Exploring the association between testosterone levels and male urethral stricture: A systematic review

Purpose: Urethral stricture is a common condition in men, affecting quality of life and burdening health care systems. Androgens support wound healing; thus, low testosterone may cause inflammation and stricture formation. This systematic review aims to explore the link between testosterone levels and urethral stricture. Materials and methods: A comprehensive search was conducted in PubMed, Cochrane, ScienceDirect, and Scopus, with risk of bias assessed with Newcastle-Ottawa scale. Five studies met the inclusion criteria, investigating the link between testosterone levels and urethral strictures. A comprehensive search was conducted in PubMed, Cochrane, ScienceDirect, and Scopus, with risk of bias assessed with Newcastle-Ottawa scale. Results: Five studies met the inclusion criteria, investigating the link between testosterone levels and urethral strictures . Patients with recurrent strictures had significantly lower testosterone levels (342.00 ± 133.89 ng/dL) compared with those without recurrence (428.53 ± 133.55 ng/dL). Low testosterone was also associated with reduced periurethral vascularity. Stricture length was longer in patients with low testosterone (195.3 ng/dL) compared with those with normal levels (427.9 ng/dL). In addition, patients with urethral stricture demonstrated lower testosterone levels (394 ng/ dL) compared with healthy controls (488 ng/dL), and another study confirmed this statement with similar findings in stricture patients (386.00 ± 225.60 ng/dL) versus controls (660.82 ± 298.26 ng/dL). Conclusion: In conclusion, our systematic review suggests that low testosterone contributes to the occurrence and recurrence of urethral stricture. Because testosterone aids periurethral vascularity and healing, lacking testosterone might increase stricture risk. Further studies exploring the use of androgen-based therapies as preventive or adjunctive therapy are necessary. Furthermore, testosterone levels could be integrated as part of the diagnostic or therapeutic approach in patients suffering from urethral stricture, particularly recurrent urethral strictures.