Testosterone supplementation is associated with a low risk of worsening lower urinary tract symptoms (LUTS), a study found.
In fact, researchers found that many men experienced an improvement in symptoms, with minimal change in PSA level. This observation, they concluded, may prove useful to clinicians given the emphasis placed on LUTS progression by the FDA when initiating testosterone replacement therapy (TRT) in men with benign prostatic hyperplasia, according to an online report in The Journal of Urology.
Kevin T. McVary, MD, of Southern Illinois University School of Medicine in Springfield, and colleagues studied 120 hypogonadal men who underwent TRT. The men had a mean baseline American Urological Association Symptom Index (AUASI) score of 10.8 (moderate severity). The mean duration of TRT was 696 days. The maximum follow-up was nearly 10 years.
Over the study period, the men experienced a mean 1.07 improvement in AUASI score. The mean baseline PSA level was 1.6 ng/mL; this rose by 0.44 ng/mL during the study.
Fifty-five patients (45.8%) had no change in AUASI score, 38 patients (31.7%) had improvement in the score, and 27 (22.5%) experiencing a worsening of the score.
Patients who had an improvement in AUASI score had a mean 0.3 ng/mL increase in PSA level, whereas men with a worsening of their AUASI score had a mean 0.7 increase. Dr. McVary’s group also found that patients with severe LUTS had significantly greater improvements in AUASI score than those with mild or moderate LUTS at baseline.