Experience in treating patients with benign prostatic hyperplasia and testosterone deficiency in outpatient practice.

Introduction. Basic testosterone concentrations are directly related to the risk of benign prostatic hyperplasia (BPH), its growth and progression. The lower the level of testosterone, the higher the likelihood of developing prostatic hyperplasia, the higher the growth rate of the annual volume and the higher the risk of developing acute urinary retention. However, this dependence is not linear and directly depends on a combination of other individual factors, for example, the presence of concomitant prostatitis or chronic infections. Objective. To compare the effectiveness of monotherapy with α-blockers vs combined therapy (α-blockers in combination with Androgel) in patients with BPH and hypogonadism. Materials and methods. The study involved 60 men with BPH and hypogonadism, who were randomly selected during outpatient admission and divided into 2 groups of 60 people. The first group received silodosin, the second group - silodosin 8 mg + Androgel 1% locally. The duration of therapy was 6 months. The results of treatment were evaluated during four visits. Results and discussion. In the group of combined therapy according to the ICEF-5 questionnaire, an increase in the score of sexual function was registered (from 6.3 to 26.8 points, р=0,05). There was also a significant change in the following indicators compared to the monotherapy group: a decrease in PSA (from 2.25 to 1.8 ng/ml, р=0,05), an increase in prostate volume (from 55.1 to 61.3 cm3 , р=0,05), a significant decrease in the volume of residual urine (from 72 to 19 ml, р=0,05), an increase in the rate of urine flow (from 13.34 to 21.1 ml/s, р=0,05), a decrease in waist circumference (from 116 to 103.2 cm, р=0,05), a decrease in body mass index (from 35.4 to 27.2 kg/m2 , р=0,05). Conclusions. The use of local hormone replacement therapy in patients with BPH in combination with hypogonadism is justified and effective in comparison with monotherapy with α-blockers.