Department of Urology, University of Catania, Catania, Italy.
BJU Int. 2010 Dec;106(11):1700-3. doi: 10.1111/j.1464-410X.2010.09459.x.
To investigate a possible association between the severity of lower urinary tract symptoms (LUTS) and the serum levels of sex hormones in men with symptomatic benign prostatic hyperplasia (BPH) that underwent surgery for severe benign prostatic obstruction.
In all, 127 selected men with symptomatic BPH attending our urology clinic were recruited. The clinical conditions of BPH were assessed by digital rectal examination, serum prostate-specific antigen (PSA) determination, International Prostate Symptom Score (IPSS), transrectal ultrasonography and maximum urinary flow rate (Q(max) ) value at uroflussimetry. Before surgery, we measured the serum concentrations of total testosterone (TT) and free testosterone (FT), oestradiol, prolactin, luteinizing hormone and follicle-stimulating hormone. We excluded men with endocrine diseases, those with prostate disease who were receiving antiandrogen therapy and those with psychological diseases. The relationships between the IPSS score and serum sex hormone levels were determined.
The final study population consisted of 122 men (mean age of 70.66 years), as five were excluded (three due to incomplete evaluation and two who were diagnosed with prostate cancer). On statistical analysis, the total IPSS was significantly associated with age (r= 0.405, P < 0.001) and TT (r= 0.298, P= 0.020) but not with FT or the serum levels of the other sex hormones. The serum levels of testosterone and IPSS did not correlate with prostate volume and Q(max) . PSA level and age correlated with prostate volume (r= 0.394, P < 0.001; r = 0.374, P < 0.001, respectively). We distinguished two subgroups of patients: the first group of 40 men with an IPSS of <19 and the second group of 82 with an IPSS of >19, and we evaluated the median levels of TT in each group. There was an increased risk of LUTS in men with a greater serum concentration of TT (P= 0.042), although the mean TT level was in the normal range.
In the present study, the severity of LUTS was associated with age and serum levels of TT but only age correlated with the measures of BPH, especially prostate volume. The potential effects of testosterone on LUTS may well be indirect. Additional large studies are needed to confirm these preliminary results.
研究经手术治疗严重良性前列腺增生（BPH）引起的良性前列腺梗阻的伴有症状的男性患者，其下尿路症状（LUTS）严重程度与血清性激素水平之间是否存在关联。
共纳入我院泌尿科就诊的 127 例有症状的 BPH 患者。通过直肠指检、血清前列腺特异抗原（PSA）测定、国际前列腺症状评分（IPSS）、经直肠超声和尿流率检查评估 BPH 的临床情况。在手术前，我们测量了总睾酮（TT）和游离睾酮（FT）、雌二醇、催乳素、黄体生成素和卵泡刺激素的血清浓度。我们排除了患有内分泌疾病、正在接受抗雄激素治疗的前列腺疾病患者和患有心理疾病的患者。确定了 IPSS 评分与血清性激素水平之间的关系。
最终研究人群包括 122 名男性（平均年龄 70.66 岁），有 5 人被排除（由于评估不完整有 3 人，2 人被诊断为前列腺癌）。在统计学分析中，总 IPSS 与年龄（r=0.405，P<0.001）和 TT（r=0.298，P=0.020）显著相关，但与 FT 或其他性激素的血清水平无关。睾酮血清水平与 IPSS 与前列腺体积和 Qmax 不相关。PSA 水平和年龄与前列腺体积呈正相关（r=0.394，P<0.001；r=0.374，P<0.001）。我们将患者分为两组：第一组为 40 名 IPSS<19 的患者，第二组为 82 名 IPSS>19 的患者，并评估了每组的 TT 中位数水平。尽管 TT 的平均水平处于正常范围内，但血清 TT 浓度较高的男性发生 LUTS 的风险增加（P=0.042）。
在本研究中，LUTS 的严重程度与年龄和 TT 血清水平相关，但只有年龄与 BPH 的指标相关，特别是前列腺体积。睾酮对 LUTS 的潜在影响可能是间接的。需要进一步的大型研究来证实这些初步结果。
