In this study, we examined the relationship between sex hormone levels and lower urinary tract symptoms (LUTS) in men with
benign prostatic hyperplasia (BPH) who underwent transurethral surgery. The study was conducted in 158 patients who came to our
hospital for surgery. Clinical conditions were assessed by body mass index (BMI), digital rectal examination, International Prostate
Symptom Score (IPSS) and transrectal ultrasound (TRUS). The levels of sex hormones (including total testosterone (TT), estradiol (E2),
progesterone (P), luteinizing hormone (LH), follicle‑stimulating hormone (FSH) and prolactin (PRL)) and prostate‑specific
antigen (PSA) were reviewed. Correlations were determined through statistical analysis. The mean age was 72.06 ± 8.68 years.
The total IPSS was significantly associated with the TT level (r = −0.21, P = 0.01). Other sex hormone levels were not correlated
with total IPSS. However, some ratios such as E2/ TT (r = 0.23, P = 0.00) and FSH/LH (r = −0.17, P = 0.04) were associated with
total IPSS. Further analysis showed that the nocturia was associated with age (r = 0.16, P = 0.04), BMI (r = 0.21, P = 0.01),
and TT (r = −0.19, P = 0.02). Moreover, we divided the patients into two subgroups based on IPSS severity (<20 or ≥20). The
mean TT level was in the normal range, but it was significantly related to the presence of severe LUTS. In summary, our study
has shown that the severity of LUTS is associated with TT, E2/ TT and FSH/LH in men who underwent prostate surgery. Increasing
nocturia was observed in lower testosterone patients. Additional larger studies are needed to elucidate the potential mechanisms.

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