Pre-Operative Testosterone Stimulation Does Not Improve Outcome in Distal and Mid Shaft Hypospadias Repair: A Prospective Study from A Tertiary Hospital in Bangladesh

Pre-Operative Testosterone Stimulation Does Not Improve Outcome in Distal and Mid Shaft Hypospadias Repair

Abstract

Background: There are controversies about the use of pre-operative hormonal stimulation for hypospadias repair. This study aims at assessing complications following use of pre-operative testosterone injection for distal and mid shaft hypospadias. Subjects and Methods: In this prospective comparative study 51 patients were divided into group A: received pre-operative testosterone and group B: did not receive preoperative testosterone. All underwent tubularized incised plate urethroplasty and were followed up for 6 months after operation to observe for the development of complications. The groups were compared with T test, Man Whitney U test, Chi square test or Fisher exact test where appropriate. Results: There were 15 patients in group A and 36 patients in group B. Mean age was 6.59 3.96 years in group A and 6.86 3.32 years in group B (P=0.81). Eleven patients (73.3%) received single dose of testosterone while 3 (20%) and 1 (6.7%) patients received 2 and 3 doses respectively. Sub-coronal hypospadias, 21 (41.18%) was the most common variety followed by distal penile, 18 (35.29%) and mid penile, 12 (23.53%) hypospadias. Patients who received testosterone developed more complications (7 patients, 46.67%) than patients who did not receive testosterone (12 patients, 33.33%). However, this difference was not statistically significant (P=0.48). Urethro-cutaneous fistula was the most common complications in both groups. Conclusion: Preoperative testosterone injection does not improve outcome in distal and mid shaft hypospadias repair.