PROSTATE VOLUME IN TESTOSTERONE-TREATED AND UNTREATED HYPOGONADAL MENIN COMPARISON TO AGE-MATCHED NORMAL CONTROLS

OBJECTIVE The potential use of testosterone preparations for substitut ion therapy for ageing men and for male contraception, in addition to the well established substitution therapy of male hypogonadism, make i ncreased testosterone use likely. However, little clinical information is available on the effect of testosterone therapy on the prostate in hypogonadal men. DESIGN AND MEASUREMENTS In a controlled cross-sectio nal study, prostate volume measured by transrectal ultrasonography, se rum levels of prostate-specific antigen (PSA) and sex hormones, and ur oflow parameters were determined. PATIENTS Three groups of age-matched men were enrolled in the study: 47 newly diagnosed hypogonadal men be fore testosterone treatment, 78 hypogonadal men with at least 6 months of effective testosterone therapy and 75 normal men. RESULTS Regressi on analysis revealed a significant positive correlation of prostate vo lume with age in normal men and testosterone-treated hypogonadal men, whereas no significant correlation was detected in untreated hypogonad al men. Prostate volume was significantly lower in untreated hypogonad al men (12.2 (11.0-13.5) ml) (mean (95% confidence limits)) compared t o both other groups. However, no significant difference in prostate vo lume was detected between testosterone-treated hypogonadal men (21.3 ( 19.9-22.8) ml) and normal men (22.9 (21.4-24.4) ml). Similar results w ere obtained for PSA with comparable values in the testosterone-treate d hypogonadal men (0.98 (0.88-1.10) mu g/l) and normal men (1.02 (0.91 -1.14) mu g/l), and significantly lower concentrations in the untreate d hypogonadal men (0.64 (0.55-0.73) mu g/l). No differences in uroflow parameters were detected between the three study groups. CONCLUSIONS Effective testosterone treatment of hypogonadal men results in prostat e volume and prostate-specific antigen levels comparable to age-matche d normal men. Therefore, testosterone-induced prostate growth should n ot preclude hypogonadal men from testosterone substitution therapy.