Pathogenesis of the lower urinary tract symptoms in men with hypogonadism and metabolic syndrome

The review article includes a modern view on the relationship between age-related hypogonadism, metabolic syndrome, and lower urinary tract symptoms (LUTS) in males. As a rule, LUTS in older men are considered as a manifestation of benign prostatic hyperplasia. A correlation between prostate volume and components of MS was identified, however, LUTS is considered as a polyetiological problem. According to meta-analyzes, a decrease in testosterone levels, dyslipidemia, and insulin resistance are considered as a cause of impaired urination quality in older men. These syndromes cause pathological metabolic processes in the lower urinary tract, leading to structural abnormalities in the tissues of the prostate, bladder wall, blood vessels and nerves. Testosterone replacement therapy in men with hypogonadism has a positive effect on the components of metabolic syndrome and also reduces dysfunction of the lower urinary tract. The question of the safety and efficiency of testosterone replacement therapy for the correction of urination disorders in men with hypogonadism remains debatable, which is an important medico-social problem and requires further study. Authors declare lack of the possible conflicts of interests.