Effects of male sex hormones on urodynamics in childhood: intersex patients are a natural model |
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Authors: | S Celayir Z ?lçe N Dani?mend |
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Institution: | Division of Pediatric Urology, Department of Pediatric Surgery, Cerrahpa?a Medical Faculty, University of Istanbul, Istanbul, Turkey, TR
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Abstract: | The effects of sex hormones on bladder function have been evaluated in adult females, especially in regard to postmenopausal
incontinence and bladder irritability syndromes. These have not been investigated in children in regard to urodynamic findings.
An intersex patient whose bladder is under the influence of androgens is a natural model to investigate the effects of male
sex hormones on bladder function in females. To evaluate the urodynamic findings and clinical symptoms in a group of intersex
patients and to determine how androgens influence bladder function in female children, clinical and urodynamic records of
12 intersex patients with adrenogenital syndrome were investigated retrospectively. The mean age was 9 ± 5.7 years (1.5–18)
and the mean follow-up period was 5.1 ± 4.4 years (1–12). Congenital adrenal hyperplasia (CAH) was present in all cases. Only
3 patients had urinary symptoms and incontinence, but these findings did not correlate with their urodynamic findings. None
of the patients required medications for their urinary symptoms. Nine are still being treated medically by the pediatric endocrine
team with hydrocortisone for CAH. The upper urinary tract was found to be normal with no hydronephrosis. The mean bladder
capacity (269 ± 122 ml) was lower (86.7%) than the estimated capacity for age. The mean compliance was 20 ± 13.7 ml/cmH2O. No unstable detrusor contractions were encountered. The most remarkable finding was this reduced bladder capacity of androgenized
female patients for age, which shows the antagonistic effect of androgens on bladder urodynamics in females.
Accepted: 11 January 2000 |
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Keywords: | Intersex Urodynamics Incontinence |
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