Endocrine status in elderly men with lower urinary tract symptoms: Correlation of age, hormonal status, and lower urinary tract function

Objectives. To correlate endocrine parameters in elderly men with lower uri nary tract symptoms (LUTS) to patient age and clinical parameters such as p rostate volume, prostate-specific antigen (PSA) levels, and uroflowmetry an d to compare the clinical and endocrinologic parameters in men with or with out hypogonadism. Methods. Men (40 years old or older) with untreated LUTS as defined by an I nternational Prostate Symptom Score (IPSS) of 7 or greater due to benign pr ostatic hyperplasia were included in this study and underwent the following investigations: IPSS, free uroflow study, postvoid residual volume, transr ectal ultrasound for assessment of prostate volume, serum PSA determination , and an endocrine study, including testosterone, human luteinizing hormone , human follicle-stimulating hormone, prolactin, dehydroepiandrostendione-s ulphate (DHEA-S), and prolactin. Results. Three hundred twelve men (mean age 62.8 +/- 10.6 years, range 40 t o 91) were analyzed. The serum levels of estradiol (correlation coefficient [r] = 0.19), human luteinizing hormone (r = 0.32), human follicle-stimulat ing hormone (r = 0.19), and DHEA-S (r = -0.39) correlated (P <0.05) with ag e; no such correlation was seen for testosterone (r = 0.04; P >0.05) or pro lactin (r = 0.09; P >0.05). Estradiol (but not testosterone) correlated (r = 0.17, P = 0.01) with prostate volume. The peak flow rate and PSA did not correlate with any endocrinologic parameter. Hypogonadism (serum testostero ne less than 3.0 ng/mL) was detected in 22.1% of patients and had no impact on clinical (IPSS, peak flow rate, prostate volume, and PSA level) or endo crine (human luteinizing hormone, human follicle-stimulating hormone, estra diol, prolactin, and DHEA-S) parameters. Conclusions. A number of age-related endocrine changes are seen in elderly men with LUTS. Hypogonadism is seen in approximately one fifth of elderly m en with LUTS, but in our study it had no impact on symptom status, PSA leve l, prostate volume, uroflowmetry, or endocrine parameters. (C) 2000, Elsevi er Science Inc.