Exploring the Role of Testosterone Replacement Therapy in Benign Prostatic Hyperplasia and Prostate Cancer: A Review of Safety

André Rizzuti,Gustavo Stocker,Heitor O Santos

doi:10.3390/uro2010005

Abstract

Increased risk of prostate diseases triggered by testosterone replacement therapy (TRT) remains a worldwide concern. That said, we reviewed the safety of TRT in the spheres of benign prostatic hyperplasia (BPH) and prostate cancer (PCa), exploring clinical findings in this regard. Compelling evidence based on meta-analyses of randomized and observational studies indicates safety for TRT in patients suffering from prostate disorders such as BPH and PCa, at the same time improving lower tract urinary symptoms. Thus, the harmful relationship geared toward androgens and BPH seems to be overestimated as TRT has sufficient safety and, if properly prescribed, may counteract several metabolic problems. Even after PCa treatment, the benefits of TRT could outweigh the risk of recurrence, but further long-term randomized clinical trials are needed to elucidate unresolved questions.

Highlights

Decline in serum testosterone (T) levels is an overt clinical issue, mainly in aging men, and massive scientific effort has been made to better address pharmacological and nonpharmacological strategies in this setting [1,2,3,4,5,6]
Epidemiological studies show an association of male hypogonadism with a greater prevalence and risk of developing cardiometabolic disorders such as dyslipidemia, obesity, diabetes, and hypertension [9,10]
DHT is a vital hormone for embryological differentiation of the prostate during the intrauterine period, it can be considered a triggering factor for prostate disorders such as prostate cancer (PCa) and benign prostatic hyperplasia (BPH) [23]

Summary

Introduction

Decline in serum testosterone (T) levels is an overt clinical issue, mainly in aging men, and massive scientific effort has been made to better address pharmacological and nonpharmacological strategies in this setting [1,2,3,4,5,6]. Other pathological conditions can lead to primary and secondary hypogonadism, such as infiltrative diseases, testicular and pituitary trauma, varicocele, cryptorchidism, orchitis, hyperprolactinemia, obesity, and some genetic syndromes [8]. Several meta-analyses have shown that men with hypogonadism are at increased risk of all-cause mortality and cardiovascular diseases [7,8,11,12,13]

Methods

Results

Conclusion