacyjne donoszą, że TRT poprawia przeżywalność w porównaniu do ludzi, którzy nie byli leczeni [ </span></span><a href="https://uroweb.org/guideline/male-hypogonadism/#note_56" style="-webkit-font-smoothing: antialiased; -webkit-tap-highlight-color: rgb(0, 160, 227); background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">56</span></a><span style="margin: 0px; padding: 0px;"> , </span><a href="https://uroweb.org/guideline/male-hypogonadism/#note_110" style="-webkit-font-smoothing: antialiased; -webkit-tap-highlight-color: rgb(0, 160, 227); background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">110</span></a><span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;"> ]. </span><span style="margin: 0px; padding: 0px;">Odkrycia te są obsługiwane przez dużą retrospektywną analizę 6,355 mężczyzn leczonych TRT w porównaniu do 19,065 osób postronnych, które nie wykazują zwiększonego ryzyka zawału serca z TRT [ </span></span><a href="https://uroweb.org/guideline/male-hypogonadism/#note_111" style="-webkit-font-smoothing: antialiased; -webkit-tap-highlight-color: rgb(0, 160, 227); background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">111</span></a><span style="margin: 0px; padding: 0px;"> ].</span></div> <div class="bodytekst" style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; line-height: 18px; margin: 0px; outline: 0px; padding: 0px 0px 20px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;">Ostrożnie należy jednak stosować u mężczyzn z wcześniej istniejącą chorobą sercowo-naczyniową. </span><span style="margin: 0px; padding: 0px;">Po pierwsze, musi być starannie hipogonadyzm zdiagnozowano ponad wszelką wątpliwość. </span><span style="margin: 0px; padding: 0px;">Po drugie, jeśli TRT jest przepisywana wtedy poziom testosteronu nie powinna przekraczać zakres średnich normalne i hematokryt nie powinien przekraczać 0,54. </span><span style="margin: 0px; padding: 0px;">Dostosowanie dawki testosteronu, może być konieczne i / lub venesection (500 ml), należy uwzględnić i powtórzono w razie potrzeby, jeśli wartość hematokrytu jest większa niż 0,54. </span><span style="margin: 0px; padding: 0px;">Wartość> 54 opiera się na zwiększone ryzyko śmiertelności sercowo-naczyniowej z Framingham Heart Study [ </span></span><a href="https://uroweb.org/guideline/male-hypogonadism/#note_112" style="-webkit-font-smoothing: antialiased; -webkit-tap-highlight-color: rgb(0, 160, 227); background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">112</span></a><span style="margin: 0px; padding: 0px;"> ], która została ostatnio potwierdzona w innym badaniu [ </span><a href="https://uroweb.org/guideline/male-hypogonadism/#note_113" style="-webkit-font-smoothing: antialiased; -webkit-tap-highlight-color: rgb(0, 160, 227); background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">113</span></a><span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;"> ]. </span><span style="margin: 0px; padding: 0px;">Wartość ta jest również obsługiwany przez znaną zwiększonym ryzykiem zakrzepicy wrodzoną stanie idiopatycznej erytropoezy [ </span></span><a href="https://uroweb.org/guideline/male-hypogonadism/#note_114" style="-webkit-font-smoothing: antialiased; -webkit-tap-highlight-color: rgb(0, 160, 227); background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">114</span></a><span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;"> ]. </span><span style="margin: 0px; padding: 0px;">Większość pacjentów z chorobami układu krążenia będzie otrzymywał terapii przeciwpłytkowej. </span><span style="margin: 0px; padding: 0px;">Elektrokardiogram przed TRT w ocenie hipogonadyzmu może być brane pod uwagę.</span></span></div> <div class="bodytekst" style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; line-height: 18px; margin: 0px; outline: 0px; padding: 0px 0px 20px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;">Żylna choroba zakrzepowo-zatorowa w jednym badaniu mężczyzn na TRT odnotowano 42 przypadków, z których 40 miało dowody na podstawowej trombofilii (także niedobór Czynnik V Leiden, mutacje protrombiny, homocystynuria), z czego 39 miało ich stan zdiagnozowano po zdarzeniu. </span><span style="margin: 0px; padding: 0px;">Wysokie endogenne poziomy testosteronu i / lub estradiolu nie są związane ze zwiększonym ryzykiem zakrzepicy żylnej [ </span></span><a href="https://uroweb.org/guideline/male-hypogonadism/#note_115" style="-webkit-font-smoothing: antialiased; -webkit-tap-highlight-color: rgb(0, 160, 227); background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">115</span></a><span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;"> ]. </span><span style="margin: 0px; padding: 0px;">TRT jest przeciwwskazane u mężczyzn z ciężką przewlekłą niewydolnością serca jak retencja płynów może prowadzić do zaostrzenia choroby. </span><span style="margin: 0px; padding: 0px;">Niektóre badania w tym jeden 12 miesięcy trwania wykazały, że mężczyźni z umiarkowaną przewlekłą niewydolnością serca (NYHA klasa III) mogą korzystać z niskimi dawkami testosteronu, które osiągają w połowie normalny poziom testosteronu Zakres [ </span></span><a href="https://uroweb.org/guideline/male-hypogonadism/#note_48" style="-webkit-font-smoothing: antialiased; -webkit-tap-highlight-color: rgb(0, 160, 227); background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">48</span></a><span style="margin: 0px; padding: 0px;"> ,</span><a href="https://uroweb.org/guideline/male-hypogonadism/#note_116" style="-webkit-font-smoothing: antialiased; -webkit-tap-highlight-color: rgb(0, 160, 227); background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">116</span></a><span style="margin: 0px; padding: 0px;"> , </span><a href="https://uroweb.org/guideline/male-hypogonadism/#note_117" style="-webkit-font-smoothing: antialiased; -webkit-tap-highlight-color: rgb(0, 160, 227); background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">117</span></a><span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;"> ]. </span><span style="margin: 0px; padding: 0px;">Jeśli zostanie podjęta decyzja o leczeniu hipogonadyzmu u mężczyzn z przewlekłą niewydolnością serca, istotne jest, że pacjent jest przestrzegane, z oceną kliniczną i pomiary testosteronu i hematokryt, w regularnych odstępach czasu.