Relationship of sex hormones and nocturia in lower urinary tract symptoms induced by benign prostatic hyperplasia

Objective: The study sought to clarify the relationship between sex hormone levels and lower urinary tract symptoms (LUTS) in patients with benign prostate hyperplasia. Methods: Between 2007 and 2010, serum total testosterone (TT), free testosterone, and estradiol were prospectively measured in patients who were transferred to our university hospital. The 924 subjects were divided into two groups. Group I (n = 646) were treated with an alpha blocker only and group II (n = 278) were treated with an alpha blocker + a 5-alpha reductase inhibitor over 3 months before their visit. Clinical conditions were assessed by digital rectal examination, prostate-specific antigen, International Prostate Symptom Score (IPSS), transrectal ultrasonography and maximum urinary flow rate and postvoid residual urine. Results: The mean age was 69.65 ± 6.56 years. The total IPSS and subscore (storage symptom) was significantly associated with age (p < 0.001/p < 0.05) and the TT level (p < 0.05/p < 0.05). TT level was significantly decreased in patients with ≥4 episodes of nocturia. The TT level was significantly related to the presence of severe LUTS (p < 0.05). Conclusions: Endogenous testosterone may have a beneficial effect on lower urinary tract function and that a high frequency of nocturia may induce testosterone deficiency.