Exploring the efficacy of testosterone undecanoate in male children with 5α‐reductase deficiency

Abstract

Importance Children with 5‐alpha‐reductase deficiency (5α‐RD) and hypospadias present with micropenis, which makes it difficult to obtain sufficient tissue for urethral reconstruction. Objective We investigated the therapeutic effects of oral testosterone undecanoate and established a standard androgen treatment protocol for patients with 5α‐RD with micropenis. Methods Patients with 5α‐RD were treated with oral testosterone undecanoate for 3 months as a course. All patients were treated with no more than 3 courses. If the penile length (PL) reached 2.5 cm (the minimum criterion for surgery) or greater than or equal to −2.5 standard deviations (SDs) (lower limit of normal), testosterone undecanoate was considered to be effective. Results The median age of 90 patients with 5α‐RD was 1.7 years (0.9, 3.1 years). The baseline PL was 1.9 ± 0.6 cm before treatment. At the end of the first course, the PL of 63 patients (70%) reached 2.5 cm, and 49 patients (54%) reached greater than or equal to −2.5 SDs. After two treatment courses, the PL of 81 patients (90%) reached 2.5 cm, and 90 patients (100%) reached greater than or equal to −2.5 SDs. After three courses, the PL of all patients reached 2.5 cm, and all patients reached a PL greater than or equal to −2.5 SDs. No abnormal increase was observed in height‐SD score, weight‐SD score, or ratio of bone age to chronological age during the 1–3‐year follow‐up. Interpretation After 3–9 months of treatment, PL increased to the target length. No severe adverse reactions were observed during follow‐up. Testosterone undecanoate was safe and effective in children with 5α‐RD with micropenis.

Testosterone undecanoate treatment for muscle weakness in a male with hypogonadotropic hypogonadism delayed puberty: A case report

“…The results showed that after 3-9 months of therapy, penile length was obtained, and the safety and effectiveness of administering TU were identified in children with micropenis. 28 The patient also reported that the muscle weakness and lack of energy had disappeared after the first TU injection. The meta-analysis study conducted by Skinner et al showed that administration of testosterone therapy via intramuscular injection had an effect on increasing total body strength by 11.2%, increasing lower extremity strength by 10.4%, and increasing upper extremity strength by 12.9%.…”

Current perspectives in hypospadias research: A scoping review of articles published in 2021 (Review)

“…One is that prenatal factors: diabetes, intake of progestins, estrogens, β-blockers, assisted reproductive technology, and diethylstilbestrol (treatment in grandmothers can lead to a greater risk for hypospadias in offspring and grandsons) (207,(213)(214)(215)(216)(217). The other is that in some penile malformations, preoperatory testosterone treatment is conducted for improved results (218)(219)(220).…”

Efficacy of hormone therapy on stretched penile length in micropenis: A systematic review

“…Of the remaining articles, seven were removed because they were published in languages other than English. Full-text assessment removed one article due to being an editorial, four articles due to nonstandard measurement (micropenis in these articles is defined as stretched penile length at least 2 standard deviations below the mean instead of 2.5), and one article due to the patients suffering from hypospadias, leaving at last 8 articles 8,9,[15][16][17][18][19][20] . The screening process is represented by a flowchart in Figure 1.…”