</span></span></div> <h3 style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; font-style: italic; font-weight: 400; line-height: 30px; margin: 0px 0px 0px 80px; outline: 0px; padding: 0px; position: relative; text-rendering: optimizeLegibility; vertical-align: baseline;"> <span class="kop3_bolditalic" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: 700; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><a href="https://www.blogger.com/null" name="5_6_4" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"></a><span class="list" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; display: inline-block; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: 400; line-height: inherit; margin: 0px 0px 0px -80px; outline: 0px; padding: 0px; vertical-align: baseline; width: 80px;"><span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;">5.6.4.</span></span></span><span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;"> Obturacyjny bezdech senny</span></span></span></h3> <div class="bodytekst" style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; line-height: 18px; margin: 0px; outline: 0px; padding: 0px 0px 20px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;">Nie ma dowodów na korelację TRT zgodne z obturacyjnego bezdechu sennego (OSA). </span><span style="margin: 0px; padding: 0px;">Nie ma również dowody, że TRT może prowadzić do wystąpienia lub pogorszenia stanu [ </span></span><a href="https://uroweb.org/guideline/male-hypogonadism/#note_118" style="-webkit-font-smoothing: antialiased; -webkit-tap-highlight-color: rgb(0, 160, 227); background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">118</span></a><span style="margin: 0px; padding: 0px;"> ].</span></div> <div class="kop2_witregel" style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; line-height: 18px; margin: 0px; outline: 0px; padding: 0px 0px 20px; vertical-align: baseline;"> <a href="https://www.blogger.com/null" name="5_7" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"></a><span class="list" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">5.7.</span></span><span style="margin: 0px; padding: 0px;"> Podsumowanie dowodów i zaleceń dotyczących czynników ryzyka leczenia zastępczego testosteronem (TRT)</span></div> <table class="tabel_zwart-wit" style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border-collapse: collapse; border-spacing: 0px; border: 1px solid rgb(102, 102, 102); box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; line-height: 18px; margin: 0px 0px 20px; max-width: 100%; outline: 0px; padding: 0px; table-layout: auto; vertical-align: baseline; width: 693px;"><thead style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <tr style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><th class="Celstijl_1" style="-webkit-font-smoothing: antialiased; background: rgb(240, 240, 240); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 1.2rem; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: 500; line-height: 1.4667rem; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="93%"><div class="tabel_bodytekstbold_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: 16px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: 700; line-height: 18px; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">Podsumowanie dowodów</span></div> </th><th class="Celstijl_1" style="-webkit-font-smoothing: antialiased; background: rgb(240, 240, 240); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 1.2rem; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: 500; line-height: 1.4667rem; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="7%"><div class="tabel_bodytekstbold_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: 16px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: 700; line-height: 18px; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">LE</span></div> </th></tr> </thead><tbody style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <tr style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><td class="Celstijl_1" style="-webkit-font-smoothing: antialiased; background: rgb(255, 255, 255); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="93%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">Opisy przypadków i małych badań kohortowych wskazują na możliwą korelację pomiędzy TRT i wystąpienia raka piersi, ale nie ma jak na razie brak mocnych dowodów na ten związek.</span></div> </td><td class="Celstijl_1" style="-webkit-font-smoothing: antialiased; background: rgb(255, 255, 255); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="7%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">3</span></div> </td></tr> <tr style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><td class="Celstijl_1" style="-webkit-font-smoothing: antialiased; background: rgb(255, 255, 255); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="93%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">Randomizowane kontrolowane badania potwierdzają hipotezę, że TRT nie doprowadzić do zmian w histologii stercza.