Testosterone supplementation does not worsen lower urinary tract symptoms

Area of Science:

• Endocrinology
• Urology
• Men's Health

Background:

• Testosterone replacement therapy (TRT) is a common treatment for hypogonadism.
• Concerns exist regarding TRT's impact on lower urinary tract symptoms (LUTS) in men with moderate to severe LUTS.
• This study investigates the effect of TRT on LUTS in hypogonadal men.

Purpose of the Study:

• To evaluate the safety and efficacy of testosterone replacement therapy in hypogonadal men, specifically concerning lower urinary tract symptoms.
• To assess the impact of TRT on the American Urological Association Symptom Index (AUASI) and prostate-specific antigen (PSA) levels.

Main Methods:

• Retrospective review of 120 hypogonadal men receiving TRT from 2002-2012.
• AUASI assessed pre- and post-TRT; testosterone and PSA levels monitored.
• Patients requiring surgery for LUTS progression were included.

Main Results:

• Mean AUASI change was -1.07, indicating mild overall improvement.
• 31.7% of patients showed significant AUASI improvement (≥3 points), while 22.5% experienced worsening (≥3 points).
• Only 3.3% of patients required surgery for LUTS progression; PSA changes were minor.

Conclusions:

• Initiating TRT in hypogonadal men carries a low risk of worsening LUTS.
• Many men experience LUTS improvement with TRT, alongside minor PSA changes.
• Larger studies are needed to further elucidate the relationship between TRT and LUTS.