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. 2024 Nov 29;16(11):e74751.
doi: 10.7759/cureus.74751. eCollection 2024 Nov.

Association Between Low Testosterone and Perioperative Outcomes in Patients Undergoing Transurethral Prostate Surgery

Jasmine S Lin  1 , Evan J Panken  2 , Sai Kumar  3 , Xinlei Mi  3 , Edward Schaeffer  2 , Robert E Brannigan  2 , Joshua A Halpern  2 , Daniel R Greenberg  2
Affiliations

Association Between Low Testosterone and Perioperative Outcomes in Patients Undergoing Transurethral Prostate Surgery

Jasmine S Lin et al. Cureus. .

Abstract

Introduction Low testosterone (T) is linked with frailty, which predicts poor postoperative recovery across many surgical procedures. Therefore, low T may impact perioperative outcomes for surgical patients. We sought to characterize the association between low T, frailty, and perioperative outcomes in patients undergoing transurethral resection of the prostate (TURP) and laser photovaporization of the prostate (PVP). Materials and methods We retrospectively reviewed men across our integrated healthcare system who underwent TURP or PVP with a recorded T level within one year prior to their procedure date. Low T was defined as a serum T <300 ng/dL. We compared clinical characteristics, lab values, and frailty, determined by the Hospital Frailty Risk Score (HFRS), of patients with low vs. normal T. Univariable and multivariable analyses were used to assess the association between low T and hospital readmission at 30, 90, and 180 days postoperatively. Results Among 175 patients who underwent either TURP or PVP, 86 (49.1%) had low T, and 89 (50.9%) had normal T. Patients with low T were older (68.7 ± 9.3 vs. 64.8 ± 11.8 years old, p = 0.016) and had longer postoperative length of stay (4.2 ± 10.5 vs. 1.4 ± 0.9 days, p = 0.03). Patients with low T had a significantly higher rate of readmission within 180 days (28% vs. 13%, p = 0.02). Low T was not independently associated with frailty. On univariable logistic regression, preoperative T was associated with readmission at 90 and 180 days. On multivariable regression, low preoperative T was no longer associated with 90-day readmission. Conclusions Almost half of the men undergoing transurethral surgery in our cohort had low T. Low T was independently associated with a higher risk of 180-day readmission on multivariable analysis. These findings indicate a possible prognostic role for low T screening in men undergoing transurethral prostatic surgery. Further studies are needed to determine whether preoperative treatment of low T can impact perioperative outcomes.

Keywords: benign prostatic hypertrophy; hypogonadism; laser photovaporization of prostate; low testosterone; sexual medicine; transurethral resection of prostate.

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Conflict of interest statement

Human subjects: Consent for treatment and open access publication was obtained or waived by all participants in this study. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.

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