THE AGE ANDROGEN DEFICIENCY AND DISORDERS OF URINATION: CLINICAL PARALLELS

THE AIM of the investigation: to analyze the connection between clinical and biomechanical characters of androgen saturation and values, characterizing the state of prostate gland and urination in older age males. PATIENTS AND METHODS. 55 males of the age from 40 to 80 years old (mean age 61,1 ± 1,3 years) with urination disorders, with BHPG 43 patients (78%) and chronic prostatitis 12 (22%). Besides basic clinical methods, to all patients an evaluation of the prostatic specific antigen, total and free blood testosterone, ultrasound investigation of kidneys, urinary bladder and prostate gland, urofloumetry was performed. Patients filled out the IPSS and AMS questionnaire, which allowed to give a quantative evaluation of the complaints on the urinary disorders and of the age androgen deficiency syndrome. RESULTS. The biochemical signs of the state of androgen deficiency were noted in 46 (83%) of the patents in the evaluation of the total blood testosterone and in 19 (35%) patents in the analysis of the free testosterone level. In accordance with the AMS questionnaire results the symptoms of the androgen age deficiency were noted in 46 (84%) cases. The sensitivity of the AMS questionnaire on the exposure of the patients with androgen deficiency was 87%, and the specificity – 11%. With the higher values of testosterone level correlated higher age of the patients, volume of the prostate gland (r=0,32; p=0,035), higher duration of urinary act (r=0,35; p=0,041), higher volume of residual urine (r=0,31; p=0,041), higher frequency of uretheropyeloectasy (r=0,28; p=0,068) and chronic renal insufficiency (r=0,49; p=0,001). The low level of blood testosterone is more frequently noted in patients with the blood group AB (IV) (χ²= 15,9; p=0,001), chronic prostatitis (r=0,26; p=0,095), with sclerosis of prostate gland (r=0,25; p=0,096), and also with the presence of the inflammation signs at the urinary tract – leucocytes, mucosa and proteins (r=0,27; p=0,083, t=2,0; p=0,056 and t=2,59; p=0,015 accordingly. The reliability of the connections between the values of androgen blood concentration and the score amount of the IPSS and AMS questionnaire was lower than the base value (p>0,1), however, the accumulation symptoms were more expressed in men with testosterone deficiency (t=2,40; p=0,020). CONCLUSION. So in accordance with received data, there is a close connection between androgen saturation of the organism and the values, characterizing the urination act, where the prostate gland plays the key role.

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