Number №4, 2013 - page 40-48

Androgens and lower urinary tract symptoms: only male gender or unsolved problems of both sexes?

Kalinchenko S.Yu., Tyuzikov I.A., Grekov E.A., Apetov S.S., Vorslov L.O., Tishova Yu.A.

In a review on the basis of the modern literary data and results of own researches one of the aspects least studied in the domestic literature – pathophysiology of low urinary tract symptoms (LUTS), connected with a role of sexual hormones (androgens) in pathogenesis at men and women is considered. With the years the expressed growth of LUTS and noctiria frequency in population irrespective of a gender is marked, and one of key mechanisms is the age deficiency of sexual hormones, promoting development of bladder hypoxic ischemia.

Androgen deficiency role in males LUTS/nocturia is authentically proved now. Contrary to it, female ageassociated LUTS/nocturia traditionally communicate with deficiency of an estrogen only, however, estrogen therapy is not capable to liquidate them as effectively, as androgen therapy at men. The author's concept confirmed with own clinical experience and while not numerous foreign researches, consists that androgen deficiency at women is the same ageassociated endocrinological phenomenon, as similar deficiency at men which leads to formation hypoxic cystopathy and LUTS/nocturia. Effective pathogenetic therapy of LUTS/nocturia at both sex should be based on hormone replacement therapy, which should be appointed by results of hormonal research as soon as possible. Stabilisation and liquidation of Males LUTS occurs by androgen replacement therapy. At females LUTS necessary to consider possibility of presence both deficiency of an estrogens, and androgens (separately or in combination) and to spend correctional hormone replacement pharmacotherapy by corresponding drugs.

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