Publication Name	World Journal of Gastrointestinal Surgery
Manuscript ID	114445
Country	China

Category	Gastroenterology & Hepatology
Manuscript Type	Observational Study
Article Title	Differences in testosterone levels in perianal diseases: A comparative study of abscesses and fistulas
Manuscript Source	Unsolicited Manuscript
All Author List	Xi Zhang, Qiang Zhang, Min-Jie Wang, Yan-Ting Sun and Jin-Gen Lu
Funding Agency and Grant Number
Corresponding Author	Jin-Gen Lu, Anorectal Department, Longhua Hospital, Shanghai University of Traditional of Chinses Medicine, No. 725, Wanping South Road, Xuhui District, Shanghai, China, Shanghai 200000, China. jingen.lu@shutcm.edu.cn
Key Words	Perianal diseases; Testosterone; Sex hormones; Anorectal abscess; Anal fistula; Inflammation; Body mass index; Cross-sectional study
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.
Citation	Zhang X, Zhang Q, Wang MJ, Sun YT, Lu JG. Differences in testosterone levels in perianal diseases: A comparative study of abscesses and fistulas. World J Gastrointest Surg 2025; In press

Received	2025-09-22 05:22
Peer-Review Started	2025-09-22 05:23
To Make the First Decision
Return for Revision	2025-10-13 07:13
Revised	2025-10-25 14:56
Second Decision	2025-11-13 02:40
Accepted by Journal Editor-in-Chief
Accepted by Executive Editor-in-Chief	2025-11-13 07:20
Articles in Press	2025-11-13 07:20
Publication Fee Transferred	2025-10-28 04:12
Edit the Manuscript by Language Editor
Typeset the Manuscript

ISSN	1948-9366 (online)
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