</span></div> </td><td class="Celstijl_1" style="-webkit-font-smoothing: antialiased; background: rgb(255, 255, 255); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="7%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">1b</span></div> </td></tr> <tr style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><td class="Celstijl_1" style="-webkit-font-smoothing: antialiased; background: rgb(255, 255, 255); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="93%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">Ostatnie badania wskazują, że terapia testosteronem nie zwiększa ryzyka zachorowania na raka prostaty, ale długoterminowych danych follow-up nie są jeszcze dostępne.</span></div> </td><td class="Celstijl_1" style="-webkit-font-smoothing: antialiased; background: rgb(255, 255, 255); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="7%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">3</span></div> </td></tr> <tr style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><td class="Celstijl_1" style="-webkit-font-smoothing: antialiased; background: rgb(255, 255, 255); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="93%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">Nie ma dowodów na związek pomiędzy TRT i obturacyjny bezdech senny.</span></div> </td><td class="Celstijl_1" style="-webkit-font-smoothing: antialiased; background: rgb(255, 255, 255); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="7%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">3</span></div> </td></tr> <tr style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><td class="Celstijl_1" style="-webkit-font-smoothing: antialiased; background: rgb(255, 255, 255); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="93%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">Nie ma żadnego faktycznego dowodu, że TRT, gdy otrzymuje się w normalnym zakresie fizjologicznym, jest odpowiednia do rozwoju poważnych zdarzeń sercowo-naczyniowych.</span></div> </td><td class="Celstijl_1" style="-webkit-font-smoothing: antialiased; background: rgb(255, 255, 255); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="7%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">1a</span></div> </td></tr> <tr style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><td class="Celstijl_1" style="-webkit-font-smoothing: antialiased; background: rgb(255, 255, 255); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="93%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">W hipogonadyzmem TRT wykazano, aby mieć pozytywny wpływ na ryzyko sercowo-naczyniowych [ </span><a href="https://uroweb.org/guideline/male-hypogonadism/#note_58" style="-webkit-font-smoothing: antialiased; -webkit-tap-highlight-color: rgb(0, 160, 227); background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">58</span></a><span style="margin: 0px; padding: 0px;"> ].</span></div> </td><td class="Celstijl_1" style="-webkit-font-smoothing: antialiased; background: rgb(255, 255, 255); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="7%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">1b</span></div> </td></tr> </tbody></table> <table class="tabel_blauw" style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border-collapse: collapse; border-spacing: 0px; border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; line-height: 18px; margin: 0px 0px 20px; max-width: 100%; outline: 0px; padding: 0px; table-layout: auto; vertical-align: baseline; width: 693px;"><thead style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <tr style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><th class="Celstijl_1_tint_PMS" style="-webkit-font-smoothing: antialiased; background: rgb(197, 218, 241); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 1.2rem; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: 500; line-height: 1.4667rem; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="87%"><div class="tabel_bodytekstbold_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: 16px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: 700; line-height: 18px; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">zalecenia</span></div> </th><th class="Celstijl_1_tint_PMS" style="-webkit-font-smoothing: antialiased; background: rgb(197, 218, 241); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 1.2rem; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: 500; line-height: 1.4667rem; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="7%"><div class="tabel_bodytekstbold_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: 16px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: 700; line-height: 18px; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">LE</span></div> </th><th class="Celstijl_1_tint_PMS" style="-webkit-font-smoothing: antialiased; background: rgb(197, 218, 241); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 1.2rem; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: 500; line-height: 1.4667rem; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="7%"><div class="tabel_bodytekstbold_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: 16px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: 700; line-height: 18px; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">GR</span></div> </th></tr> </thead><tbody style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <tr style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><td class="Celstijl_1_tint_PMS" style="-webkit-font-smoothing: antialiased; background: rgb(197, 218, 241); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="87%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">Wykonaj hematologicznej, układu krążenia, piersi i prostaty oceny przed rozpoczęciem leczenia.