Long-term effects of testosterone therapy on prostate volume and LUTS in hypogonadal men: a retrospective study.
Level 3 - non-randomized controlled study
Non-randomized retrospective longitudinal cohort study
PubMed 41891790 · doi:10.2340/sju.v61.45576
What was done
A retrospective longitudinal cohort study evaluated 511 men undergoing annual health checkups between 2004 and 2017 with no baseline treatments affecting prostate size or lower urinary tract symptoms (LUTS). Assessments included physical examination, transrectal ultrasound for prostate volume, bladder scanning for post-void residual urine, serum prostate-specific antigen (s-PSA), serum testosterone, and questionnaires for LUTS (IPSS) and late-onset hypogonadism (LOH). Over follow-up, 167 men (33%) were diagnosed with symptomatic LOH and initiated testosterone replacement therapy (TRT). A longitudinal statistical model compared treated and untreated periods across 3,745 visits (median 7 per man, including 904 after TRT initiation).
What was found
TRT was associated with a mean increase in prostate growth rate of 0.22 mL/year compared with untreated periods (p = 0.023). No statistically significant differences were observed between treated and untreated periods for LUTS (IPSS), quality of life, or s-PSA; specific numerical values and non-significant p-values for these outcomes were not reported in the abstract.
Why it matters
The findings indicate that long-term testosterone therapy in hypogonadal men results in only a minor acceleration of prostate volume growth without worsening urinary symptoms or affecting PSA levels.
Limits
The study is retrospective and non-randomized, leaving it vulnerable to confounding and selection bias. The abstract does not report specific testosterone formulations, dosages, target levels achieved, or numerical data and confidence intervals for secondary outcomes.
Cited by
- supports Testosterone replacement therapy can potentially increase prostate size and exacerbate benign prostatic hyperplasia (BPH).