In ageing males with late-onset hypogonadism, testosterone replacement therapy was linked to a small but statistically significant increase in prostate growth rate without measurable effects on urinary symptoms.
Key Findings
Results
TRT was associated with a statistically significant but small increase in prostate growth rate compared with untreated periods.
Mean increase in prostate growth rate of 0.22 mL/year compared with untreated periods (p = 0.023)
A longitudinal statistical model was used to compare periods with and without treatment
167 men (33% of 511) were diagnosed with symptomatic LOH and received TRT
Participants contributed 3745 visits (median 7 per man), including 904 (24%) after testosterone initiation
Results
No significant differences in LUTS, quality of life, or serum PSA were observed between treated and untreated periods.
IPSS (International Prostate Symptom Score) did not differ significantly between treated and untreated periods
Quality of life (QoL) scores showed no significant difference between treated and untreated periods
Serum PSA (s-PSA) showed no significant difference between treated and untreated periods
Post-void residual urine was also assessed with no significant difference reported
Methods
The study population consisted of 511 men followed from 2004 to 2017 with annual checkups including multiple assessments.
Annual checkups included physical examination, transrectal ultrasound, bladder scanning, serum PSA, serum testosterone, and questionnaires on LUTS and LOH symptoms
None of the participants had prior treatments affecting prostate size or LUTS at baseline
167 men (33%) were diagnosed with symptomatic LOH during follow-up and received TRT
Median of 7 visits per man across 3745 total visits
Background
Up to 20% of aging men have low serum testosterone (late-onset hypogonadism) and approximately 80% develop benign prostatic enlargement with increasing age.
Both age and prostate size are linked to lower urinary tract symptoms (LUTS)
The co-occurrence of LOH and BPE in aging men formed the clinical rationale for this study
The study aimed to evaluate the effect of TRT on prostate volume and LUTS in men with LOH
Ströberg P, Ghaffarpour R, Ljungberg B, Svensson J. (2026). Long-term effects of testosterone therapy on prostate volume and LUTS in hypogonadal men: a retrospective study.. Scandinavian journal of urology. https://doi.org/10.2340/sju.v61.45576