</span></div> </td><td class="Celstijl_1_tint_PMS" style="-webkit-font-smoothing: antialiased; background: rgb(197, 218, 241); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="7%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">1a</span></div> </td><td class="Celstijl_1_tint_PMS" style="-webkit-font-smoothing: antialiased; background: rgb(197, 218, 241); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="7%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">ZA</span></div> </td></tr> <tr style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><td class="Celstijl_1_tint_PMS" style="-webkit-font-smoothing: antialiased; background: rgb(197, 218, 241); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="87%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">Monitorowanie hematokrytu, hemoglobiny i PSA w trakcie terapii TRT.</span></div> </td><td class="Celstijl_1_tint_PMS" style="-webkit-font-smoothing: antialiased; background: rgb(197, 218, 241); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="7%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">3</span></div> </td><td class="Celstijl_1_tint_PMS" style="-webkit-font-smoothing: antialiased; background: rgb(197, 218, 241); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="7%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">ZA</span></div> </td></tr> <tr style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><td class="Celstijl_1_tint_PMS" style="-webkit-font-smoothing: antialiased; background: rgb(197, 218, 241); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="87%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">Oferta TRT ostrożnie u objawowych mężczyzn hipogonadyzmem, którzy zostali operowanych zlokalizowane raka gruczołu krokowego, a którzy są obecnie bez cech aktywnej choroby (tj mierzalne PSA, nieprawidłowe badanie odbytnicy, dowód kości / przerzutów do narządów trzewnych): Leczenie powinno być ograniczone do tych chorych niskie ryzyko nawrotu raka prostaty (tj Gleasona <8 1="" etapem="" font="" i="" ml="" ng="" nie="" obserwacji.="" patologiczne="" powinno="" przed="" przedoperacyjna="" psa="" pt1-2="" roku="" rozpocz="" si=""></8></span></div> </td><td class="Celstijl_1_tint_PMS" style="-webkit-font-smoothing: antialiased; background: rgb(197, 218, 241); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="7%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">3</span></div> </td><td class="Celstijl_1_tint_PMS" style="-webkit-font-smoothing: antialiased; background: rgb(197, 218, 241); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="7%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">b</span></div> </td></tr> <tr style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><td class="Celstijl_1_tint_PMS" style="-webkit-font-smoothing: antialiased; background: rgb(197, 218, 241); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="87%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">Ocenić czynniki ryzyka sercowo-naczyniowego przed rozpoczęciem TRT i optymalizacji wtórnej profilaktyki u mężczyzn z istniejącymi wcześniej chorobami układu krążenia.</span></div> </td><td class="Celstijl_1_tint_PMS" style="-webkit-font-smoothing: antialiased; background: rgb(197, 218, 241); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="7%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">1a</span></div> </td><td class="Celstijl_1_tint_PMS" style="-webkit-font-smoothing: antialiased; background: rgb(197, 218, 241); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="7%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">ZA</span></div> </td></tr> <tr style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><td class="Celstijl_1_tint_PMS" style="-webkit-font-smoothing: antialiased; background: rgb(197, 218, 241); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="87%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">Traktuj ludzi z hipogonadyzmu i albo wcześniej istniejącej choroby układu krążenia, zakrzepicy żylnej lub przewlekłą niewydolnością serca, którzy wymagają TRT ostrożnie kontrolując starannie oceny klinicznej, hematokryt (nieprzekraczającą 0,54) i poziom testosteronu utrzymuje się najlepiej jak to możliwe pod względem wieku w obrębie połowy normalnej Zakres zdrowe.</span></div> </td><td class="Celstijl_1_tint_PMS" style="-webkit-font-smoothing: antialiased; background: rgb(197, 218, 241); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="7%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">1b</span></div> </td><td class="Celstijl_1_tint_PMS" style="-webkit-font-smoothing: antialiased; background: rgb(197, 218, 241); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="7%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">ZA</span></div> </td></tr> </tbody></table> <div class="bodytekst_italic_onder_tabel_1e_regel" style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; font-style: italic; line-height: 18px; margin: -15px 0px 0px; outline: 0px; padding: 0px 0px 20px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;">PSA = swoistego antygenu sterczowego; </span><span style="margin: 0px; padding: 0px;">TRT = terapię zastępczą testosteronem.</span></span></div> <div class="bodytekst_italic_onder_tabel_1e_regel" style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; font-style: italic; line-height: 18px; margin: -15px 0px 0px; outline: 0px; padding: 0px 0px 20px; vertical-align: baseline;"> <br style="margin: 0px; padding: 0px;" /></div> <h1 style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 30px; font-stretch: inherit; font-weight: 500; line-height: 30px; margin: 0px 0px 20px 80px; outline: 0px; padding: 0px; position: relative; text-rendering: optimizeLegibility; vertical-align: baseline;"> <span class="list" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; display: inline-block; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px 0px 0px -80px; outline: 0px; padding: 0px; vertical-align: baseline; width: 80px;"><span style="margin: 0px; padding: 0px;">6.