The prevalence of lower urinary tract symptoms (LUTS) incre-ases from 8% in the fourth decade of life to more than 70% in the seventh decade. Benign prostatic hyperplasia is the most common cause of LUTS in middle-aged and elderly men. Approximately 50% of men aged 50 to 60 years, 60% of men aged 60 to 70 years, and up to 90% of men aged >80 years have some degree of BPH. The patho-genesis of LUTS in men is complex and multifactorial. Up to know many molecular structures and clinical factors such as ATP, puri-nergic system, RhoA/Rho-kinase pathway, nitric oxide, substance P, ageing, oestrogen, and testosterone have been reported to explain of the pathogenesis of the lower urinary tract symptoms. It has been reported that androgens play major role in the development of ge-nitourinary structures. Androgen receptors have been found to be present to a large extent in the epithelial cells of the urethra and the bladder. In addition, the role of testosterone and its metabolites on maintaining the reflex activity in the pelvic part of the autonomic nervous system could be demonstrated in rats. Others have postu-lated the influence of testosterone on postsynaptic non-genomic re-ceptors which are suppressing detrusor activity. Not only the penis but also in other parts of the urogenital tract nitric oxide (NO) acts as a non-adrenergic non-cholinergic neurotransmitter and the ac-tion of testosterone on the urogenital tract may be mediated by this system. Although it is not clear , recently, several studies have sug-gested a relationship between LUTS and the testosterone. The aim of this review is to evaluate the association between LUTS/BPH and testosterone with the relevant literature.
Key Words: Lower urinary tract symptoms, prostate, mesane, etiology, pathogenesis, testosterone
Abstract
The prevalence of lower urinary tract symptoms (LUTS) incre-ases from 8% in the fourth decade of life to more than 70% in the seventh decade. Benign prostatic hyperplasia is the most common cause of LUTS in middle-aged and elderly men. Approximately 50% of men aged 50 to 60 years, 60% of men aged 60 to 70 years, and up to 90% of men aged >80 years have some degree of BPH. The patho-genesis of LUTS in men is complex and multifactorial. Up to know many molecular structures and clinical factors such as ATP, puri-nergic system, RhoA/Rho-kinase pathway, nitric oxide, substance P, ageing, oestrogen, and testosterone have been reported to explain of the pathogenesis of the lower urinary tract symptoms. It has been reported that androgens play major role in the development of ge-nitourinary structures. Androgen receptors have been found to be present to a large extent in the epithelial cells of the urethra and the bladder. In addition, the role of testosterone and its metabolites on maintaining the reflex activity in the pelvic part of the autonomic nervous system could be demonstrated in rats. Others have postu-lated the influence of testosterone on postsynaptic non-genomic re-ceptors which are suppressing detrusor activity. Not only the penis but also in other parts of the urogenital tract nitric oxide (NO) acts as a non-adrenergic non-cholinergic neurotransmitter and the ac-tion of testosterone on the urogenital tract may be mediated by this system. Although it is not clear , recently, several studies have sug-gested a relationship between LUTS and the testosterone. The aim of this review is to evaluate the association between LUTS/BPH and testosterone with the relevant literature.
Key Words: Lower urinary tract symptoms, prostate, mesane, etiology, pathogenesis, testosterone