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THE EFFECT OF TESTOSTERONE REPLACEMENT THERAPY ON LOWER URINARY TRACT SYMPTOMS (2023)
Norichika Ueda*, Go Tsujimura, Takahiro Imanaka, Sohei Kuribayashi, Koichi Okada, Kentaro Takezawa, Shinichiro Fukuhara, Norio Nonomura, Suita, Japan
INTRODUCTION AND OBJECTIVE
Both late-onset hypogonadism (LOH) syndrome and lower urinary tract symptoms (LUTS) increase with age and decrease quality of life (QOL). The standard treatment for LOH syndrome is testosterone replacement therapy (TRT). Since the prostate is an androgen-dependent organ, TRT may have some effect on LUTS. However, the effect of TRT on LUTS is not fully understood. The number of patients with both LUTS and LOH syndrome is increasing, therefore it is important to understand the relationship between TRT and LUTS. In this study, we retrospectively examined the effect of TRT on LUTS.
METHODS
Ninety-four patients who received TRT for LOH syndrome from May 2017 to August 2022 were evaluated. Three months after the first testosterone administration, the Aging male's Symptoms rating scale (AMS), Sexual Health Inventory for Men (SHIM), Erection Hardness Score (EHS), International Prostate Symptom Score (IPSS), and IPSS QOL score were assessed. IPSS was also evaluated for the voiding and storage subscores, respectively.
RESULTS
Decreased testosterone level was confirmed in 1680 individuals (27.8%) and significantly associated with nocturia (Hazard ratio1.358; 95% confidence interval [CI] 1.207-1.529). This tendency was more prominent in moderate-to-severe nocturia (HR 2.049, 95% CI 1.533-2.737). Using adjusted regression analysis, we found a significant association between two variables in moderate-to-severe nocturia (HR 1.411, 95% CI 1.050-1.896). In subgroup analysis according to age, testosterone deficiency was significantly associated with nocturia in the group of ages over sixties. (HR 1.474 95% CI 1.218-1.782). Decreased level of testosterone was significantly associated with moderate-to-severe nocturia according to baseline morbidities.
CONCLUSIONS
Decreased testosterone level was significantly associated with nocturia in men after adjusting for major confounding factors. This tendency was prominent in the age group of more than sixties and the group of moderate-to-severe nocturia.
Fig.2 Forest plot
Norichika Ueda*, Go Tsujimura, Takahiro Imanaka, Sohei Kuribayashi, Koichi Okada, Kentaro Takezawa, Shinichiro Fukuhara, Norio Nonomura, Suita, Japan
INTRODUCTION AND OBJECTIVE
Both late-onset hypogonadism (LOH) syndrome and lower urinary tract symptoms (LUTS) increase with age and decrease quality of life (QOL). The standard treatment for LOH syndrome is testosterone replacement therapy (TRT). Since the prostate is an androgen-dependent organ, TRT may have some effect on LUTS. However, the effect of TRT on LUTS is not fully understood. The number of patients with both LUTS and LOH syndrome is increasing, therefore it is important to understand the relationship between TRT and LUTS. In this study, we retrospectively examined the effect of TRT on LUTS.
METHODS
Ninety-four patients who received TRT for LOH syndrome from May 2017 to August 2022 were evaluated. Three months after the first testosterone administration, the Aging male's Symptoms rating scale (AMS), Sexual Health Inventory for Men (SHIM), Erection Hardness Score (EHS), International Prostate Symptom Score (IPSS), and IPSS QOL score were assessed. IPSS was also evaluated for the voiding and storage subscores, respectively.
RESULTS
Decreased testosterone level was confirmed in 1680 individuals (27.8%) and significantly associated with nocturia (Hazard ratio1.358; 95% confidence interval [CI] 1.207-1.529). This tendency was more prominent in moderate-to-severe nocturia (HR 2.049, 95% CI 1.533-2.737). Using adjusted regression analysis, we found a significant association between two variables in moderate-to-severe nocturia (HR 1.411, 95% CI 1.050-1.896). In subgroup analysis according to age, testosterone deficiency was significantly associated with nocturia in the group of ages over sixties. (HR 1.474 95% CI 1.218-1.782). Decreased level of testosterone was significantly associated with moderate-to-severe nocturia according to baseline morbidities.
CONCLUSIONS
Decreased testosterone level was significantly associated with nocturia in men after adjusting for major confounding factors. This tendency was prominent in the age group of more than sixties and the group of moderate-to-severe nocturia.
Fig.2 Forest plot
