Improved Lower Urinary Tract Symptoms Associated With Testosterone Replacement Therapy in Japanese Men With Late-Onset Hypogonadism

Abstract

This study aimed to investigate the effects of testosterone replacement therapy (TRT) on lower urinary tract symptoms (LUTS) in men with late-onset hypogonadism (LOH) and to identify parameters predicting the efficacy of TRT in improving LUTS. This study included 60 consecutive Japanese men who were diagnosed with LOH and subsequently received TRT between January 2009 and December 2014. In this series, 250 mg of testosterone was injected intramuscularly every 3 or 4 weeks in all patients. The following parameters were retrospectively reviewed: body mass index (BMI), Aging Male Symptom (AMS) score, International Prostate Symptom Score (IPSS), International Index of Erectile Function-5 (IIEF-5) score, residual urine volume, prostate volume, serum levels of the prostate-specific antigen (PSA), and total- and free-testosterone levels before and 6 months after TRT. No significant differences were observed in BMI, residual urine volume, or prostate volume between surveys before and after TRT. The AMS score, IPSS, and IIEF-5 score were significantly improved and significant increases were noted in the serum levels of PSA and total- and free-testosterone levels after TRT. An analysis of IPSS subscores documented the significant improvement in storage symptom scores, but not in voiding symptom scores after TRT. Multivariate analyses of parameters assessed in this study identified the pretreatment AMS score, posttreatment IIEF-5 score, and prostate volume as independent predictors of improvements in IPSS following TRT. This study revealed that TRT appeared to have considerable therapeutic effects on LUTS, particularly on storage symptoms, in men with LOH.

Testosterone therapy in men with testosterone deficiency: Are we beyond the point of no return?

“…T therapy improved LUTSs in men with TD and mild BPH [6768]. Okada et al [69] demonstrated that T therapy has considerable therapeutic benefits on LUTS in Japanese men with TD.…”

Clinical relevance of low androgen to gastroesophageal reflux symptoms

“…This finding may imply that a deficiency of testosterone can widely affect the functions of multiple organs including psychological and physical systems [1]. SDS and AMS scale are frequently used to assess the severity of depression and LOH syndrome, respectively [7,12,13]. Since typical symptoms of LOH include depression, they are believed to be helpful for LOH screening [5,6,14].…”

Effects of Testosterone Treatment on Quality of Life in Patients With Chronic Kidney Disease

“…With regard to lower urinary tract symptoms (LUTS) in CKD patients, Chen et al (Chen, 2019) proposed bladder urothelial dysfunction, chronic inflammation, and change in sensory protein in the bladder urothelium as the mechanisms of bladder instability in patients with CKD and end-stage renal disease (ESRD). Some recent studies have reported that testosterone treatment improved LUTS (Okada et al, 2018; Yucel et al, 2017). Although more research is necessary on LUTS in CKD patients with TD, the opinion stated in the current guidelines is that in general, testosterone treatment does not greatly affect LUTS induced by BPH (Bhasin et al, 2018; Morgentaler et al, 2019).…”