International Prostate Symptom Score and Quality of Life Index for Lower Urinary Tract Symptoms Are Associated with Aging Males Symptoms Rating Scale for Late-Onset Hypogonadism Symptoms

Abstract

Purpose Although patients with late-onset hypogonadism (LOH) often experience lower urinary tract symptoms (LUTS), LUTS are not generally included in LOH symptoms. No study has examined the direct relation of the Aging Males Symptoms rating scale (AMS) and the International Prostate Symptom Score (IPSS) with the quality of life (QOL) index. We analyzed the relation between the IPSS and QOL index and various factors including the AMS in patients with LOH syndromes. Materials and Methods This study comprised 1,688 men with LOH symptoms who visited our hospital or affiliated clinic. Factors associated with the IPSS were assessed in terms of age, scores of several questionnaires including the AMS, endocrinological variables, and serum concentration of PSA. Among these same factors, those associated with the QOL index were also evaluated. Finally, the same analyses were repeated in 187 patients with low serum testosterone concentration (<3.0 ng/mL). Results In a multivariate analysis using the significant items from the univariate analysis, AMS, age, and Erection Hardness Score correlated significantly with the IPSS. A trend analysis using items other than the AMS as adjustment factors also confirmed the relationship between an increase in QOL index and an increase in AMS. Similar results were obtained in the analysis of patients with low serum testosterone concentration. Conclusions We revealed that the relation of IPSS with the QOL index for LUTS is closely associated with the AMS for LOH, regardless of testosterone level. When patients complain of LOH symptoms, a careful, detailed inquiry into LUTS is required.

Understanding human aging and the fundamental cell signaling link in age-related diseases: the middle-aging hypovascularity hypoxia hypothesis

“…Testosterone replacement therapy (TRT) is recommended for late-onset hypogonadism in aging males over 65 years old ( Nieschlag, 2020 ; Burte et al, 2021 ), but it is still a subject of controversy ( Diokno, 2022 ; Mian et al, 2022 ). Regardless of testosterone levels, most symptomatic late-onset hypogonadism has been shown not to be correlated ( Li et al, 2020c ; Ishikawa et al, 2020 ; La Vignera et al, 2020 ; Tsuru et al, 2022 ).…”

Correlation between Higher Aging Males’ Symptoms Scores and a Higher Risk of Lower Urinary Tract Symptoms

“…Another potential mechanism is that low testosterone concentration influences an elevated blood glucose level, a worsening lipid profile, increased body weight, and increased blood pressure, causing problems such as atherosclerosis [22][23][24]. Based on these mechanisms, LUTSs may be induced by LOH syndrome, and testosterone replacement treatment may restore these phenomena [22]. On the other hand, LUTSs sometimes improve after androgen deprivation therapy with 5-alpha reductase treatment due to a reduction in the prostate volume.…”

Relationship Between Serum Testosterone and Severity of Lower Urinary Tract Symptoms Among Malaysian Men

“…Plausible causes of the disparity would include differences in genetic and epigenetic makeup and in socioeconomic background, which require further investigation. Its high prevalence indicates that thorough evaluation of ageing men presenting with LUTS, with or without late-onset hypogonadism syndrome, is vital as these symptoms are closely associated, regardless of testosterone level [24].…”