The Role of Pre-Operative Androgen Stimulation in Hypospadias Surgery

The 2014 review article examined the use of pre-operative androgen stimulation, like dihydrotestosterone (DHT) and testosterone, in hypospadias surgery. It aimed to determine if this practice could improve surgical outcomes by enlarging the penis and enhancing results. However, the evidence was limited and controversial, with a lack of large-scale, randomized, controlled trials. Some studies indicated temporary penile size and tissue vascularity increases, but the impact on surgical success and complication rates was unclear. A preliminary randomized study showed potential benefits of DHT in reducing complications and improving cosmetic outcomes, but more research with larger sample sizes and placebo controls was necessary. The review also mentioned that androgen metabolism might influence wound healing, and that the administration route of testosterone did not significantly affect penile length outcomes. The conclusion called for more high-quality research to establish the efficacy and protocols for hormonal treatment in hypospadias surgery.