Effect of Preoperative Hormonal Therapy in hypospadias surgery: a survey on the current practice at the Clinic for Pediatric surgery, Clinical Center University of Sarajevo

To evaluate the effects of transdermal dihydrotestosterone treatment based on the results of hypospadias repair and complications rates in children with primary hypospadias. A total of 79 randomized children who were a mean of 38.2 ±2.8 months old and had primary hypospadias were included in the study between January 2012 and December 2017. 36 children were treated with 2.5% dihydrotestosterone transdermal gel twice a day, applied directly onto the penile shaft and glans for one month prior surgery (group 1), and 43 children did not receive any treatment preoperatively (group 2). Mean ages of the children in groups 1 and 2 were similar (37.3 ± 6.3 months and 39.1±5.9 months, respectively). The urethral meatus was coronal in 30.5%, penile in 69.5 % of the patients in group 1, while it was coronal in 46.5 % and penile in 53.5% of the patients in group 2. Postoperative complications included urethrocutaneous fistula in 6 patients (13.9%) in group 2, compared to 1 patient (2.7%) in group 1. There were 2 patients with meatal stenosis in group 2 (4.7%), and 3 (8.3%) patients with meatal stenosis in group 1. Finally, there was a significant difference between the overall reoperation rates of group 2 (8 patients, 18.6%) and group 1 (1 patient, 2.7%) (p<0.05). Pretreatment with 2.5% dihydrotestosterone transdermal gel before hypospadias repair is beneficial in decreasing complication rates.