</span></span><span style="margin: 0px; padding: 0px;"> DALSZE DZIAŁANIA</span></h1> <h2 style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 17px; font-stretch: inherit; font-weight: 500; line-height: 20px; margin: 0px 0px 0px 80px; outline: 0px; padding: 0px; position: relative; text-rendering: optimizeLegibility; vertical-align: baseline;"> <span style="border: 0px; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; padding: 0px; vertical-align: baseline;"><a href="https://www.blogger.com/null" name="6_1" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"></a><span class="list" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; display: inline-block; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px 0px 0px -80px; outline: 0px; padding: 0px; vertical-align: baseline; width: 80px;"><span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;">6.1.</span></span></span><span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;"> Monitorowanie pacjentów otrzymujących terapię zastępczą testosteronem</span></span></span></h2> <div class="bodytekst" style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; line-height: 18px; margin: 0px; outline: 0px; padding: 0px 0px 20px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;">Regularne obserwacji jest konieczne u pacjentów otrzymujących terapię testosteronem, które mogą wystąpić objawy potencjalnie zależnych od androgenów i warunki w wyniku TRT. </span><span style="margin: 0px; padding: 0px;">Uboczne skutki TRT są ograniczone, ale ich występowania i znaczenie kliniczne nie jest jeszcze jasne. </span><span style="margin: 0px; padding: 0px;">Głównym celem jest Trt złagodzenia objawów klinicznych niedoboru testosteronu. </span><span style="margin: 0px; padding: 0px;">Staranne monitorowanie zmian klinicznych objawów niedoboru testosteronu powinny być istotną częścią każdej wizyty kontrolnej. </span><span style="margin: 0px; padding: 0px;">Skutki TRT na zainteresowania seksualnego może już pojawić się po trzech tygodniach leczenia i osiągają plateau na sześć tygodni [ </span></span><a href="https://uroweb.org/guideline/male-hypogonadism/#note_49" style="-webkit-font-smoothing: antialiased; -webkit-tap-highlight-color: rgb(0, 160, 227); background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">49</span></a><span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;"> ]. </span><span style="margin: 0px; padding: 0px;">Zmiany w erekcji i ejakulacji może wymagać maksymalnie sześciu miesięcy [ </span></span><a href="https://uroweb.org/guideline/male-hypogonadism/#note_49" style="-webkit-font-smoothing: antialiased; -webkit-tap-highlight-color: rgb(0, 160, 227); background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">49</span></a><span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;"> ]. </span><span style="margin: 0px; padding: 0px;">Wpływ na jakość życia, a także na depresyjnego nastroju, może być wykrywalne w ciągu jednego miesiąca, ale maksymalny efekt może trwać dłużej [ </span></span><a href="https://uroweb.org/guideline/male-hypogonadism/#note_49" style="-webkit-font-smoothing: antialiased; -webkit-tap-highlight-color: rgb(0, 160, 227); background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">49</span></a><span style="margin: 0px; padding: 0px;"> ].</span></div> <h2 style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 17px; font-stretch: inherit; font-weight: 500; line-height: 20px; margin: 0px 0px 0px 80px; outline: 0px; padding: 0px; position: relative; text-rendering: optimizeLegibility; vertical-align: baseline;"> <span style="border: 0px; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; padding: 0px; vertical-align: baseline;"><a href="https://www.blogger.com/null" name="6_2" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"></a><span class="list" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; display: inline-block; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px 0px 0px -80px; outline: 0px; padding: 0px; vertical-align: baseline; width: 80px;"><span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;">6.2.</span></span></span><span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;"> Poziom testosteronu</span></span></span></h2> <div class="bodytekst" style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; line-height: 18px; margin: 0px; outline: 0px; padding: 0px 0px 20px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;">Nie ma jeszcze wystarczających danych, aby zdefiniować optymalny poziom testosteronu w surowicy podczas TRT.</span><span style="margin: 0px; padding: 0px;">Ekspertyza sugeruje, że TRT należy przywrócić poziom testosteronu w surowicy do połowy normalnego zakresu określonych grup wiekowych mężczyzn, która jest zazwyczaj wystarczająca do złagodzenia różnorodnych objawów niedoboru hormonu. </span><span style="margin: 0px; padding: 0px;">Optymalny harmonogram monitorowania poziomu testosteronu w surowicy, jest również zależne od formulacji TRT używany. </span><span style="margin: 0px; padding: 0px;">Ma to znaczenie dla oceny objawów regresji i brak odpowiedzi skłania zakończeniu leczenia i ewentualnej ponownej diagnozy.