Observational study on sex hormone levels in peripheral blood of male patients with anorectal abscess and anal fistula

Abstract

Abstract Objectives To investigate the preoperative levels of sex hormones in patients with anorectal abscesses and anal fistula. Design and methods: Male patients with anorectal abscesses, anal fistula, and hemorrhoids were preoperatively admitted to the Department of Anorectal Medicine, Longhua Hospital, Shanghai University of Traditional Chinese Medicine(SHUTCM) between October 2021 and March 2023. Patients are grouped according to disease. For each group, sex hormones were evaluated before the operation. Results A total of 249 male patients were eligible for the study, including 64 patients in the hemorrhoid group, 64 patients with anorectal abscesses, and 121 patients with anal fistula. Patients with anorectal abscesses had significantly lower testosterone(T) levels than patients with hemorrhoids and fistula (P = 0.003, P < 0.001), and luteinizing hormone (LH) levels were higher than those in the fistula group (P = 0.027). Tlevels are even lower in patients with anorectal abscesses when the following conditions are present: leukocytes above the normal range abscesses greater than or equal to 2 quadrants in extent, no fistula formation, and duration of disease less than 7 days. In patients with fistulas, T levels were lower in overweight patients and those with fistulas with internal openings above the dentate line, while diabetes, hypertension, type of fistula, number of fistulas, and presence of inflammatory bowel manifestations were not significantly associated with T levels. Conclusions Low T levels suggest early, severely infected, unformed fistula disease features in patients with anorectal abscesses, as well as high internal openings in patients with anal fistulas.