Copyright
©The Author(s) 2026. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Surg. Jan 27, 2026; 18(1): 114445
Published online Jan 27, 2026. doi: 10.4240/wjgs.v18.i1.114445
Published online Jan 27, 2026. doi: 10.4240/wjgs.v18.i1.114445
Differences in testosterone levels in perianal diseases: A comparative study of abscesses and fistulas
Xi Zhang, Qiang Zhang, Min-Jie Wang, Yan-ting Sun, Jin-Gen Lu, Department of Anorectal, Longhua Hospital, Shanghai University of Traditional Chinses Medicine, Shanghai 200032, China
Xi Zhang, Department of Anorectal, Shanghai Putuo District Hospital of Traditional Chinese Medicine, Shanghai 200062, China
Author contributions: Zhang X and Lu JG designed research study; Wang MJ and Sun YT collected the data; Zhang X and Zhang Q analyzed the data and wrote the manuscript; all authors have read and approve the final manuscript.
Institutional review board statement: This study was performed in line with the principles of the Declaration of Helsinki. Approval was granted by the Ethics Committee of the Longhua Hospital, Shanghai University of Traditional of Chinses Medicine (No. 2020 LCSY032).
Informed consent statement: Informed consent was obtained from all individual participants included in the study.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
STROBE statement: The authors have read the STROBE Statement—checklist of items, and the manuscript was prepared and revised according to the STROBE Statement—checklist of items.
Data sharing statement: Access to clinical data requires ethical approval. Requests can be submitted to dzx0930@163.com.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Jin-Gen Lu, Chief Physician, Professor, Department of Anorectal, Longhua Hospital, Shanghai University of Traditional Chinses Medicine, No. 725 Wanping South Road, Xuhui District, Shanghai 200032, China. jingen.lu@shutcm.edu.cn
Received: September 22, 2025
Revised: October 25, 2025
Accepted: November 13, 2025
Published online: January 27, 2026
Processing time: 124 Days and 18.4 Hours
Revised: October 25, 2025
Accepted: November 13, 2025
Published online: January 27, 2026
Processing time: 124 Days and 18.4 Hours
Core Tip
Core Tip: This study challenges the classic high-androgen hypothesis in perianal infections by demonstrating that patients with active anorectal abscess exhibit a significantly lower testosterone (T) level compared to those with hemorrhoids or fistulas, which is independently associated with systemic inflammation and obesity. We propose two novel hypotheses, namely a dynamic shift from high to low T, and a pathogenic role of inherent low T. The new endocrinological perspective suggests that restoring T could be a future adjunctive therapeutic strategy.