Endogenous Testosterone Recovery after Enucleation for BPH: Clinical Insights into the Concept of "Normal" Testosterone.
Baseline testosterone under 4.5 ng/mL was linked to higher odds of postoperative testosterone rise.
Endogenous Testosterone Recovery after Enucleation for BPH: Clinical Insights into the Concept of "Normal" Testosterone.
Lower urinary tract symptoms (lower urinary tract symptoms), particularly nocturia, may disrupt sleep and have been hypothesized to suppress the hypothalamic-pituitary-gonadal axis.
To evaluate postoperative total testosterone (testosterone) changes after anatomical endoscopic enucleation of the prostate and to identify a preoperative testosterone threshold that predicts clinically meaningful testosterone elevation.
We conducted a single-center retrospective cohort study of men undergoing anatomical endoscopic enucleation of the prostate between 2018 and 2021.
testosterone under 4.5 predicted a later rise, over 4-fold higher odds
The mean age was 69.7 years, and 92 of 304 patients (30.3%) achieved postoperative testosterone elevation.
ROC analysis demonstrated moderate discrimination (AUC 0.737; 95% CI 0.678-0.797), with a Youden-optimal testosterone cut-off of 4.525 ng/mL (sensitivity 72.8%, specificity 64.2%).
On bootstrap internal validation, the optimism-corrected AUC was 0.738, and the optimal cut-off varied across resamples (95% range 3.13-5.07 ng/mL), indicating that the threshold is exploratory.
In this uncontrolled cohort, a preoperative testosterone threshold around 4.5 ng/mL identified men more likely to show postoperative testosterone elevation; this exploratory finding warrants prospective, controlled validation before the current "normal" testosterone range is reconsidered.