Department of Urology, Osaka University Graduate School of Medicine
Introduction: 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, Aging males 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: TRT improved AMS, SHIM and EHS significantly (all p<0.01). In the evaluation of urinary symptoms, TRT did not improve any of the IPSS total scores, IPSS voiding subscores, IPSS storage subscores, or IPSS QOL scores in the LUTS mild group (IPSS: 8 or less), but in the LUTS moderate-severe group (IPSS: 8-35), TRT significantly improved them all (IPSS total scores: 14.2 ± 0.9 vs 9.8 ± 1.1: p<0.001, IPSS voiding subscores: 8. 0 ± 0.6 vs 5.3 ± 0.8: p<0.001, IPSS storage subscores: 6.3 ± 0.6 vs 4.5 ± 0.5: p=0.003, IPSS QOL scores: 3.9 ± 0.2 vs 3.0 ± 0.3: p=0.002, respectively) ( Fig. 1). Conclusions: TRT for LOH patients does not exacerbate LUTS but improves LUTS, especially for moderate or severe LUTS patients. SOURCE OF Funding: none
