CJK 10. Nocturia and sex hormones in men with symptomatic BPH

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)