Relationship of lower urinary tract symptoms severity with serum levels of sex hormones and prostate specific antigen in men with or without type ii diabetes mellitus

Other Title(s)

العلاقة بين شدة أعراض اضطرابات المجاري البولية السفلى و بين مستوى الهورمونات الجنسية و المستضد الخاص بالبروستات لدى الرجال المصابين و غير المصابين بداء السكري من النوع الثاني

Dissertant

Mahmud, Ihsan Shakir

Thesis advisor

al-Duhan, Jamal Ahmad Abd al-Bari
Salih, Murtada Muhammad

University

University of Basrah

Faculty

Medicine College

University Country

Iraq

Degree

Master

Degree Date

2013

English Abstract

Background Lower Urinary Tract Symptoms (LUTS) represent an important problem of aging men.

LUTS affect 15–60% of men aged more than 40 years.

Benign Prostatic Hyperplasia (BPH) is by far the most common cause of LUTS and both aging and sex hormones are generally accepted to have a role in the etiopathogenesis of LUTS/BPH.

Androgens are considered to have permissive role in development of BPH while the role of estrogens is not fully explained.

Aims of the study This study was carried out to assess the serum levels of sex hormones and prostatic specific antigen (PSA) in patients with LUTS with or without type two diabetes mellitus and to measure any association between the serum levels of sex hormones and the severity of LUTS or volume of prostate.

Patients and Methods This etiological study was carried out from the first of November 2011 to the end of January 2013 on one hundred (94) patients suffering from LUTS for more than one month , twelve of them were suffering from type two diabetes mellitus.

These patients attended Basrah General Hospital outpatient Clinic of Urological Surgery seeking for management.

The medical history of these patients was reported including their IPSS.

General and urological examinations were done to the patients; also an ultrasound was done to them to check the renal system and measure prostate volume.

Four ml of venous blood was drawn from each patient to measure LH, FSH, free and total testosterone, estradiol and PSA and the results were used to assess the presence of any association with IPSS or prostate volume.

Also fasting blood sugar, blood urea, serum creatinine and TSH were measured to identify unknown diabetic patients and exclude those with renal failure or dysthyroidism, respectively.

Results Mean prostate volume of non-diabetic patients was (39.3 ± 23.7) ml with significant increase of prostate volume with age.

Diabetic patients had mean prostate volume of (51.6 ± 21.6) ml and had larger prostate volume than non-diabetics in each age group but they didn’t show a significant increase in prostate volume with age.

There was no effect of family history of BPH or hypertension on prostate volume.

The IPSS, irritative, obstructive and bother scores of non-diabetic patients didn’t differ significantly (p> 0.05) from those of diabetic patients but they were correlated positively with age.

The correlation between IPSS and prostate volume disappeared after age adjustment.

Nocturia was the most frequent symptom while weak stream was the most bothering one.

There were no correlations in the current study between gonadotropins and IPSS or any of its subgroups but men with moderate to severe LUTS tended to have significantly lower mean of FSH.

Free but not total testosterone was negatively correlated with age and neither of them correlated with prostate volume.

Patient with moderate to severe LUTS showed higher serum total testosterone and lower free testosterone than those mild LUTS without reaching significant correlation.

The only significant negative correlation was between free testosterone and bother score in diabetic patients.

Estradiol didn’t correlate with age or prostate volume.

Estradiol showed significant associations and correlations with IPSS, irritative and bother scores in non-diabetic patients and these correlations persisted after adjustment for age and prostate volume indicating that estradiol may act as independent risk factor for LUTS.

Conclusions Patients with LUTS tend to have higher level of total testosterone and estradiol and lower levels of free testosterone with increasing symptom severity .Estradiol has the most significant relationships and may act as an independent risk factor for LUTS.

Main Subjects

Pharmacy, Health & Medical Sciences

No. of Pages

139

Table of Contents

• APA
• MLA
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Language

English

Data Type

Arab Theses

Record ID

BIM-745120