No relationship between total testosterone, LUTS

San Francisco-Researchers in Colorado found no relationship between total testosterone and lower urinary tract symptoms in what may be the largest cross-sectional study of the association to date.

Data for the study were collected from 13,487 men during Prostate Cancer Awareness Week (PCAW) screenings conducted nationwide between 2003 and 2008.

"This gave us a population across the entire United States," said co-author Alexa Hughes, a student at the University of Colorado Health Sciences Center, Aurora, CO, working with E. David Crawford, MD, and colleagues.

Men showing current use of any urinary medications or history of prostate cancer were not included. The study offers a large and highly diverse sample but did not measure free or bioavailable testosterone, Hughes noted during a presentation at the AUA annual meeting in San Francisco.

The mean age of men in the study was 61 years, AUA SS was 6.95, total testosterone was 400.1 ng/dL, PSA was 1.7 ng/mL, and BMI was 27.5. Across the entire cohort, 65% of men had mild LUTS, 30% had moderate LUTS, and 5% had severe LUTS. There was a near linear association between increasing age and increasing LUTS severity.

In univariate analysis, age, DRE-estimated volume, and PSA all showed a significant correlation with LUTS (p<.001), but neither total testosterone (p=.658) nor BMI (p=.456) showed any association with LUTS. In a multi-regression analysis, age, DRE volume, and PSA all retained a significant association with LUTS (p<.001) and BMI became a significant factor (p=.001). Factors significantly associated with the increased prevalence of moderate or severe LUTS included age ≥65 years (odds ratio, 1.31), DRE prostate volume ≥30 grams (OR, 1.66), and PSA ≥1.5 ng/mL (OR, 1.79).

For every unit increase in age, from younger than 50 to 50-65 and older than 65 years, there was a 50% greater chance of moderate or severe LUTS. For every increase in PSA group-under 1.5, 1.5 to 4.0, and >4.0-there was a 40% greater chance of moderate or severe LUTS. Total testosterone carried an odds ratio of 0.97 for moderate or severe LUTS.

"What we found was that increasing age and PSA are associated with LUTS, but total testosterone is not," Dr. Crawford said.