Urinary stricture has been linked to hypoandrogenism. The purpose of this research was to find and quantify the correlation between elevated testosterone and urethral stricture. Case-control research was carried out from the first of the year 2019 until the first of 2021. 

Patients who presented to a urology clinic with a diagnosis of anterior urethral stricture formed the case group, while those who presented with non-voiding-related problems served as controls. On the morning of the collection, between 7:30 and 9:30, a 10 cc blood sample was to be taken from each group. The result was classified as case or control. The levels of total testosterone, free testosterone, bioavailable testosterone, and hypoandrogenism (total testosterone <300 ng/dL) were the exposure factors. Each exposure adjusted OR was determined. 

Age, BMI, hypertension, diabetes, smoking status, and thyroxine levels were all considered potential confounding factors. A total of 67 (64.3) healthy individuals were used as controls compared to 149 patients (mean age of 59.5).  Total testosterone levels were considerably lower in patients with urethral stricture (394 ng/dL) compared to healthy individuals (488 ng/dL). Similarly, the rate of hypoandrogenism was much higher in the urethral stricture group (26% vs. 7.5%). Reduced risk of urethral stricture was associated with rising total testosterone concentrations by 34% (adjusted OR 0.66, 95% CI: 0.51-0.86) for every 100-unit rise in testosterone concentrations. Similar reductions of 18% and 10% were seen with increases of 1 unit of free testosterone and 10 units of bioavailable testosterone, respectively. 

The adjusted OR for the association between hypoandrogenism and urethral stricture was 4.01 (95% CI: 1.37-11.7). These results show that low testosterone levels (hypoandrogenism) independently correlate with a higher risk of developing an enlarged urethra in men.

Source: auajournals.org/doi/10.1097/JU.0000000000002879