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Effects of oral testosterone undecanoate treatment for severe hypospadias

  • Urology - Original Paper
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Abstract

Purpose

We sought to evaluate the effects of oral testosterone undecanoate treatment based on the temporary growth of penis and the complications of surgery in children with microphallic hypospadias.

Materials and methods

A total of 72 randomized consecutive children with microphallic hypospadias were included in the study from March 2011 to September 2013. While 34 children were treated with oral testosterone undecanoate treatment prior to surgery on time (group 1), 36 children did not receive any treatment preoperatively (group 2). All children underwent hypospadias repair using transverse preputial island flap (Duckett technique) urethroplasty or combination of Duckett and Thiersch–Duplay techniques. Penile length, diameter, serum testosterone level, and secondary effects were recorded before and after therapy in group 1. Postoperative complications were assessed with respect to fistulas, urethral strictures, diverticula, meatal stenosis, and glanular dehiscence in both groups.

Results

Mean penile length and diameter increased significantly by 1.06 ± 0.53 cm (P < 0.05) and 0.30 ± 0.09 cm (P < 0.05). Postoperative complications included urethrocutaneous fistulas in nine patients (25 %) in group 2 compared to two patients (5.9 %) in group 1 (P < 0.05). While three patients (8.3 %) in group 2 had urethral strictures, no patient in the testosterone group had this complication (P > 0.05). There were three patients (8.3 %) with diverticula in group 2 and three patients (8.9 %) with this complication in group 1 (P > 0.05). None of our patients had signs or symptoms of meatal stenosis, glanular dehiscence, or residual chordee in both groups. Finally, there was a significant difference between the overall reoperation rates of group 2 (14 patients, 38.9 %) and group 1 (five patients, 14.7 %, P < 0.05).

Conclusions

Pretreatment with oral testosterone undecanoate was effective in improving the temporary penile growth and decreasing the surgical complications in children with microphallic hypospadias.

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References

  1. Ding J, Li Q, Li S et al (2014) Ten years’ experience for hypospadias repair: combined buccal mucosa graft and local flap for urethral reconstruction. Urol Int 93(4):454–459

    Article  PubMed  Google Scholar 

  2. Li Y, Mao M, Dai L (2012) Time trends and geographic variations in the prevalence of hypospadias in China. Birth Defects Res A Clin Mol Teratol 94(1):36–41

    Article  CAS  PubMed  Google Scholar 

  3. Nordenvall AS, Frisen L, Nordenstrom A et al (2014) Population based nationwide study of hypospadias in Sweden, 1973 to 2009: incidence and risk factors. J Urol 191(3):783–789

    Article  PubMed  Google Scholar 

  4. Bastos AN, Oliveira LR, Ferrarez CE et al (2011) Structural study of prepuce in hypospadias—does topical treatment with testosterone produce alterations in prepuce vascularization? J Urol 185(6 Suppl):2474–2478

    Article  CAS  PubMed  Google Scholar 

  5. Ahmad R, Chana RS, Ali SM et al (2011) Role of parenteral testosterone in hypospadias: a study from a teaching hospital in India. Urol Ann 3(3):138–140

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  6. Snodgrass WT, Villanueva C, Granberg C et al (2014) Objective use of testosterone reveals androgen insensitivity in patients with proximal hypospadias. J Pediatr Urol 10(1):118–122

    Article  PubMed  Google Scholar 

  7. Kaya C, Bektic J, Radmayr C et al (2008) The efficacy of dihydrotestosterone transdermal gel before primary hypospadias surgery: a prospective, controlled, randomized study. J Urol 179(2):684–688

    Article  CAS  PubMed  Google Scholar 

  8. Chen R (ed) (1994) Practical handbook of pediatric endocrinology. Shanghai Science and Technology Pulishing House, Shanghai, China, p 87

  9. Lee PA, Mazur T, Danish R et al (1980) Micropenis. I. Criteria, etiologies and classification. Johns Hopkins Med J 146:156–163

    CAS  PubMed  Google Scholar 

  10. Malik RD, Liu DB (2014) Survey of pediatric urologists on the preoperative use of testosterone in the surgical correction of hypospadias. J Pediatr Urol 10(5):840–843

    Article  PubMed  Google Scholar 

  11. Nerli RB, Koura A, Prabha V et al (2009) Comparison of topical versus parenteral testosterone in children with microphallic hypospadias. Pediatr Surg Int 25(1):57–59

    Article  CAS  PubMed  Google Scholar 

  12. Luo CC, Lin JN, Chiu CH et al (2003) Use of parenteral testosterone prior to hypospadias surgery. Pediatr Surg Int 19(1–2):82–84

