LUTS Not Worsened by Testosterone Replacement

SAN DIEGO—Clinicians have been caution in the use of testosterone replacement therapy (TRT) in men with moderate to severe lower urinary tract symptoms (LUTS), but new findings presented at the American Urological Association annual meeting suggest that TRT does not worsen these symptoms.

In a retrospective study of the Northwestern Memorial Faculty Foundation outpatient database from 2002 to 2012, Jeffrey Pearl, MD, of the University of California San Francisco Department of Surgery, and colleagues identified 120 men with hypogonadism who underwent TRT. They continuously measured PSA and testosterone levels, as well as adverse effects. The mean duration of TRT was 23 months.

The AUA Symptom Index (AUASI) score decreased by 1.07 from a baseline 10.8; mean PSA levels rose by 0.44 ng/mL from a baseline of 1.6 ng/mL. Patients with a baseline PSA greater than 4.0 (6.7%) showed greater improvement in AUASI than patients with a baseline PSA of less than 4.0. Almost 32% of men had a greater than three-point improvement in AUASI score and 22.5% had a three-point worsening of AUASI score.

About 7.5% of patients initiated new medications for their LUTS with no significant change in AUASI.

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