Survey of pediatric urologists on the preoperative use of testosterone in the surgical correction of hypospadias

Malik, Rena D.; Liu, Dennis B.

doi:10.1016/j.jpurol.2014.02.008

Cited by 39 publications

(25 citation statements)

References 12 publications

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“…[13, 17–19] A recent survey of pediatric urologists showed that testosterone was still prescribed in patients with proximal hypospadias, small appearing penis, reduced glans circumference or reduced urethral plate. [20] More defined parameters for use of testosterone have been reported by others, for example in select patients with glans measuring <14mm in diameter. [21, 22] Future prospective studies will be needed to determine the value and role of testosterone.…”

Section: Discussionmentioning

confidence: 99%

Management of Proximal Hypospadias with 2-Stage Repair: 20-Year Experience

et al. 2015

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Purpose To describe our experience with 2-stage proximal hypospadias repair and report outcomes. To look at patient and procedure characteristics associated with surgical complications. Materials and Methods This was a retrospective study of patients with proximal hypospadias who underwent staged repair from January 1993–December 2012. Demographics, preoperative management, and operative technique were reviewed. Complications included glans dehiscence, fistula, meatal stenosis, non-meatal stricture, urethrocele/diverticula, and residual chordee. Cox proportional hazards model was used to evaluate the associations between the time to surgery for complications and patient- and procedure level factors. Results There were 134 patients. The median age at time of first stage surgery was 8.8 months. The median age at time of second stage surgery was 17.1 months and median time between surgeries was 8 months. The median follow-up was 3.8 years. Complications were seen in 71/134 (53%), the most common being fistula in 39/134 (29.1%). Reoperation was performed in 66/134 (49%) patients. Median time from urethroplasty to surgery for complication was 14.9 months. Use of preoperative testosterone decreased risk of having surgery for complication by 27% (hazard ratio (HR)=0.73 95%CI:0.55–0.98, p=0.04). In addition, patients that identified as Hispanic had an increased risk of having surgery for complications (HR=2.40 95%CI:1.28–4.53, p=0.01). Conclusions This study reviews the largest cohort of patients undergoing 2-stage hypospadias repair at a single institution. Complications and reoperation are close to 50% in the setting of complex genital reconstruction.

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Section: Discussionmentioning

confidence: 99%

Management of Proximal Hypospadias with 2-Stage Repair: 20-Year Experience

et al. 2015

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“…18 Despite a lack of high-quality evidence to support that testosterone supplementation improves outcomes, it remains a widely used practice reported by 78% of practicing urologists. 19 Therapy must be stopped 1-2 months prior to surgery to avoid adverse effects during or after surgery. 20 …”

Section: Role Of Preoperative Androgen Therapymentioning

confidence: 99%

Current hypospadias management: Diagnosis, surgical management, and long-term patient-centred outcomes

Keays

Davé

2017

CUAJ

104

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“…[7][8][9][10][11][12][13][14] However, preoperative hormone therapy has not been ubiquitously accepted and, in some extent, remained controversial. 15 Increasing concerns have been raised over potential negative effects of preoperative hormone therapy such as increased erections and pubic hair growth, and accelerated linear height and bone age. [7][8][9]16 In addition, androgens were reported to inhibit wound healing and increase inflammation.…”

Section: Resultsmentioning

confidence: 99%

Meta-analysis of Androgen Insensitivity in Preoperative Hormone Therapy in Hypospadias

Zhao¹,

Yin²,

Yang³

et al. 2015

Urology

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We have defined that the prevalence of androgen resistance in hypospadias is 7.14% (95% CI, 3.16%-15.31%). To distinguish isolated hypospadias from patients with androgen insensitivity syndrome, we recommend that androgen-resistant patients should be specifically targeted by molecularly focused diagnosis. Management strategies should include identification of mutations in the androgen receptor gene, timely surgery to repair hypospadias, and long-term follow-up of sexual function and fertility later in life.

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Survey of pediatric urologists on the preoperative use of testosterone in the surgical correction of hypospadias

Cited by 39 publications

References 12 publications

Management of Proximal Hypospadias with 2-Stage Repair: 20-Year Experience

Management of Proximal Hypospadias with 2-Stage Repair: 20-Year Experience

Current hypospadias management: Diagnosis, surgical management, and long-term patient-centred outcomes

Meta-analysis of Androgen Insensitivity in Preoperative Hormone Therapy in Hypospadias

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