    CAS  PubMed  Google Scholar 

  13. Ishii T, Hayashi M, Suwanai A et al (2010) The effect of intramuscular testosterone enanthate treatment on stretched penile length in prepubertal boys with hypospadias. Urology 76(1):97–100

    Article  PubMed  Google Scholar 

  14. Baskin LS, Ebbers MB (2006) Hypospadias: anatomy, etiology, and technique. J Pediatr Surg 41(3):463–472

    Article  PubMed  Google Scholar 

  15. Zheng DC, Yao HJ, Cai ZK et al (2015) Two-stage urethroplasty is a better choice for proximal hypospadias with severe chordee after urethral plate transection: a single-center experience. Asian J Androl 17(1):94–97

    Article  PubMed Central  PubMed  Google Scholar 

  16. Xu N, Xue XY, Li XD et al (2014) Comparative outcomes of the tubularized incised plate and transverse island flap onlay techniques for the repair of proximal hypospadias. Int Urol Nephrol 46(3):487–491

    Article  PubMed  Google Scholar 

  17. Springer A, Krois W, Horcher E et al (2011) Trends in hypospadias surgery: results of a worldwide survey. Eur Urol 60(6):1184–1189

    Article  PubMed  Google Scholar 

  18. Braga LH, Lorenzo AJ, Bagli DJ et al (2008) Ventral penile lengthening versus dorsal plication for severe ventral curvature in children with proximal hypospadias. J Urol 180(4 Suppl):1743–1748

    Article  PubMed  Google Scholar 

  19. Zheng DC, Wang H, Lu MJ et al (2013) A comparative study of the use of a transverse preputial island flap (the Duckett technique) to treat primary and secondary hypospadias in older Chinese patients with severe chordee. World J Urol 31(4):965–969

    Article  PubMed  Google Scholar 

  20. Nuhoglu B, Ayyildiz A, Balci U et al (2006) Surgical treatment options in proximal hypospadias: retrospective analysis of 171 cases at a single institution. Int Urol Nephrol 38(3–4):593–598

    PubMed  Google Scholar 

  21. Bologna RA, Noah TA, Nasrallah PF, McMahon DR (1999) Chordee:varied opinions and treatments as documented in a survey of the American Academy of Pediatrics. Sect Urol 53:608

    Article  CAS  Google Scholar 

  22. Castagnetti M, Zhapa E, Rigamonti W (2013) Primary severe hypospadias: comparison of reoperation rates and parental perception of urinary symptoms and cosmetic outcomes among 4 repairs. J Urol 189:1508–1513

    Article  PubMed  Google Scholar 

  23. Gilliver SCRJ, Atkinson SJ, Ashcroft GS (2007) Androgens influence expression of matrix proteins and proteolytic factors during cutaneous wound healing. Lab Invest 87(9):871–881

    Article  CAS  PubMed  Google Scholar 

  24. Gilliver SC, Ashcroft JJ, Ashcroft GS (2007) The hormonal regulation of cutaneous wound healing. Clin Dermatol 25:56–62

    Article  PubMed  Google Scholar 

  25. Stern JM, Chen J, Peters SB et al (2004) Testosterone treatment of human foreskin in a novel transplant model. Urology 63(5):999–1003

    Article  PubMed  Google Scholar 

  26. Gorduza DB, Gay CL, de Mattos ES et al (2011) Does androgen stimulation prior to hypospadias surgery increase the rate of healing complications? A preliminary report. J Pediatr Urol 7(2):158–161

    Article  PubMed  Google Scholar 

  27. Koff SA, Jayanthi VR (1999) Preoperative treatment with human chorionic gonadotropin in infancy decreases the severity of proximal hypospadias and chordee. J Urol 162(4):1435–1439

    Article  CAS  PubMed  Google Scholar 

  28. Sakakibara N, Nonomura K, Koyanagi T (1991) Use of testosterone ointment before hypospadias repair. Urol Int 47(1):40–43

    Article  CAS  PubMed  Google Scholar 

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Acknowledgments

This work was supported by grants from the Specialized Research Fund for the Doctoral Program of Higher Education (20111107110007).

Conflict of interest

The authors declare that they have no conflict of interest.

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Correspondence to Wei-ping Zhang.

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Chen, C., Gong, Cx. & Zhang, Wp. Effects of oral testosterone undecanoate treatment for severe hypospadias. Int Urol Nephrol 47, 875–880 (2015). https://doi.org/10.1007/s11255-015-0972-6

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  • DOI: https://doi.org/10.1007/s11255-015-0972-6

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