Determinant role of gonadal sex hormones in the pathogenesis of urolithiasis in a male subject - a document for male predominancy (case study).

OBJECTIVE: Urolithiasis is a multifactorial disorder influenced by both intrinsic and environmental factors. Among the studied factors, male gender with a three times higher incidence of urolitlithiasis than female gender is considered as a risk factor, but the influence of sex hormones on urinary stone formation remains undetermined. Since the association between serum testosterone and urolithiasis has yet received only limited attention, the pathogenesis of this male predisposition still remains to be elucidated and thus the reason for this male predominance remains apparently obscure. METHODS AND
RESULTS: In this case study, one healthy 38-year old male who participated in a nutrition study developed a minor flank pain and has been subjected to ultrasonography which showed 4-5 mm calculi located within renal middle calyxes of both kidneys. In addition, the results of twice repeated estimation of testosterone, free testosterone, estradiol, dihydrotestosterone and sex hormone binding globulin revealed hyperandrogenicity as also confirmed by the estimation of those hormones in eight males of the same age.
CONCLUSION: So far, the association between serum gonadal steroids and urolithiasis in males received only limited attention and the recommendation for steroid investigation as a basic evaluation to rule out treatable systemic causes in urolithiasis patients is warranted. This rare finding in man seems to be the first report on this issue presented.