Lee Min Ho, Shin Yu Seob, Kam Sung Chul
Department of Urology, Gyeongsang National University Changwon Hospital, Changwon, Korea.
Department of Urology, Jeonbuk National University Medical School, Jeonju, Korea.
Int Neurourol J. 2021 Mar;25(1):12-22. doi: 10.5213/inj.2040234.117. Epub 2021 Jan 19.
Lower urinary tract symptoms (LUTS) are a cluster of voiding symptoms, such as weak stream, hesitancy, intermittency, urinary frequency, urgency, and nocturia. LUTS are frequent in elderly men and it considered the ultimate clinical symptoms of benign prostatic hyperplasia. With aging, male hypogonadism is increased which is defined as decreased ability of the testes to produce sperm and sex steroids because of a pituitary/hypothalamic, or testicular deficiency. In academic andrology associations, the term "male hypogonadism" is commonly used to categorize testosterone deficiency. Testosterone deficiency syndrome (TDS) is defined as a decrease in serum testosterone accompanied by symptoms such as libido decrease, depressive disorder, erectile dysfunction, and fatigue. Although the mechanism about testosterone-replacement therapy (TRT) effects on men with hypogonadism is not yet identified, TRT has been shown to effectively relieve the symptoms of TDS as well as LUTS by several studies. Although the present review demonstrates the effectiveness and safety of TRT in men with TDS by prior studies, future large scale of clinical trials should be conducted to present more high-quality evidence to clinicians and patients.
下尿路症状（LUTS）是一系列排尿症状，如尿流无力、排尿踌躇、尿流中断、尿频、尿急和夜尿症。LUTS在老年男性中很常见，被认为是良性前列腺增生的最终临床症状。随着年龄增长，男性性腺功能减退症会增加，其定义为由于垂体/下丘脑或睾丸功能不足，睾丸产生精子和性激素的能力下降。在学术男科学协会中，“男性性腺功能减退症”一词通常用于对睾酮缺乏进行分类。睾酮缺乏综合征（TDS）定义为血清睾酮降低，并伴有性欲减退、抑郁障碍、勃起功能障碍和疲劳等症状。尽管睾酮替代疗法（TRT）对性腺功能减退男性的作用机制尚未明确，但多项研究表明TRT能有效缓解TDS以及LUTS的症状。尽管本综述通过先前的研究证明了TRT对TDS男性的有效性和安全性，但未来仍应进行大规模临床试验，为临床医生和患者提供更多高质量证据。
