Objective: To determine the relationship between androgens,
lower urinary tract symptoms (LUTS) and urodynamic variables
of bladder outlet obstruction (BOO) in patients with LUTS/
benign prostatic hyperplasia (BPH).
Methods: In 924 patients with a mean age of 70 years, blood
levels of total testosterone, free testosterone, estradiol were
measured. The clinical conditions of BPH were assessed by
digital rectal examination, serum prostate-specific antigen (PSA)
determination, International Prostate Symptom Score (IPSS),
transrectal ultrasonography and maximum urinary flow rate
(Qmax) value at uroflowmetry.
Results: Mean age is 70.13. On statistical analysis, the
total IPSS and subscore (storage symptom) was significantly
associated with age (r=0.425, P<0.001/ r =0.379, P<0.05)) and
TT (r=–0.153, P<0.05/ r=–0.147, P<0.05) but not with FT or
Estradiol. The serum levels of testosterone and IPSS did not
correlate with prostate volume and Qmax. In addition, TT was
significantly related to the presence of severe lower urinary tract
symptoms (IPSS 20 or greater) (P<0.05). Univariate analysis
revealed that cardiovascular disease (n=66), diabetes mellitus
(n=96), hypertension (n=438) but not hyperlipidemia were positively correlated with the prevalence of nocturia.
Conclusions: The severity of LUTS was associated with
age and serum levels of TT, but only age correlated with the
measures of BPH, especially prostate volume. Our findings also
support that testosterone deficiency may be a pathophysiological
mechanism connecting LUTS.
Key Words: Lower urinary tract symptoms (LUTS); Sex
hormones; Benign prostatic hyperplasia (BPH)