</span></span></div> <h2 style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 17px; font-stretch: inherit; font-weight: 500; line-height: 20px; margin: 0px 0px 0px 80px; outline: 0px; padding: 0px; position: relative; text-rendering: optimizeLegibility; vertical-align: baseline;"> <span style="border: 0px; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; padding: 0px; vertical-align: baseline;"><a href="https://www.blogger.com/null" name="6_3" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"></a><span class="list" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; display: inline-block; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px 0px 0px -80px; outline: 0px; padding: 0px; vertical-align: baseline; width: 80px;"><span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;">6.3.</span></span></span><span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;"> Gęstość kości</span></span></span></h2> <div class="bodytekst" style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; line-height: 18px; margin: 0px; outline: 0px; padding: 0px 0px 20px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;">Gęstość mineralna kości (BMD) powinna być monitorowana tylko u mężczyzn, których BMD było nienormalne przed rozpoczęciem TRT. </span><span style="margin: 0px; padding: 0px;">Wzrost BMD lędźwiowego odcinka kręgosłupa mogą być wykrywalne już po sześciu miesiącach TRT i może trwać jeszcze przez trzy lata [ </span></span><a href="https://uroweb.org/guideline/male-hypogonadism/#note_49" style="-webkit-font-smoothing: antialiased; -webkit-tap-highlight-color: rgb(0, 160, 227); background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">49</span></a><span style="margin: 0px; padding: 0px;"> ].</span></div> <h2 style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 17px; font-stretch: inherit; font-weight: 500; line-height: 20px; margin: 0px 0px 0px 80px; outline: 0px; padding: 0px; position: relative; text-rendering: optimizeLegibility; vertical-align: baseline;"> <span style="border: 0px; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; padding: 0px; vertical-align: baseline;"><a href="https://www.blogger.com/null" name="6_4" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"></a><span class="list" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; display: inline-block; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px 0px 0px -80px; outline: 0px; padding: 0px; vertical-align: baseline; width: 80px;"><span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;">6.4.</span></span></span><span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;"> Hematokryt</span></span></span></h2> <div class="bodytekst" style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; line-height: 18px; margin: 0px; outline: 0px; padding: 0px 0px 20px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">Ważne jest, aby używać tylko minimalny lub żaden żylnego okluzji podczas pobierania próbki krwi do pomiarów hematokrytu [ </span><a href="https://uroweb.org/guideline/male-hypogonadism/#note_114" style="-webkit-font-smoothing: antialiased; -webkit-tap-highlight-color: rgb(0, 160, 227); background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">114</span></a><span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;"> ]. </span><span style="margin: 0px; padding: 0px;">Podwyższone wartości hematokrytu jest najczęstszym skutkiem ubocznym TRT. </span><span style="margin: 0px; padding: 0px;">Znaczenie kliniczne z wysokim poziomem hematokrytu jest niejasna, ale może to być związane z nadmierną lepkością i zakrzepicy [ </span></span><a href="https://uroweb.org/guideline/male-hypogonadism/#note_115" style="-webkit-font-smoothing: antialiased; -webkit-tap-highlight-color: rgb(0, 160, 227); background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">115</span></a><span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;"> ]. </span><span style="margin: 0px; padding: 0px;">Efekt erytropoezy mogą stać się widoczne na trzy miesiące i pikami przy dwunastu miesięcy [ </span></span><a href="https://uroweb.org/guideline/male-hypogonadism/#note_49" style="-webkit-font-smoothing: antialiased; -webkit-tap-highlight-color: rgb(0, 160, 227); background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">49</span></a><span style="margin: 0px; padding: 0px;"> ].</span></div> <h2 style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 17px; font-stretch: inherit; font-weight: 500; line-height: 20px; margin: 0px 0px 0px 80px; outline: 0px; padding: 0px; position: relative; text-rendering: optimizeLegibility; vertical-align: baseline;"> <span style="border: 0px; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; padding: 0px; vertical-align: baseline;"><a href="https://www.blogger.com/null" name="6_5" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"></a><span class="list" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; display: inline-block; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px 0px 0px -80px; outline: 0px; padding: 0px; vertical-align: baseline; width: 80px;"><span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;">6.5.</span></span></span><span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;"> Bezpieczeństwo prostaty</span></span></span></h2> <div class="bodytekst" style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; line-height: 18px; margin: 0px; outline: 0px; padding: 0px 0px 20px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">TRT powoduje marginalny wzrost PSA oraz objętości gruczołu krokowego, plateau na 12 miesięcy [ </span><a href="https://uroweb.org/guideline/male-hypogonadism/#note_49" style="-webkit-font-smoothing: antialiased; -webkit-tap-highlight-color: rgb(0, 160, 227); background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">49</span></a><span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;"> ]. </span><span style="margin: 0px; padding: 0px;">Poprzednich TRT obawy, że może zwiększać ryzyko wystąpienia raka prostaty były sprzeczne z szeregu