@article{cbee30fb78944b9f98e72a81b52d41b5,
title = "Testosterone replacement therapy is associated with an increased risk of urolithiasis",
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.",
keywords = "Hypogonadism, Male aging, Testosterone, Urinary calculi, Urolithiasis",
author = "McClintock, {Tyler R.} and Valovska, {Marie Therese I.} and Kwon, {Nicollette K.} and Cole, {Alexander P.} and Wei Jiang and Kathrins, {Martin N.} and Naeem Bhojani and Haleblian, {George E.} and Tracey Koehlmoos and Haider, {Adil H.} and Shehzad Basaria and Trinh, {Quoc Dien}",
note = "Funding Information: Funding Dr. Haider reports receiving grants from the Henry M. Jackson Foundation of the Department of Defense, the Orthopaedic Research and Education Foundation, and the National Institutes of Health, and non-financial research supports from the Centers for Medicare and Medicaid Services Office of Minority Health. Dr. Trinh reports receiving research support from the Brigham Research Institute Fund to Sustain Research Excellence, the Bruce A. Beal and Robert L. Beal Surgical Fellowship, the Genentech Bio-Oncology Career Development Award from the Conquer Cancer Foundation of the American Society of Clinical Oncology (Grant # 10202), a Health Services Research pilot test grant from the Defense Health Agency, the Clay Hamlin Young Investigator Award from the Prostate Cancer Foundation (Grant # 16YOUN20), and an unrestricted educational grant from the Vattikuti Urology Institute. Funding Information: Acknowledgements The Center for Surgery and Public Health and the Uniformed Services University of Health Sciences are jointly supported by the Henry M. Jackson Foundation for the Advancement of Military Medicine to provide protected research efforts involving the analysis and study of military TRICARE data (Grant # HU0001-11-1-0023). The contents of this publication are the sole responsibility of the authors and do not necessarily reflect the views, assertions, opinions, or policies of the Uniformed Services University of the Health Sciences (USUHS), the United States Department of Defense (DoD), or any other agency. Publisher Copyright: {\textcopyright} 2019, Springer-Verlag GmbH Germany, part of Springer Nature.",
year = "2019",
month = dec,
day = "1",
doi = "10.1007/s00345-019-02726-6",
language = "English",
volume = "37",
pages = "2737--2746",
journal = "World Journal of Urology",
issn = "0724-4983",
publisher = "Springer Verlag",
number = "12",
}