PMID- 37148486 OWN - NLM STAT- MEDLINE DCOM- 20230628 LR - 20230701 IS - 1573-2584 (Electronic) IS - 0301-1623 (Print) IS - 0301-1623 (Linking) VI - 55 IP - 7 DP - 2023 Jul TI - Voiding function improves under long-term testosterone treatment (TTh) in hypogonadal men, independent of prostate size. PG - 1649-1658 LID - 10.1007/s11255-023-03602-4 [doi] AB - BACKGROUND: Functional hypogonadism is a condition in which some, but not all, older men have low testosterone levels. Rather than chronological age per se, the causality of hypogonadism includes obesity and impaired general health (e.g., metabolic syndrome). An association between testosterone deficiency and lower urinary tract symptoms (LUTS) has been reported, yet due to prostate safety concerns, men with severe LUTS (IPSS score > 19) have invariably been excluded from entering testosterone trials. Irrespective, exogenous testosterone has not been demonstrated to cause de novo or worsen mild to moderate LUTS. OBJECTIVE: This study investigated whether long-term testosterone therapy (TTh) could have a protective effect on improving the symptoms of LUTS in hypogonadal men. However, the exact mechanism by which testosterone exerts is beneficial effect remains uncertain. PATIENTS AND METHODS: In this study 321 hypogonadal patients with an average age of 58.9 +/- 9.52 years received testosterone undecanoate in 12-week intervals for 12 years. One hundred and forty-seven of these males had the testosterone treatment interrupted for a mean of 16.9 months before it was resumed. Total testosterone, International Prostate Symptom Scale (IPSS), post-voiding residual bladder volume and aging male symptoms (AMS) were measured over the study period. RESULTS: Prior to TTh interruption, it was observed that testosterone stimulation improved the men's IPSS, AMS and post-voiding residual bladder volume, while their prostate volume significantly increased. During the TTh interruption, there was a significant worsening in these parameters, although the increase in prostate volume continued. When TTh was resumed, these effects were reversed, implying that hypogonadism may require lifelong treatment. CI - (c) 2023. The Author(s). FAU - Yassin, Aksam AU - Yassin A AUID- ORCID: 0000-0001-5457-3443 AD - Surgical Research Section, Department of Surgery, Hamad Medical Corporation and Men's Health, Doha, Qatar. AD - Center of Medicine and Health Sciences, Dresden International University, Dresden, Germany. AD - Weill Cornell School of Medicine, Urology, Doha, Qatar. FAU - Alwani, Mustafa AU - Alwani M AUID- ORCID: 0000-0001-9463-3754 AD - Surgical Research Section, Department of Surgery, Hamad Medical Corporation and Men's Health, Doha, Qatar. FAU - Al-Zoubi, Raed M AU - Al-Zoubi RM AUID- ORCID: 0000-0002-0548-429X AD - Surgical Research Section, Department of Surgery, Hamad Medical Corporation and Men's Health, Doha, Qatar. ralzoubi@hamad.qa. AD - Department of Biomedical Sciences, QU-Health, College of Health Sciences, Qatar University, 2713, Doha, Qatar. ralzoubi@hamad.qa. AD - Department of Chemistry, Jordan University of Science and Technology, PO Box 3030, Irbid, 22110, Jordan. ralzoubi@hamad.qa. FAU - Aboumarzouk, Omar M AU - Aboumarzouk OM AUID- ORCID: 0000-0002-7961-7614 AD - Surgical Research Section, Department of Surgery, Hamad Medical Corporation and Men's Health, Doha, Qatar. AD - College of Medicine, Qatar University, Doha, Qatar. AD - School of Medicine, Dentistry and Nursing, The University of Glasgow, Glasgow, UK. FAU - Talib, Raidh AU - Talib R AD - Surgical Research Section, Department of Surgery, Hamad Medical Corporation and Men's Health, Doha, Qatar. FAU - Nettleship, Joanne AU - Nettleship J AD - Biomolecular Research Centre, Sheffield Hallam University, Sheffield, UK. FAU - Kelly, Daniel AU - Kelly D AUID- ORCID: 0000-0002-7463-0692 AD - Biomolecular Research Centre, Sheffield Hallam University, Sheffield, UK. AD - Department of Oncology and Metabolism, Medical School, University of Sheffield, Sheffield, UK. FAU - Albaba, Bassam AU - Albaba B AD - Center of Medicine and Health Sciences, Dresden International University, Dresden, Germany. LA - eng PT - Journal Article DEP - 20230506 PL - Netherlands TA - Int Urol Nephrol JT - International urology and nephrology JID - 0262521 RN - 3XMK78S47O (Testosterone) SB - IM MH - Humans MH - Male MH - Aged MH - Middle Aged MH - Prostate MH - Testosterone/therapeutic use MH - *Hypogonadism/complications/drug therapy MH - Obesity/complications MH - Urination MH - *Lower Urinary Tract Symptoms/etiology/complications PMC - PMC10293434 OTO - NOTNLM OT - Benign prostate hyperplasia OT - Hypogonadism OT - LUTS OT - Prostate cancer OT - Testosterone COIS- AY received partial compensation for data entry, honoraria and occasionally travel grants from Bayer AG and is a Member of the Advisory Board for Testosterone, Besin Health Care, Pharma. DMK has received honoraria and occasionally travel grants from Bayer AG. EDAT- 2023/05/06 19:42 MHDA- 2023/06/28 06:42 PMCR- 2023/05/06 CRDT- 2023/05/06 14:57 PHST- 2023/02/12 00:00 [received] PHST- 2023/04/12 00:00 [accepted] PHST- 2023/06/28 06:42 [medline] PHST- 2023/05/06 19:42 [pubmed] PHST- 2023/05/06 14:57 [entrez] PHST- 2023/05/06 00:00 [pmc-release] AID - 10.1007/s11255-023-03602-4 [pii] AID - 3602 [pii] AID - 10.1007/s11255-023-03602-4 [doi] PST - ppublish SO - Int Urol Nephrol. 2023 Jul;55(7):1649-1658. doi: 10.1007/s11255-023-03602-4. Epub 2023 May 6.