Voiding function improves under long-term testosterone treatment (TTh) in hypogonadal men, independent of prostate size

YASSIN, Aksam, ALWANI, Mustafa, AL-ZOUBI, Raed M., ABOUMARZOUK, Omar M., TALIB, Raidh, NETTLESHIP, Joanne, KELLY, Daniel and ALBABA, Bassam (2023). Voiding function improves under long-term testosterone treatment (TTh) in hypogonadal men, independent of prostate size. International Urology and Nephrology, 55, 1649-1658.

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Official URL: https://link.springer.com/article/10.1007/s11255-0...
Open Access URL: https://link.springer.com/content/pdf/10.1007/s112... (Published version)
Link to published version:: https://doi.org/10.1007/s11255-023-03602-4


Background Functional hypogonadism is a condition in which some, but not all, older men have low testosterone levels. Rather than chronological age per se, the causality of hypogonadism includes obesity and impaired general health (e.g., metabolic syndrome). An association between testosterone deficiency and lower urinary tract symptoms (LUTS) has been reported, yet due to prostate safety concerns, men with severe LUTS (IPSS score > 19) have invariably been excluded from entering testosterone trials. Irrespective, exogenous testosterone has not been demonstrated to cause de novo or worsen mild to moderate LUTS. Objective This study investigated whether long-term testosterone therapy (TTh) could have a protective effect on improving the symptoms of LUTS in hypogonadal men. However, the exact mechanism by which testosterone exerts is beneficial effect remains uncertain. Patients and methods In this study 321 hypogonadal patients with an average age of 58.9 ± 9.52 years received testosterone undecanoate in 12-week intervals for 12 years. One hundred and forty-seven of these males had the testosterone treatment interrupted for a mean of 16.9 months before it was resumed. Total testosterone, International Prostate Symptom Scale (IPSS), post-voiding residual bladder volume and aging male symptoms (AMS) were measured over the study period. Results Prior to TTh interruption, it was observed that testosterone stimulation improved the men’s IPSS, AMS and post-voiding residual bladder volume, while their prostate volume significantly increased. During the TTh interruption, there was a significant worsening in these parameters, although the increase in prostate volume continued. When TTh was resumed, these effects were reversed, implying that hypogonadism may require lifelong treatment.

Item Type: Article
Uncontrolled Keywords: Benign prostate hyperplasia; Hypogonadism; LUTS; Prostate cancer; Testosterone; 1103 Clinical Sciences; Urology & Nephrology; 3202 Clinical sciences
Identification Number: https://doi.org/10.1007/s11255-023-03602-4
Page Range: 1649-1658
SWORD Depositor: Symplectic Elements
Depositing User: Symplectic Elements
Date Deposited: 15 May 2023 14:49
Last Modified: 11 Oct 2023 13:47
URI: https://shura.shu.ac.uk/id/eprint/31871

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