In the long term, testosterone therapy increased the risk of receiving a diagnosis of BPH in hypogonadal males, but did not change the need for prostatic interventions in hypogonadal males with BPH.
Key Findings
Results
In a large cohort of hypogonadal males, 17.8% were diagnosed with benign prostatic hyperplasia.
Total cohort consisted of 882,570 hypogonadal males identified from the 2011-2020 IBM MarketScan database.
157,185 of these patients (17.8%) were diagnosed with BPH.
Patients were above 18 years old.
Models were adjusted for age, region, population density, and comorbidities.
Results
For the first 2.5 years after hypogonadism diagnosis, testosterone therapy was not associated with a significant difference in BPH diagnosis compared to no testosterone therapy.
HR: 1.00, 95% CI: 0.98-1.01, P = .66.
TT within the last 6 months was considered a time-varying covariate in Cox proportional hazard models.
ICD-9, ICD-10, CPT, HCPCS, and NDC codes were used for diagnoses, interventions, and medications.
Results
From 2.5 years onward, males on testosterone therapy had a 32% higher risk of receiving a diagnosis of BPH compared to those not on testosterone therapy.
HR: 1.32, 95% CI: 1.28-1.36, P < .001.
This finding emerged only after the 2.5-year threshold following hypogonadism diagnosis.
Cox proportional hazard models were used with TT as a time-varying covariate.
Results
Hypogonadal males with BPH who received testosterone therapy showed no significant difference in prostatic interventions compared to those who did not receive testosterone therapy.
HR: 0.95, 95% CI: 0.89-1.00, P = .08.
The analysis evaluated the relationship between TT in hypogonadal males with BPH and prostatic interventions.
CPT and HCPCS procedure codes were used to identify interventions.
Fendereski K, Horns J, Dehghanbanadaki H, Watkins C, Hotaling J. (2025). The Impact of Testosterone Therapy on Benign Prostatic Hyperplasia in Hypogonadal Males.. Urology. https://doi.org/10.1016/j.urology.2024.11.006