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01-12-2019 | Urolithiasis | Original Article

Testosterone replacement therapy is associated with an increased risk of urolithiasis

Authors: Tyler R. McClintock, Marie-Therese I. Valovska, Nicollette K. Kwon, Alexander P. Cole, Wei Jiang, Martin N. Kathrins, Naeem Bhojani, George E. Haleblian, Tracey Koehlmoos, Adil H. Haider, Shehzad Basaria, Quoc-Dien Trinh

Published in: World Journal of Urology | Issue 12/2019

Abstract

Purpose

To determine whether TRT in men with hypogonadism is associated with an increased risk of urolithiasis.

Methods

We conducted a population-based matched cohort study utilizing data sourced from the Military Health System Data Repository (a large military-based database that includes beneficiaries of the TRICARE program). This included men aged 40–64 years with no prior history of urolithiasis who received continuous TRT for a diagnosis of hypogonadism between 2006 and 2014. Eligible individuals were matched using both demographics and comorbidities to TRICARE enrollees who did not receive TRT. The primary outcome was 2-year absolute risk of a stone-related event, comparing men on TRT to non-TRT controls.

Results

There were 26,586 pairs in our cohort. Four hundred and eighty-two stone-related events were observed at 2 years in the non-TRT group versus 659 in the TRT group. Log-rank comparisons showed this to be a statistically significant difference in events between the two groups (p < 0.0001). This difference was observed for topical (p < 0.0001) and injection (p = 0.004) therapy-type subgroups, though not for pellet (p = 0.27). There was no significant difference in stone episodes based on secondary polycythemia diagnosis, which was used as an indirect indicator of higher on-treatment testosterone levels (p = 0.14).

Conclusion

We observed an increase in 2-year absolute risk of stone events among those on TRT compared to those who did not undergo this hormonal therapy. These findings merit further investigation into the pathophysiologic basis of our observation and consideration by clinicians when determining the risks and benefits of placing patients on TRT.

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Title: Testosterone replacement therapy is associated with an increased risk of urolithiasis
Authors: Tyler R. McClintock
Marie-Therese I. Valovska
Nicollette K. Kwon
Alexander P. Cole
Wei Jiang
Martin N. Kathrins
Naeem Bhojani
George E. Haleblian
Tracey Koehlmoos
Adil H. Haider
Shehzad Basaria
Quoc-Dien Trinh
Publication date: 01-12-2019
Publisher: Springer Berlin Heidelberg
Keywords: Urolithiasis
Testosterone
Hypogonadism
Published in: World Journal of Urology / Issue 12/2019
Print ISSN: 0724-4983
Electronic ISSN: 1433-8726
DOI: https://doi.org/10.1007/s00345-019-02726-6

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Testosterone replacement therapy is associated with an increased risk of urolithiasis

Abstract

Purpose

Methods

Results

Conclusion

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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