meta-analizach [ </span></span><a href="https://uroweb.org/guideline/male-hypogonadism/#note_70" style="-webkit-font-smoothing: antialiased; -webkit-tap-highlight-color: rgb(0, 160, 227); background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">70</span></a><span style="margin: 0px; padding: 0px;"> , </span><a href="https://uroweb.org/guideline/male-hypogonadism/#note_88" style="-webkit-font-smoothing: antialiased; -webkit-tap-highlight-color: rgb(0, 160, 227); background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">88</span></a><span style="margin: 0px; padding: 0px;"> ,</span><a href="https://uroweb.org/guideline/male-hypogonadism/#note_89" style="-webkit-font-smoothing: antialiased; -webkit-tap-highlight-color: rgb(0, 160, 227); background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">89</span></a><span style="margin: 0px; padding: 0px;"> , </span><a href="https://uroweb.org/guideline/male-hypogonadism/#note_91" style="-webkit-font-smoothing: antialiased; -webkit-tap-highlight-color: rgb(0, 160, 227); background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">91</span></a><span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;"> ]. </span><span style="margin: 0px; padding: 0px;">Jednak nie ma wystarczających danych długoterminowe dostępne do wniosku, że nie ma bezpieczeństwa na raka stercza z TRT. </span><span style="margin: 0px; padding: 0px;">Dlatego monitorowanie prostaty pozostaje wskazane. </span><span style="margin: 0px; padding: 0px;">Obiekty o znacznej lub ciągłego wzrostu poziomu PSA muszą zostać zbadane, aby wykluczyć raka prostaty.</span></span></div> <h2 style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 17px; font-stretch: inherit; font-weight: 500; line-height: 20px; margin: 0px 0px 0px 80px; outline: 0px; padding: 0px; position: relative; text-rendering: optimizeLegibility; vertical-align: baseline;"> <span style="border: 0px; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; padding: 0px; vertical-align: baseline;"><a href="https://www.blogger.com/null" name="6_6" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"></a><span class="list" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; display: inline-block; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px 0px 0px -80px; outline: 0px; padding: 0px; vertical-align: baseline; width: 80px;"><span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;">6.6.</span></span></span><span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;"> Monitorowanie układu krążenia</span></span></span></h2> <div class="bodytekst" style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; line-height: 18px; margin: 0px; outline: 0px; padding: 0px 0px 20px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;">Należy zachować ostrożność u mężczyzn z współistniejącą chorobą sercowo-naczyniową. </span><span style="margin: 0px; padding: 0px;">U mężczyzn cierpiących na przewlekłą niewydolność serca TRT może spowodować zatrzymania płynów i nasilenie stanu [ </span></span><a href="https://uroweb.org/guideline/male-hypogonadism/#note_116" style="-webkit-font-smoothing: antialiased; -webkit-tap-highlight-color: rgb(0, 160, 227); background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">116</span></a><span style="margin: 0px; padding: 0px;"> , </span><a href="https://uroweb.org/guideline/male-hypogonadism/#note_117" style="-webkit-font-smoothing: antialiased; -webkit-tap-highlight-color: rgb(0, 160, 227); background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">117</span></a><span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;"> ]. </span><span style="margin: 0px; padding: 0px;">Jeśli zostanie podjęta decyzja o leczeniu hipogonadyzmu u mężczyzn z przewlekłymi chorobami serca, istotne jest, że pacjent jest przestrzegane, z oceną kliniczną i pomiary testosteronu i hematokryt, w regularnych odstępach czasu.</span></span></div> <div class="kop2_witregel" style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; line-height: 18px; margin: 0px; outline: 0px; padding: 0px 0px 20px; vertical-align: baseline;"> <a href="https://www.blogger.com/null" name="6_7" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"></a><span class="list" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">6.7.</span></span><span style="margin: 0px; padding: 0px;"> Zalecenia dotyczące obserwacji</span></div> <table class="tabel_blauw" style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border-collapse: collapse; border-spacing: 0px; border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; line-height: 18px; margin: 0px 0px 20px; max-width: 100%; outline: 0px; padding: 0px; table-layout: auto; vertical-align: baseline; width: 693px;"><thead style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <tr style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><th class="Celstijl_1_tint_PMS" style="-webkit-font-smoothing: antialiased; background: rgb(197, 218, 241); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 1.2rem; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: 500; line-height: 1.4667rem; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="87%"><div class="tabel_bodytekstbold_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: 16px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: 700; line-height: 18px; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">zalecenia</span></div> </th><th class="Celstijl_1_tint_PMS" style="-webkit-font-smoothing: antialiased; background: rgb(197, 218, 241); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 1.2rem; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: 500; line-height: 1.4667rem; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="7%"><div