title: Hormone therapy in hypospadias surgery: a systematic review.
abstract: Surgical correction of hypospadias is proposed to improve the aesthetic and functional quality of the penis. Hormone therapy preceding surgical correction is indicated to obtain better surgical conditions. However, there is divergence in the literature regarding the hormone therapy of choice, time of its use before surgery, appropriate dose, and route of application. To try to elucidate this matter, an electronic survey of the databases PubMed and Cochrane Central Library was conducted, limited to articles in English published since 1980. Search strategy identified 14 clinical trials that matched the inclusion criteria. Analysis was made in terms of study design, classification of hypospadias, association with chordee and cryptorchidism, type of hormone, route of application, dose and duration of treatment, penile length before and after hormone therapy, glans circumference before and after hormone therapy, adverse effects, and surgical complications. From the trials evaluated it was not possible to determine the ideal neoadjuvant treatment. A preference for use of testosterone was observed. Intramuscular administration seems to have fewer adverse effects than topical treatment. Side effects were seldom described, and treated patients were not followed on a long-term basis. The scarcity of randomized and controlled clinical trials regarding the topic impairs the establishment of a protocol. In conclusion, although preoperative hormone therapy is currently used before hypospadias surgery, its real benefit in terms of improvement of the penis and surgical results has not been defined.
authors.affiliation: Federal University of Juiz de Fora - UFJF, Av. Rio Branco, 2985/sl. 605, Juiz de Fora, MG 36010012, Brazil. Electronic address: jmbnetto@uropedjf.com.br.
authors.forename: Jose Murillo B
authors.initials: JM
authors.lastname: Netto
authors.forename: Carlos Eduardo P F
authors.initials: CE
authors.lastname: Ferrarez
authors.forename: Anucha Andrade
authors.initials: AA
authors.lastname: Schindler Leal
authors.forename: Silvio
authors.initials: S
authors.lastname: Tucci
authors.forename: Carlos Augusto
authors.initials: CA
authors.lastname: Gomes
authors.forename: Ubirajara
authors.initials: U
authors.lastname: Barroso
mesh_terms: D000728:Androgens / Q000008:administration & dosage / Q000009:adverse effects; D002648:Child; D006063:Chorionic Gonadotropin / Q000008:administration & dosage* / Q000009:adverse effects; D013196:Dihydrotestosterone / Q000008:administration & dosage* / Q000009:adverse effects; D006801:Humans; D007021:Hypospadias / Q000188:drug therapy* / Q000601:surgery*; D008297:Male; D013739:Testosterone / Q000008:administration & dosage* / Q000009:adverse effects
chemical_list: D000728:Androgens; D006063:Chorionic Gonadotropin; D013196:Dihydrotestosterone; D013739:Testosterone
keywords: Children; Dihydrotestosterone; Hormone therapy; Human chorionic gonadotropin; Hypospadias; Testosterone