Nelson Vergel
Founder, ExcelMale.com
A recent review finds no evidence that testosterone replacement therapy (TRT) causes or worsens lower urinary tract symptoms (LUTS) or benign prostatic hyperplasia (BPH).
Furthermore, although the Endocrine Society and other associations have suggested severe LUTS as a contraindication to TRT treatment, investigators found little evidence to support it after reviewing the limited research.
http://www.renalandurologynews.com/...-not-appear-to-worsen-lutsbph/article/459243/
Urology. 2015 Nov 23. pii: S0090-4295(15)01053-5. doi: 10.1016/j.urology.2015.11.006. [Epub ahead of print]
The Relationship between Testosterone Replacement Therapy and Lower Urinary Tract Symptoms: A Systematic Review.
Kathrins M1, Doersch K2, Nimeh T1, Canto A3, Niederberger C1, Seftel A3.
Abstract
OBJECTIVES:
To systematically review prospective trials evaluating the clinical effects of testosterone replacement therapy on lower urinary tract symptoms and prostate volume.
MATERIALS AND METHODS:
We performed a literature review through PubMed, EMBASE, and Cochrane Library from 1994 to 2015 for prospective trials of hypogonadal men with benign prostatic hyperplasia/lower urinary tract symptoms treated with testosterone replacement therapy. We evaluated the abstracts for outcomes related to International Prostate Symptom Score, prostate volume, and urodynamic parameters.
RESULTS:
An original cohort of 3079 abstracts was reviewed. 35 trials were selected for inclusion. The majority of trials reviewed found no significant prostate growth due to testosterone replacement therapy. Studies of men with baseline mild lower urinary tract symptoms demonstrated either no change or an improvement in symptoms after treatment. There was a lack of relevant urodynamic studies. Trials of men with the metabolic syndrome demonstrated uniform improvement in lower urinary tract symptoms. 46% of all the trials identified included exclusion criteria for baseline severe-range lower urinary tract symptoms or other signs of obstructive lower urinary tract symptoms.
CONCLUSIONS:
The current literature demonstrates scant support for a causative relationship between testosterone replacement therapy, de-novo or worsening lower urinary tract symptoms, and prostate volume. Furthermore, our review found an absence of high quality evidence that would support guideline recommendations that testosterone replacement therapy is relatively contraindicated in men with severe-range lower urinary tract symptoms. Future clinical trials with more inclusive voiding criteria are needed.
Furthermore, although the Endocrine Society and other associations have suggested severe LUTS as a contraindication to TRT treatment, investigators found little evidence to support it after reviewing the limited research.
http://www.renalandurologynews.com/...-not-appear-to-worsen-lutsbph/article/459243/
Urology. 2015 Nov 23. pii: S0090-4295(15)01053-5. doi: 10.1016/j.urology.2015.11.006. [Epub ahead of print]
The Relationship between Testosterone Replacement Therapy and Lower Urinary Tract Symptoms: A Systematic Review.
Kathrins M1, Doersch K2, Nimeh T1, Canto A3, Niederberger C1, Seftel A3.
Abstract
OBJECTIVES:
To systematically review prospective trials evaluating the clinical effects of testosterone replacement therapy on lower urinary tract symptoms and prostate volume.
MATERIALS AND METHODS:
We performed a literature review through PubMed, EMBASE, and Cochrane Library from 1994 to 2015 for prospective trials of hypogonadal men with benign prostatic hyperplasia/lower urinary tract symptoms treated with testosterone replacement therapy. We evaluated the abstracts for outcomes related to International Prostate Symptom Score, prostate volume, and urodynamic parameters.
RESULTS:
An original cohort of 3079 abstracts was reviewed. 35 trials were selected for inclusion. The majority of trials reviewed found no significant prostate growth due to testosterone replacement therapy. Studies of men with baseline mild lower urinary tract symptoms demonstrated either no change or an improvement in symptoms after treatment. There was a lack of relevant urodynamic studies. Trials of men with the metabolic syndrome demonstrated uniform improvement in lower urinary tract symptoms. 46% of all the trials identified included exclusion criteria for baseline severe-range lower urinary tract symptoms or other signs of obstructive lower urinary tract symptoms.
CONCLUSIONS:
The current literature demonstrates scant support for a causative relationship between testosterone replacement therapy, de-novo or worsening lower urinary tract symptoms, and prostate volume. Furthermore, our review found an absence of high quality evidence that would support guideline recommendations that testosterone replacement therapy is relatively contraindicated in men with severe-range lower urinary tract symptoms. Future clinical trials with more inclusive voiding criteria are needed.