class="tabel_bodytekstbold_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: 16px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: 700; line-height: 18px; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">LE</span></div> </th><th class="Celstijl_1_tint_PMS" style="-webkit-font-smoothing: antialiased; background: rgb(197, 218, 241); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 1.2rem; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: 500; line-height: 1.4667rem; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="7%"><div class="tabel_bodytekstbold_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: 16px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: 700; line-height: 18px; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">GR</span></div> </th></tr> </thead><tbody style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <tr style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><td class="Celstijl_1_tint_PMS" style="-webkit-font-smoothing: antialiased; background: rgb(197, 218, 241); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="87%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">Ocenić odpowiedź na leczenie w trzech, sześciu i dwunastu miesięcy po rozpoczęciu leczenia, a następnie co rok.</span></div> </td><td class="Celstijl_1_tint_PMS" style="-webkit-font-smoothing: antialiased; background: rgb(197, 218, 241); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="7%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> 4</div> </td><td class="Celstijl_1_tint_PMS" style="-webkit-font-smoothing: antialiased; background: rgb(197, 218, 241); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="7%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">do</span></div> </td></tr> <tr style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><td class="Celstijl_1_tint_PMS" style="-webkit-font-smoothing: antialiased; background: rgb(197, 218, 241); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="87%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;">Monitorowanie hematokrytu w trzech, sześciu i dwunastu miesięcy a następnie co rok. </span><span style="margin: 0px; padding: 0px;">Zmniejszenie dawki testosteronu lub przełączyć preparat testosteronu pozajelitowego miejscowego lub venesection jeśli hematokryt wynosi powyżej 0,54. </span><span style="margin: 0px; padding: 0px;">Jeśli pozostaje podwyższony hematokryt, stop testosteronu i przywrócić w mniejszej dawce raz hematokryt unormowała.</span></span></div> </td><td class="Celstijl_1_tint_PMS" style="-webkit-font-smoothing: antialiased; background: rgb(197, 218, 241); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="7%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">4</span></div> </td><td class="Celstijl_1_tint_PMS" style="-webkit-font-smoothing: antialiased; background: rgb(197, 218, 241); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="7%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">do</span></div> </td></tr> <tr style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><td class="Celstijl_1_tint_PMS" style="-webkit-font-smoothing: antialiased; background: rgb(197, 218, 241); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="87%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;">Ocenić zdrowia prostaty poprzez badanie palpacyjne i PSA przed rozpoczęciem TRT. </span><span style="margin: 0px; padding: 0px;">Działania podjęte przez PSA w trzech, sześciu i dwunastu miesięcy a następnie co rok.</span></span></div> </td><td class="Celstijl_1_tint_PMS" style="-webkit-font-smoothing: antialiased; background: rgb(197, 218, 241); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="7%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">4</span></div> </td><td class="Celstijl_1_tint_PMS" style="-webkit-font-smoothing: antialiased; background: rgb(197, 218, 241); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="7%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">do</span></div> </td></tr> <tr style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><td class="Celstijl_1_tint_PMS" style="-webkit-font-smoothing: antialiased; background: rgb(197, 218, 241); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="87%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">Ocenić mężczyzn z chorobami układu sercowo-naczyniowego na objawy sercowo-naczyniowe przed TRT jest inicjowana i kontynuować ścisłą ocenę kliniczną podczas TRT.</span></div> </td><td class="Celstijl_1_tint_PMS" style="-webkit-font-smoothing: antialiased; background: rgb(197, 218, 241); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="7%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">1b</span></div> </td><td class="Celstijl_1_tint_PMS" style="-webkit-font-smoothing: antialiased; background: rgb(197, 218, 241); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="7%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">ZA</span></div> </td></tr> </tbody></table> <div class="bodytekst_italic_onder_tabel_1e_regel" style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; font-style: italic; line-height: 18px; margin: -15px 0px 0px; outline: 0px; padding: 0px 0px 20px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;">BMD = gęstość mineralna kości; </span><span style="margin: 0px; padding: 0px;">PSA = swoistego antygenu sterczowego; </span><span style="margin: 0px; padding: 0px;">TRT = terapię zastępczą testosteronem.</span></span></div>

HIPOGONADYZM MĘSKI - WYTYCZNE EUROPEJSKIEGO TOWARZYSTWA UROLOGICZNEGO (2/2)

5.  ZARZĄDZANIE CHOROBA 5.1.  Wskazania i przeciwwskazania do leczenia Leczenie Testosteron ma na celu przywrócenie poziomu testoster...

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