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Gonadal dysfunction in male patients with Budd Chiari syndrome and its reversibility with treatment

Nitin Ramani1, Kashmira Kawli1, Abhijeet Karad1

  • 1Department of Gastroenterology, Seth G S Medical College and KEM Hospital, Parel, Mumbai, 400012, India.

Hepatology International
|March 18, 2022
PubMed

Insights

Gonadal dysfunction is common in men with Budd Chiari syndrome (BCS). Hypogonadotropic hypogonadism (HH) is the most frequent type and significantly improves with treatment, alongside erectile function.

Area of Science:

  • Endocrinology
  • Reproductive Medicine
  • Hepatology

Background:

  • Budd Chiari syndrome (BCS) affects adolescents and adults, with increased survival raising concerns about quality of life, including sexual function and fertility.
  • Assessing gonadal function in male BCS patients is crucial for comprehensive patient care.

Purpose of the Study:

  • To evaluate the prevalence of gonadal dysfunction in male patients diagnosed with BCS.
  • To determine the impact of treatment on gonadal function and sexual health in these patients.

Main Methods:

  • Prospective assessment of 30 newly diagnosed male BCS patients.
  • Evaluation of erectile function using the International Index of Erectile Function (IIEF) questionnaire.
  • Hormonal analysis (FSH, LH, SHBG, estradiol, testosterone variants) and semen parameters (sperm count, motility) at baseline and 6 months post-treatment.

Main Results:

  • 53.3% of patients were sexually active; 31% experienced erectile dysfunction.
  • Hypogonadotropic hypogonadism (HH) was prevalent in 50% of cases, followed by hypergonadotropic hypogonadism (HyH) in 23%.
  • After 6 months of treatment, 60% of HH patients normalized gonadal function, compared to 14% of HyH patients. Erectile dysfunction decreased, but sperm parameters showed no significant improvement.

Conclusions:

  • Gonadal dysfunction is a significant issue in male BCS patients.
  • Hypogonadotropic hypogonadism is the predominant form and shows substantial improvement with BCS treatment.
  • Treatment positively impacts erectile function, though fertility markers require further investigation.
Abstract

Keywords:
CirrhosisHepatic vein thrombosisHypogonadismMale infertilityPortal hypertension

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