Effects of Testosterone Replacement Therapy on Lower Urinary Tract Symptoms

Purpose of Review: While early studies suggested that testosterone replacement therapy would enlarge the prostate and worsen lower urinary tract symptoms, this review seeks to examine the combined evidence of observational studies, randomized control trials, and meta-analyses published on the topic to determine if testosterone replacement therapy worsens lower urinary tract symptoms in hypogonadal men. Recent Findings: The combined evidence of 15 randomized control trials and 2 meta-analyses has demonstrated emphatically that testosterone replacement therapy has no effect on lower urinary tract symptoms in hypogonadal men with mild and moderate symptoms. Summary: No randomized control trial has sufficiently examined the effect of testosterone replacement therapy in men with severe lower urinary tract symptoms. While a few observational studies have seen no effect when hypogonadal men with severe lower urinary tract symptoms are treated with testosterone replacement therapy, future randomized controlled trials specifically studying the effect of testosterone on men with severe lower urinary tract symptoms are warranted. In summary, clinicians should rest assured that testosterone does not worsen lower urinary tract symptoms in hypogonadal men with mild or moderate lower urinary tract symptoms.