[Testosterone supplementation therapy for improvement of lower urinary tract symptoms: Progress in studies]

The theory that prostate growth depends on androgens has caused the worry clinically that the testosterone supplementation therapy (TST) may increase the prostate volume and worsen lower urinary tract symptoms (LUTS). However, more and more findings show that TST does not increase the prostate volume in patients with late-onset hypogonadism (LOH) or affect the IPSS, which may be attributed to the saturation of the androgen receptor. Testosterone deficiency and metabolic syndrome are risk factors for LUTS, the former affecting the autonomic nerve function, relaxation and blood supply of the bladder and urethral smooth muscle, and Rho enzyme activity, while the latter enhancing sympathetic activity and causing the body's inflammatory state and arteriosclerosis. Findings have proved that TST can improve LUTS in patients with LOH, with even better effect in those with a higher baseline IPSS or metabolic syndrome. More researches are needed to confirm the role of TST in improving LUTS.