Endoscopic Enucleation of Prostate Could Increase Testosterone Levels in Hypotestosteronemic Patients with Bladder Outlet Obstruction

Abstract

Background: We evaluated the impact of endoscopic enucleation of the prostate on testosterone levels in hypotestosteronemic patients with bladder outlet obstruction. Methods: We enrolled 294 men with lower urinary tract symptoms (LUTS) who received surgery between January 2019 and December 2020 in simple tertiary centre. The inclusion criteria were as follows: being a male patient aged 45–95 years and having recurrent urinary tract infection, having previously failed medical treatment for LUTS or urine retention, and undergoing bipolar or thulium laser enucleation of the prostate. The preoperative and postoperative data were retrospectively reviewed. Results: This study included 112 men with a mean age of 69.4 years. The mean preoperative and postoperative testosterone levels were 4.8 and 4.98, respectively. Of the patients, 88 (78.6%) received ThuLEP and 24 received BipolEP. We divided the patients into two groups according to preoperative serum testosterone levels: normal-testosterone (≥3 ng/mL) and low-testosterone (<3 ng/mL) groups. A significant change in testosterone levels (p = 0.025) was observed in the low-testosterone group. In contrast, no significant difference in testosterone levels was noted in the normal-testosterone group (p = 0.698). Conclusions: Endoscopic enucleation surgery of the prostate could improve postoperative testosterone levels in hypotestosteronemic patients with bladder outlet obstruction.

Interlinking circadian rhythms with urological health and blood pressure fluctuations: Insights from Kato Y et al.'s study on nocturnal polyuria in men with LUTS

“…6 Furthermore, our investigations have shown that patients with low testosterone levels who underwent anatomical endoscopic enucleation of the prostate saw a postoperative increase in testosterone, suggesting that effective LUTS treatment could also confer an endogenous TRT effect. 7 Given the multifaceted nature of LUTS and their significant impact on patients' quality of life, our discussion underscores the importance of considering a broader spectrum of factors, including nocturia, NP, and testosterone levels. These factors serve as indicators for monitoring the extent to which LUTS may be disrupting the circadian rhythm.…”