Effectiveness of nephrolithiasis surgical treatment on the background of replacement testosterone therapy

Nair S Tagirov

doi:10.17816/ped10247-54

Abstract

The goal of the study is to assess the effectiveness and safety of testosterone replacement therapy in males with androgenic deficiency and nephrolithiasis who require surgical treatment. Patients and methods. All in all 565 patients were involved in the study. In 226 of them (40%) surgical treatment was used. In a majority of these cases (90%) contact uretherolithotripsy was used. In half of the patients uretheroscopy had revealed large and long-lasting concrements. In order to assess the effectiveness of nephrolithiasis surgical treatment on the background of testosterone replacement treatment the assessment of hormonal status during pre- and postoperative periods was accomplished, duration and intensity of pain during the early post-operative period was evaluated as well as narcotic analgetics application frequency and the duration of antibacterial therapy and the stay in the hospital. Results of the study. Replacement testosterone therapy during the early postoperative period in male patients with nephrolithiasis and androgen deficit has been demonstrated to reduce the leukocyteuria duration and the need for antibacterial therapy thus decreasing the stay at the hospital. Replacement testosterone therapy in male patients with nephrolithiasis and androgen deficit who had dealt with surgical treatment has been shown to decrease the pain duration and intensity thus decreasing the need for narcotic analgetics. The use of replacement testosterone therapy in the complex treatment of nephrolithiasis in patients after surgery contributes to faster liquidation of hyperglycemia and normalization of carbohydrate metabolism. Replacement testosterone therapy in male patients with androgen deficit and nephrolithiasis who need surgical treatment contributes to reduction of kidney stone disease relapse rate. Conclusion. Replacement testosterone therapy in male patients with nephrolithiasis and androgen deficit who need surgical treatment considerably improve the postoperative period quality.

Highlights

Мочекаменная болезнь — одно из наиболее распространенных заболеваний почек и мочевыделительной системы во всем мире и у мужчин и у женщин
Nephrolithiasis is one of the most frequent ailments of kidneys and urinary tract in both males and females. It is especially vital for male patients with androgenic deficit and metabolic syndrome
In order to assess the effectiveness of nephrolithiasis surgical treatment on the background of testosterone replacement treatment the assessment of hormonal status during pre- and postoperative periods was accomplished, duration and intensity of pain during the early post-operative period was evaluated as well as narcotic analgetics application frequency and the duration of antibacterial therapy and the stay in the hospital

Summary

ПАЦИЕНТЫ И МЕТОДЫ ИССЛЕДОВАНИЯ

1. Следует отметить, что более чем в 50 % случаев у пациентов, которым была выполнена уретероскопия, были обнаружены крупные и длительно «стоящие на месте» конкременты, у 10 (4,9 %) пациентов первичная дистанционноударно-волновая литотрипсия оказалась неэффективной (после двух сеансов), а у 82 (40 %) — выбор КУЛТ был обусловлен наличием множественных конкрементов по типу «каменной дорожки». В зависимости от использования заместительной терапии тестостероном все пациенты были разделены на две группы: основную (300 человек) и контрольную (165 человек). Д. Пациентам старшей возрастной группы, не планирующим детей, назначали андрогель без криоконсервации спермы и при отсутствии противопоказаний через 2 месяца переводили на внутримышечное введение тестостерона ундеканоата 1000 мг один раз в 12 месяцев или тестостерона энантата по 250 мг каждые 15–30 дней.

Контрольная Control

Консервативная терапия Concervative therapy

Findings

Андрогены Androgenas