Urolithiasis bei der Langzeitherapie mit GnRH-Agonisten bei Paraphilien – 3 Fallberichte

Treatment of Paraphilic Disorders in Sexual Offenders or Men With a Risk of Sexual Offending With Luteinizing Hormone-Releasing Hormone Agonists: An Updated Systematic Review

“…As shown by current research, a loss of bone mineral density can be found especially during LHRH agonist treatment. 43,70 Thus, bone mineral density should be measured at baseline and at least every 2 years. As suggested by a recent case report, osteopenia or osteoporosis after LHRH agonist treatment also might cause the development of calcium-oxalate urinary stones that could ultimately lead to acute or chronic kidney failure.…”

“…As suggested by a recent case report, osteopenia or osteoporosis after LHRH agonist treatment also might cause the development of calcium-oxalate urinary stones that could ultimately lead to acute or chronic kidney failure. 70 Furthermore, in patients who do not show a decrease in serum testosterone and serum LH and follicle-stimulating hormone levels after the first 4 weeks of LHRH agonist treatment, conducting a brain MR scan should be considered to identify structural abnormalities, especially anomalies of the pituitary gland, because of the risk of pituitary apoplexy under LHRH agonist treatment. 68 Importantly, pituitary apoplexy can occur in hormone-active and hormone-inactive adenomas, indicating that measurements of serum hormone concentrations might not be sufficient to detect patients at risk (the patient described in the present review had normal thyroid-stimulating hormone, thyroxine, prolactin, LH, follicle-stimulating hormone, testosterone, corticotrophin, and cortisol serum concentrations before LHRH agonist treatment was initiated).…”

“…69 30 sexual offenders with a paraphilic disorder (mainly pedophilia) were treated with LHRH agonists at a forensic outpatient center in Berlin, Germany. 70 3 patients developed osteoporosis and had to be treated because of calcium-oxalate monohydrate urinary stones. 70 Voß et al 71 described their experiences concerning treatment withdrawal trials in 15 of these 30 patients.…”

“…70 3 patients developed osteoporosis and had to be treated because of calcium-oxalate monohydrate urinary stones. 70 Voß et al 71 described their experiences concerning treatment withdrawal trials in 15 of these 30 patients. In all cases, LHRH agonist withdrawal was supported by psychotherapy and supervised by an experienced clinician.…”