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Increased serum creatinine associated with testicular microlithiasis in adult Japanese men: A retrospective cohort
Jun Hagiuda1, Kiyoshi Takamatsu2, Ken Nakagawa1
1Department of Urology, Tokyo Dental College Ichikawa General Hospital, Ichikawa, Japan.
Background:
Testicular microlithiasis (TM) is thought to be associated with testicular tumors and impaired spermatogenesis; however, its etiology remains unclear.
Objectives:
To identify factors, other than testicular function, that are associated with testicular microlithiasis.
Materials And Methods:
We enrolled males who underwent ultrasound examination of the scrotum at Tokyo Dental College Ichikawa General Hospital. The patients were categorized into two groups: those with or those without testicular microlithiasis. Background and blood test data were compared between the groups.
Results:
Testicular microlithiasis was observed in 72 of the 828 (8.7%) patients enrolled. Ages ranged from 15 to 87 years (mean age, 40.0 years). A history of germ cell tumor was significantly more prevalent in patients with testicular microlithiasis than in those without (1.3 vs. 16.7%; p < 0.001). Blood test data showed that, patients with testicular microlithiasis had significantly higher serum creatinine levels (0.91 vs. 1.04 mg/dL; p = 0.046) and lower calcium levels (9.4 vs. 9.3 mg/dL; p = 0.031) than those without. Serum creatinine levels (> 1.00 mg/dL) and germ cell tumors were significantly associated with testicular microlithiasis in both univariate and multivariate analyses. The prevalence of testicular microlithiasis increased in patients older than 50 years. Age (> 50 years) was associated with testicular microlithiasis in univariate analysis. The mean body weight tended to be heavier (70.7 vs. 72.2 kg; p = 0.051) and epididymitis was observed more frequently (3.2 vs. 8.3%; p = 0.056) in patients with testicular microlithiasis than in those without.
Discussion And Conclusion:
A history of testicular tumors and elevated serum creatinine levels were associated with testicular microlithiasis. Testicular microlithiasis was observed across all age groups, with a tendency to increase in patients older than 50 years. Patients with testicular microlithiasis were slightly heavier and had a higher prevalence of epididymitis than those without. Our findings suggest that, in addition to testicular dysgenesis, other factors are involved in the development of testicular microlithiasis.
Insights
Testicular microlithiasis is linked to a history of testicular tumors and higher creatinine levels. Its prevalence increases after age 50, suggesting factors beyond testicular dysgenesis are involved.
Area of Science:
- Urology
- Andrology
- Radiology
Background:
- Testicular microlithiasis (TM) is associated with testicular tumors and impaired spermatogenesis.
- The exact causes of testicular microlithiasis remain unclear.
- This study investigates factors beyond testicular function linked to TM.
Purpose of the Study:
- To identify non-spermatogenesis-related factors associated with testicular microlithiasis.
- To explore the relationship between TM and patient history, blood test results, and demographics.
Main Methods:
- Retrospective analysis of 828 male patients undergoing scrotal ultrasound.
- Patients were divided into groups with and without testicular microlithiasis.
- Comparison of background data, medical history, and blood test results between groups.
Main Results:
- Testicular microlithiasis found in 8.7% of patients.
- A history of germ cell tumors was significantly more common in patients with TM (16.7% vs 1.3%).
- Elevated serum creatinine (p=0.046) and lower calcium levels (p=0.031) were observed in the TM group. TM prevalence increased in patients over 50 years old.
Conclusions:
- History of testicular tumors and elevated serum creatinine are associated with TM.
- TM prevalence increases with age, particularly after 50.
- Findings suggest additional factors, beyond testicular dysgenesis, contribute to TM development.
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