A literature review of GLP-1 agonists for the urologist: What do we know so far?

Abstract

Objectives:

Urologists are noting a surge in patients they see who are concurrently taking weight-loss injections, due to exponential rises in prescriptions of glucagon-like peptide-1 receptor agonists (GLP-1RAs) for medical and aesthetic purposes. This study aims to summarise current evidence around GLP-1RAs by categorising their unintended benefits and side effects across common urological conditions that may have important ramifications within the field of urology.

Materials and methods:

Comprehensive literature review using PubMed^®, MEDLINE^® and Google™ Scholar for relevant scientific articles published in English. Manual bibliography search and “related article” functions were employed to supplement original searches.

Results:

Current knowledge of the collateral impact of GLP-1RA on common urological conditions, such as erectile dysfunction (ED), UTIs, urolithiasis, urological malignancies and hypogonadism is conflicting and predominantly based on weak levels of evidence. Pubmed^® identifies 79 relevant studies relating GLP-1RA to the chosen common urological conditions. There are no randomised controlled trials (RCTs) dedicated to GLP-1RA whose primary outcome pertains directly to urological symptoms and/or sequelae.

Conclusion:

GLP-1RA may exert clinically relevant effects across multiple urological domains; however, current evidence is insufficient to draw definitive conclusions. Long-term safety data are lacking. Urologists should remain vigilant while prospective, urology-focused RCTs are urgently needed.

Levels of evidence:

Not applicable.

Keywords

urolithiasis erectile dysfunction urinary tract infection hypogonadism urological malignancy GLP-1 agonist

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