title: Lower urinary tract symptoms improve with testosterone replacement therapy in men with late-onset hypogonadism: 5-year prospective, observational and longitudinal registry study.
abstract: OBJECTIVE
  Many men with "late-onset hypogonadism" (LOH) experience lower urinary tract symptoms (LUTS) that can be distressing and may decrease quality of life. LUTS often appear in men when testosterone levels begin to decline, which could be a significant association. We investigated whether testosterone replacement could alleviate LUTS in men with LOH.
  
  
  METHODS
  Two hundred and sixty-one hypogonadal patients (mean age 59.5 years) presenting with erectile dysfunction, having also been evaluated for LUTS, received a single testosterone undecanoate injection at day 1, at week 6 and quarterly thereafter. Parameters, including International Prostate Symptom Score (IPSS), post-voiding residual urine volume, transrectal ultrasound, prostate volume and prostate-specific antigen were measured at each treatment visit. Two hundred and fifty-nine patients were included in the full analysis set. These were subsequently divided into weight losers (L ≥ 5 % weight loss at last visit from baseline) and non-losers (NL). t test analyses were used to compare the IPSS means of these subgroups. The potentially confounding effect on IPSS of using the phosphodiesterase-5 inhibitor (PDE5i) vardenafil was also accounted for.
  
  
  RESULTS
  Mean IPSS showed a significant decrease with time following initiation of testosterone treatment (p < 0.05). No significant differences were observed in either IPSS between L and NL groups or in mean IPSS between vardenafil users and non-users.
  
  
  CONCLUSIONS
  Testosterone replacement is associated with improvements in LUTS which are not confounded by weight loss or PDE5i. The mechanisms of this association require further investigation.
authors.affiliation: Department of Urology, Klinikum Braunschweig, Brunswick, Germany.
authors.forename: Dany-Jan
authors.initials: DJ
authors.lastname: Yassin
authors.forename: Yousef
authors.initials: Y
authors.lastname: El Douaihy
authors.forename: Aksam A
authors.initials: AA
authors.lastname: Yassin
authors.forename: James
authors.initials: J
authors.lastname: Kashanian
authors.forename: Ridwan
authors.initials: R
authors.lastname: Shabsigh
authors.forename: Peter G
authors.initials: PG
authors.lastname: Hammerer
mesh_terms: D017668:Age of Onset; D000368:Aged; D007172:Erectile Dysfunction / Q000188:drug therapy; D005058:Eunuchism / Q000150:complications*; D020249:Hormone Replacement Therapy; D006801:Humans; D007093:Imidazoles / Q000627:therapeutic use; D008137:Longitudinal Studies; D059411:Lower Urinary Tract Symptoms / Q000188:drug therapy* / Q000453:epidemiology / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D010879:Piperazines / Q000627:therapeutic use; D011446:Prospective Studies; D012042:Registries; D013450:Sulfones / Q000627:therapeutic use; D013739:Testosterone / Q000627:therapeutic use*; D016896:Treatment Outcome; D014227:Triazines / Q000627:therapeutic use; D000069058:Vardenafil Dihydrochloride
chemical_list: D007093:Imidazoles; D010879:Piperazines; D013450:Sulfones; D014227:Triazines; D013739:Testosterone; D000069058:Vardenafil Dihydrochloride