Serum Testosterone and Dihydrotestosterone and Incidence and Progression of Lower Urinary Tract Symptoms: Results From the REDUCE Study

No AccessJournal of UrologyAdult Urology24 Oct 2023Serum Testosterone and Dihydrotestosterone and Incidence and Progression of Lower Urinary Tract Symptoms: Results From the REDUCE Study James P. Daniels, James Mirocha, Michie Adjei, Daniel Moreira, and Stephen J. Freedland James P. DanielsJames P. Daniels *Correspondence: Cedars-Sinai Medical Center (e-mail address: E-mail Address: [email protected] https://orcid.org/0000-0002-2401-2474 Cedars-Sinai Medical Center More articles by this author , James MirochaJames Mirocha https://orcid.org/0000-0002-2338-193X Cedars-Sinai Medical Center More articles by this author , Michie AdjeiMichie Adjei https://orcid.org/0000-0001-8270-2345 Cedars-Sinai Medical Center More articles by this author , Daniel MoreiraDaniel Moreira The University of Illinois College of Medicine More articles by this author , and Stephen J. FreedlandStephen J. Freedland https://orcid.org/0000-0002-8104-6419 Cedars-Sinai Medical Center More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003738AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack Citations ShareFacebookLinked InTwitterEmail Abstract Purpose: Though the pathogenesis of benign prostatic hyperplasia is unclear, it was previously believed that increasing androgen levels contributed, though not all data support this idea. We tested if elevated serum testosterone or dihydrotestosterone were risk factors for lower urinary tract symptoms incidence in asymptomatic men and for lower urinary tract symptoms progression in symptomatic men. Materials and Methods: A post hoc analysis of REDUCE was performed in 3009 asymptomatic men and in 2145 symptomatic men. REDUCE was a randomized trial of dutasteride for prostate cancer prevention in men with an elevated prostate-specific antigen and negative prestudy biopsy. We estimated multivariable adjusted hazard ratios and 95% confidence intervals using Cox models to test the association between quintiles of serum testosterone and dihydrotestosterone at baseline and lower urinary tract symptoms incidence and progression and tested for interaction by treatment arm (dutasteride vs placebo). Results: In asymptomatic men, there was no evidence serum testosterone or dihydrotestosterone were related to lower urinary tract symptoms incidence (P = .9, P = .4). In symptomatic men, there was no evidence serum testosterone or dihydrotestosterone were related to lower urinary tract symptoms progression (P = .9, P = .7). Results were similar in both placebo and dutasteride arms (all P interaction ≥ .3). Conclusions: In REDUCE, higher serum testosterone and higher serum dihydrotestosterone were not associated with either lower urinary tract symptoms incidence in asymptomatic men or lower urinary tract symptoms progression in symptomatic men. 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Crossref, Medline, Google Scholar 26. Metabolic syndrome and benign prostatic hyperplasia: an update. Asian J Urol.2017; 4(3):164-173. Crossref, Medline, Google Scholar Support: Dr Daniels and Dr Adjei are both funded by NIH grants TL1 DK132768 and U2C DK129496. Conflict of Interest Disclosures: The Authors have no conflicts of interest to disclose. Ethics Statement: All procedures performed in this study involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. This study is IRB approved. Original Review Type: Non-Review Committee Exempt. IRB protocol number is Pro00038922. The IRB coordinator is Erin Van Hoy. Author Contributions: S.F. conceived the idea and helped edit the manuscript. J.D. wrote the manuscript and created figures and tables. J.M. was responsible for statistical analysis. M.A. helped in writing and editing the manuscript. D.M. helped produce the database used for this project and provided critical input into the manuscript. © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Supplementary Materials Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.Keywordstestosteronelower urinary tract symptomsbenign prostatic hyperplasiaDHTandrogensMetrics Author Information James P. Daniels Cedars-Sinai Medical Center *Correspondence: Cedars-Sinai Medical Center (e-mail address: E-mail Address: [email protected] More articles by this author James Mirocha Cedars-Sinai Medical Center More articles by this author Michie Adjei Cedars-Sinai Medical Center More articles by this author Daniel Moreira The University of Illinois College of Medicine More articles by this author Stephen J. Freedland Cedars-Sinai Medical Center More articles by this author Expand All Support: Dr Daniels and Dr Adjei are both funded by NIH grants TL1 DK132768 and U2C DK129496. Conflict of Interest Disclosures: The Authors have no conflicts of interest to disclose. Ethics Statement: All procedures performed in this study involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. This study is IRB approved. Original Review Type: Non-Review Committee Exempt. IRB protocol number is Pro00038922. The IRB coordinator is Erin Van Hoy. Author Contributions: S.F. conceived the idea and helped edit the manuscript. J.D. wrote the manuscript and created figures and tables. J.M. was responsible for statistical analysis. M.A. helped in writing and editing the manuscript. D.M. helped produce the database used for this project and provided critical input into the manuscript. Advertisement PDF downloadLoading ...