Reversing Urethral Hypovascularity Through Testosterone and Estrogen Supplementation

Yura, Emily; Bury, Matthew I.; Chan, Yvonne Y.; Morey, Allen F.; Sharma, Arun K.; Hofer, Matthias

doi:10.1016/j.urology.2020.06.103

Cited by 9 publications

(8 citation statements)

References 19 publications

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“…This is of specific interest as given the component of devascularization in this condition it supports prior findings of decreased urethral and periurethral vascularity in a hypogonadal environment 1 and the ability to restore vascularity with hormone resupplementation. 2 This not only provides a hypothesis of a causal relationship between hypogonadism and urethral stricture disease since the current study can only show an association between both, but also suggests that hormone replacement therapy in hypogonadal men could be used clinically to prevent stricture formation.…”

Section: Editorial Commentsupporting

confidence: 52%

Editorial Comment

Hofer

2022

Journal of Urology

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Section: Editorial Commentsupporting

confidence: 52%

Editorial Comment

Hofer

2022

Journal of Urology

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“…Testosterone restored CD31 and AR expression to higher levels than the non-castrate control group [27]. Estrogen supplementation improved CD31 but not AR or TIE-2 expression [27]. These findings demonstrate that testosterone supplementation restores periurethral vascularity in an animal model.…”

Section: Testosterone Supplementation and Urethral Vascularitymentioning

confidence: 65%

“…Following supplementation with testosterone the overall vessel count, AR, and TIE-2 expression increased significantly. Testosterone restored CD31 and AR expression to higher levels than the non-castrate control group [27]. Estrogen supplementation improved CD31 but not AR or TIE-2 expression [27].…”

Section: Testosterone Supplementation and Urethral Vascularitymentioning

confidence: 86%

“…As the evidence supporting a link between low serum testosterone and urethral vascularity grows, efforts shifted toward determining if urethral vascularity could be improved with hormone supplementation. Yura and colleagues [27] first evaluated this in a rat model. They divided 24 Sprague Dawley rats into four groups: non-castrate control, castrate, castrate with testosterone supplementation, and castrate with estrogen supplementation.…”

Section: Testosterone Supplementation and Urethral Vascularitymentioning

confidence: 99%

“…Over the last 5-6 years, much has been learned regarding the impact of testosterone on urethral vascularity and stricture disease (Table 1, Ref [18,19,[23][24][25][26][27][28]). However, there is still more work to be done as this emerging area translates into clinical practice.…”

Section: Future Directionsmentioning

confidence: 99%

See 2 more Smart Citations

Testosterone, Urethral Vascularity, and Urethral Stricture Disease: A Review

Hammad¹,

Yafi²,

Barham³

2022

JOMH

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Urethral stricture disease is one of the oldest described urologic pathologies and urethroplasty is associated with high success rates. Many urethral strictures are thought to arise from iatrogenic injury or radiation therapy which can create ischemic insults to the urethra. In developed countries, most urethral strictures are idiopathic; therefore, much is still unknown about the etiology and pathogenesis of this disease. Testosterone is known to mediate vasculogenesis through vascular endothelial growth factor (VEGF) and hypoxia inducible factor-1α (HIF-1α) pathways in various organs. Recently, testosterone has been shown to mediate urethral vasculogenesis. In the setting of testosterone deficiency, androgen supplementation can improve urethral vascularity. Further, there appears to be a high incidence of testosterone deficiency in men with urethral strictures. Despite many advances in our understanding of testosterone's association with the urethra over the past few years, there remains much to be learned about the mechanism of testosterone on urethral stricture etiology and whether testosterone deficiency and supplementation impact urethral reconstruction outcomes.

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