Ihsan S Mahmood*, Jamal A Al-Dohan@ & Murtatha M Salih$
*,@Department of Biochemistry, $Department of Surgery, College of Medicine, University of Basrah, Basrah, IRAQ.
The objective of this study is to investigate the relationship between sex hormone levels and prostate volume in patients with lower urinary tract symptoms (LUTS).
This study involved 66 patients suffering from LUTS for more than one month, with age ranged from 36 to 85 years who attended Basrah General Hospital outpatient clinic of urological surgery seeking management, eleven of them were suffering from non-insulin dependent diabetes mellitus (NIDDM). The medical and surgical history were taken through special questionnaire and the severity of LUTS was assessed by International Prostate Symptom Score (IPSS). General and urological examinations were done to them. Four ml of venous blood was drawn from each patient to measure luteinizing hormone (LH), follicle stimulating hormone (FSH), total testosterone (TT), free testosterone (fT), estradiol (E2) and prostate specific antigen (PSA) and the results were used to assess the presence of any association with IPSS or prostate volume. Also fasting blood sugar, blood urea, serum creatinine and thyroid stimulating hormone (TSH) were measured to identify unknown diabetic patients and exclude those with renal failure or dysthyroidism.
Mean±SD of age and prostate volume of the patients were (63.8±9.5) years and (45.5±24.8) ml, respectively. The IPSS and bother scores were (17.3±6.5) and (3.8±1.4), respectively. Mean serum FSH, LH, TT, fT and E2 were (11.5±13.0) mIU/ml, (6.7±5.9) mIU/ml, (4.6±2.4) ng/ml, (6.5±4.8) pg/ml and (47.9±24.4), respectively. Patients with larger prostate volume (>40 ml) had significantly higher mean age and also had higher mean estradiol level after age adjustment (p value <0.05). Prostate volume showed significant correlations with age, PSA and with E2 after age adjustment, but not with IPSS or any of the other sex hormones. The most important other correlation is the negative correlation between total testosterone and IPSS. Diabetes mellitus, hypertension and family history of BPH didn’t seem to have significant effect on prostate volume.
In conclusion, age is the main determiner of prostate volume. Sex hormone doesn’t affect prostate volume significantly apart from estradiol, and their contribution to severity of LUTS may have other mechanisms.