Z Medi Clinics and Z Medi Spa
-

Consent male testosterone pellet implantation

General:

Testosterone pellet implantation has been used for androgen replacement since 1940. The Bio-identical hormone pellets are comprised of concentrated naturally derived hormones. These hormones are designed to be biologically identical to the hormones produced by the male body.

On average, testosterone pellets deliver testosterone consistently for four to six months depending on the patient. Therefore, they are implanted at 4–6-month intervals.

 

Benefits:

The bioavailability of testosterone from the pellets is virtually complete. The potential benefits of testosterone include a possible increase in bone density, short term memory, energy, muscle mass, libido and sense of well-being. Additionally, it may decrease the frequency and severity of headaches and offer protection against Alzheimer’s and Parkinson’s disease.  

There is no first pass hepatic inactivation and no change in clotting factors. Current pellets are well standardized and release testosterone at a consistent rate which minimizes swings in plasma testosterone levels seen with injections and other forms of testosterone therapy. This is beneficial as it decreases the frequency of commonly seen effects of testosterone such as increased blood counts and increased amounts of estrogen.  It is also suitable for patients who do not absorb the topical creams and gels and who do not like the frequent dosing and fluctuations of sublingual lozenges (troches).

 

Pre pellet insertion:

Laboratory evaluation including the measurement of various hormone levels will be obtained prior to consultation with the provider.  During the consultation, the medical provider will review the medical history to determine if the patient is a candidate for hormone pellet therapy.  If appropriate, the dose of testosterone hormone will be determined by the medical provider based on several factors including symptoms, laboratory evaluation and body weight.  Laboratory evaluation will be required periodically and at various intervals determined by the provider.

 

You must notify the medical provider of any of the following prior to scheduling the procedure:

  • allergy to latex

  • allergy to epinephrine

  • allergy to anesthetic medications such as Lidocaine

  • congenital or acquired conditions associated with increased bleeding

  • use of blood thinning/anti-coagulant (Coumadin, Plavix) or aspirin therapy (These medications may need to be stopped a few days prior to your procedure. Never discontinue use of these medications without first consulting your medical provider.

 

Antibiotics (Keflex or Doxycycline) may be given prior to the procedure if you are diabetic or have had a joint replacement. Additional antibiotics may be given following the procedure if deemed necessary by the medical provider.

 

Pellet insertion:

You may drive yourself to and from the procedure.  This is performed by a medical provider as an outpatient office procedure using sterile technique. An injection of a local anesthetic consisting of 1% lidocaine with or without epinephrine is used to numb the area. Once the area has been sufficiently numbed, a small incision is made in the skin most commonly in the upper buttock region or the lower abdomen wall. A small pellet or pellets, approximately the size of a grain of rice are inserted beneath the skin, into the fatty tissue. The procedure takes approximately 10 minutes and is associated with minimal discomfort. There may be minimal discomfort following the procedure.

 

Post pellet insertion:

Instructions on the post pellet insertion sheet must be followed to avoid possible risks and/or minimize discomfort. 

 

Tylenol can be used for minor pain alleviation. All anti-inflammatory medications including ibuprofen (Advil, Motrin), Aspirin, Naprosyn (Aleve) and any other prescription anti-inflammatories should be avoided for 2 -3 days due to increased risk of bleeding.

  

Sitting in any standing water such as in a pool, bathtub, hot tub, jacuzzi or sauna and all vigorous physical activity (especially lunges, squats, walking or running at an incline) should be avoided for 7 days following the insertion of the pellets.

 

 A ‘booster’ insertion of hormone pellets may be recommended after the initial pellet insertion based on lab results and symptoms.

 

Risks and Contraindications:

Testosterone hormone treatment is not to be used in patients with known history of prostate cancer.  Strong family history of prostate cancer should be reported to medical provider prior to initiation of any form of testosterone therapy, including but not limited to testosterone pellet insertion. Although Testosterone is not known to cause prostate cancer, it may stimulate growth of the prostate and therefore can cause growth of underlying, and possibly undiagnosed, prostate cancer.  For this reason, laboratory evaluation of the prostate specific antigen (PSA) level will need to be checked prior to initiation of testosterone therapy and at periodic and regular intervals to be determined by the medical provider.  If there is any concern about prostate cancer and/or the PSA level is found to be elevated, you will require further evaluation by a urologist.  In this case, pellets may be placed only after clearance by a urologist.  You should familiarize yourself with the information on ‘Prostate Protection’.

 

Testosterone may lead to an increase in the production of red blood cells (which is a normal function of testosterone). For this reason, laboratory evaluation of the complete blood count (CBC) will need to be checked prior to initiation of testosterone therapy and at periodic intervals determined by the medical provider.  If the blood count levels are found to be elevated above normal, you may be asked to donate blood.

 

All forms of Testosterone hormone replacement, including pellets,  can lead to increased conversion of excess testosterone into the hormone estrogen through a process called aromatization. This increase in Estrogen can result in symptoms such as water retention, growth of breast tissue, breast tenderness, decreased libido, erectile dysfunction and mood changes. Daily use of the supplement DIM (Diindolylmethane) is recommended to decrease the process of aromatization.  In some cases, the use of medications may be prescribed to help regulate estrogen levels while undergoing testosterone therapy.

 

Testosterone, delivered by pellet implantation, may also decrease testicular size and sperm production. For this reason, it is important to notify our medical providers if you wish to maintain fertility.

 

 

Possible side effects/reactions:

 

  • brief stinging or burning sensation for a few seconds following administration of lidocaine local prior to pellet insertion

  • brief shakiness, jitteriness, and heart racing due to use of epinephrine

  • Slight, temporary discoloration or bruising of the skin may be normal

  • minor swelling and/or soreness at insertion site, common for 2 – 3 days, may perisist for up to 2 weeks

  • infection, abscess or bleeding

  • irritation of skin due to post insertion dressing

  • lack of effect (from lack of absorption)

  • transient fluid retention

  • extrusion of pellet

  • elevation of blood levels including, but not limited to CBC, PSA, liver function studies

  • increased growth of hormone dependent tumors

 

 

I have read and understand the above information. I understand the procedure, benefits, risks and alternatives to the Implantation of Testosterone Pellets’ and testosterone therapy. I agree to allow the Providers at Z Med Clinics’ locations to implant the testosterone pellets. I agree to all of the above-mentioned information and will follow up as instructed.

 

I will notify my health care practitioner if there are any concerns I may have. I agree to hold Z Med Clinic’s providers, staff, officers, businesses, associates, and clinics harmless to any complications that may occur.

Clear