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.

中文翻译：

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睾丸激素替代疗法与尿石症的风险增加有关。

目的确定性腺功能减退症男性的TRT是否与尿路结石的风险增加相关。方法我们使用了军事健康系统数据存储库（一个大型的军事数据库，其中包括TRICARE计划的受益人）中的数据，进行了基于人群的队列研究。其中包括2006年至2014年之间接受连续TRT诊断性腺功能减退的40-64岁无尿路结石病史的男性。根据人口统计学和合并症，将符合条件的个体与未接受TRT的TRICARE入组者进行匹配。主要结果是发生结石相关事件的2年绝对风险，将接受TRT的男性与未接受TRT的男性进行比较。结果我们的队列中有26,586对。非TRT组在2年时观察到482次结石相关事件，而TRT组为659次。对数秩比较显示，这是两组事件之间的统计学差异（p <0.0001）。对于局部治疗（p <0.0001）和注射治疗（p = 0.004）亚组观察到这种差异，但对于小丸（p = 0.27）没有观察到。根据继发性红细胞增多症的诊​​断，结石发作没有显着差异，后者被用作治疗中睾丸激素水平较高的间接指标（p = 0.14）。结论我们发现，与未接受激素治疗的患者相比，接受TRT治疗者的2年绝对结石风险绝对增加。