Kelly Christina de Castro Paiva1, André Netto Bastos2, Laura Pimenta Miana3, Eveline de Souza Barros3, Plínio Santos Ramos4, Lara Meneguelli Miranda5, Natália Maia Faria5, André Avarese de Figueiredo5, José de Bessa6, José Murillo B Netto7. 1. Division of Pediatric Surgery, Department of Pediatrics, Federal University of Juiz de Fora (UFJF), MG, Brazil; Division of Pediatric Surgery, Department of Pediatrics, Hospital and Maternidade Therezinha de Jesus of School of Medical Sciences and Health of Juiz de Fora (HMTJ/SUPREMA), MG, Brazil. 2. Department of Morphology, Federal University of Juiz de Fora (UFJF), MG, Brazil. Electronic address: andre@cortesvillela.com.br. 3. Division of Urology, Department of Surgery, Hospital and Maternidade Therezinha de Jesus of School of Medical Sciences and Health of Juiz de Fora (HMTJ/SUPREMA), MG, Brazil. 4. School of Medical Sciences and Health of Juiz de Fora (HMTJ/SUPREMA), MG, Brazil. 5. Division of Urology, Department of Surgery, Federal University of Juiz de Fora (UFJF), MG, Brazil. 6. Division of Urology, Department of Surgery, State University of Feira de Santana (UEFS), BA, Brazil. 7. Division of Urology, Department of Surgery, Hospital and Maternidade Therezinha de Jesus of School of Medical Sciences and Health of Juiz de Fora (HMTJ/SUPREMA), MG, Brazil; Division of Urology, Department of Surgery, Federal University of Juiz de Fora (UFJF), MG, Brazil. Electronic address: jose.murillo@ufjf.edu.br.
Abstract
INTRODUCTION: The use of preoperative hormonal stimulation before hypospadias surgery aims to increase penile size and achieve better surgical results; however, the rules are not clear in the literature. We evaluated the effects of topical testosterone and estrogen in the hypospadic penis regarding biometric measures, side effects, and serum hormonal levels. To our knowledge, this is the first study using estradiol prior to hypospadias surgery. PATIENTS AND METHODS: Sixty-nine children with hypospadias were randomly divided into three study groups: a control group (CG) of 17 children given placebo cream; a testosterone group (TG) of 28 children who used 1% testosterone propionate; and an estradiol group (EG) of 24 children using 0.01% estradiol. All subjects applied the topical ointment on the entire penis, twice daily for 30 days before surgical correction. Biometric evaluation of the penis included penile length and diameter, glans diameter, distance from the urethral meatus to the tip, and the width of the urethral plate. These measurements as well as serum hormone level, and side effects were evaluated prior to hormone use, and 30 and 90 days after. RESULTS: After 30 days an increase in penile diameter and length and diameter of the glans were observed in TG (p < 0.05). The width of the urethral plate and distance from meatus to the tip increased in TG, although not significantly. The most frequent side effects were appearance of pubic hair and darkening of the genital skin, mainly in TG, but these were transient and disappeared after 90 days of treatment. No significant variations were seen in serum hormonal levels (Table). CONCLUSION: As in previous studies, an increase in penile length and diameter, and glans diameter was observed with the use of testosterone. Proximal urethral plate width and distance from the meatus to the tip of the penis had a tendency to increase also in TG. Estradiol did not change biometric measure of the penis. Few side effects occurred after both hormones, and any that did improved after 90 days follow-up and did not change hormone serum levels. CONCLUSION: Preoperative use of topical testosterone increases penile size, diameter of the penis and glans. The use of estradiol does not change penile biometry. Side effects occur mainly with the use of testosterone and are transient. No significant and persistent hormonal changes were observed.
RCT Entities:
INTRODUCTION: The use of preoperative hormonal stimulation before hypospadias surgery aims to increase penile size and achieve better surgical results; however, the rules are not clear in the literature. We evaluated the effects of topical testosterone and estrogen in the hypospadic penis regarding biometric measures, side effects, and serum hormonal levels. To our knowledge, this is the first study using estradiol prior to hypospadias surgery. PATIENTS AND METHODS: Sixty-nine children with hypospadias were randomly divided into three study groups: a control group (CG) of 17 children given placebo cream; a testosterone group (TG) of 28 children who used 1% testosterone propionate; and an estradiol group (EG) of 24 children using 0.01% estradiol. All subjects applied the topical ointment on the entire penis, twice daily for 30 days before surgical correction. Biometric evaluation of the penis included penile length and diameter, glans diameter, distance from the urethral meatus to the tip, and the width of the urethral plate. These measurements as well as serum hormone level, and side effects were evaluated prior to hormone use, and 30 and 90 days after. RESULTS: After 30 days an increase in penile diameter and length and diameter of the glans were observed in TG (p < 0.05). The width of the urethral plate and distance from meatus to the tip increased in TG, although not significantly. The most frequent side effects were appearance of pubic hair and darkening of the genital skin, mainly in TG, but these were transient and disappeared after 90 days of treatment. No significant variations were seen in serum hormonal levels (Table). CONCLUSION: As in previous studies, an increase in penile length and diameter, and glans diameter was observed with the use of testosterone. Proximal urethral plate width and distance from the meatus to the tip of the penis had a tendency to increase also in TG. Estradiol did not change biometric measure of the penis. Few side effects occurred after both hormones, and any that did improved after 90 days follow-up and did not change hormone serum levels. CONCLUSION: Preoperative use of topical testosterone increases penile size, diameter of the penis and glans. The use of estradiol does not change penile biometry. Side effects occur mainly with the use of testosterone and are transient. No significant and persistent hormonal changes were observed.
Authors: Kiarash Taghavi; Lomani A O'Hagan; Jacqueline K Hewitt; Pierre DE Mouriquand Journal: J Paediatr Child Health Date: 2022-07-06 Impact factor: 1.929