Combination Therapy of Androgen Replacement and Alpha-blockers in Patients with PADAM and Severe LUTS

Hong, Jun Hyuk; Ahn, Tai Young

Abstract

PURPOSE
Severe LUTS (lower urinary tract symptoms) have been considered to be a contraindication to ART (androgen replacement therapy) in PADAM (partial androgen deficiency in aging male) patients. But increasing numbers of patients presenting with PADAM have also LUTS due to the enlarged prostate. We investigated the effect of ART to the prostate in whom LUTS are controlled with alpha-blockers.
MATERIALS AND METHODS
Of those patients who visited our clinic for PADAM symptoms and had decreased serum levels of total testosterone( <2.8 ng/ml, Biodata, Italy), men with severe voiding symptoms(IPSS 20~35) were recruited. Oral androgen(testosterone undecanoate 160 mg/day) and doxazosin(2~4 mg/day) were administered. IPSS score, prostate volume by TRUS, and serum PSA were assessed.
RESULTS
A total of 25 patients were enrolled. Mean patient age was 63.5(51~89) years and median duration of follow-up was 754 days. Initial prostate volume by TRUS was 34.50+/-10.22 ml. Voiding symptoms evaluated by IPSS score improved significantly from 24.12+/-2.54 to 14.64+/-6.01(p <0.01). Serum PSA level showed no significant change from 1.20+/-0.54 ng/ml to 1.30+/-1.05 ng/ml.
CONCLUSIONS
PADAM patients with severe voiding symptoms could be treated with a combination of androgen therapy and alpha-blockers. Further studies with longer follow-up would be required to confirm our results.