The Efficacy of Dihydrotestosterone Transdermal Gel Pretreatment in Primary Hypospadias Surgery: A Prospective,Controlled Randomized Study |
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| Institution: | 1. Invasive Cardiology Unit, Centre Hospitalier de Montluçon, 18 Avenue du 8 Mai 1945, 03100 Montluçon, France;2. Carol Davila University of Medecine, 37 Dionisie Lupu, 1st District, 020022 Bucharest, Romania;3. Department of Cardiovascular Sciences, Sapienza University of Rome, Viale del Policlinico 155, 00161 Rome, Italy;1. The Hospital for Sick Children, Toronto, ON, Canada;2. Faculty of Medicine, University of Southampton, Southampton, UK;3. International Pleuropulmonary Blastoma (PPB) Registry, Children’s Hospitals and Clinics of Minnesota, Minneapolis, MN, USA;4. Kaiser Permanente Roseville Women and Children’s Center, Roseville, CA, USA;5. Children’s National Medical Centre, Washington, DC, USA;6. Lauren V Ackerman Laboratory of Surgical Pathology, Washington University Medical Centre, St. Louis, MO, USA |
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| Abstract: | PurposeEfficacy evaluation of transdermal dihydrotestosterone (DHT) treatment based on the results of hypospadias repair in children with primary hypospadias.Material and MethodsBetween September 2004 and April 2006, a randomized total of 75 children with primary hypospadias with a mean age of 33.4±3.7 months were evaluated. While 37 children (Group 1) were treated with a daily application of 2.5% DHT transdermal gel for 3 months, 38 children of group 2 did not receive DHT before operation. All children underwent hypospadias repair using tubularized incised plate urethroplasty. Postoperative complications of the children were analysed using the Mann-Whitney U test with respect to fistula, urethral strictures, meatal stenosis, glandular dehiscence and scar formation.Results4 patients (10.5%) of group 2 developed urethrocutaneous fistulae compared to group 1 in which only one fistula was found (2.7% p>0.05). While 3 patients (7.8%) in group 2 had glandular dehiscence, no patients in the DHT group had one (p<0.05). There were 2 cases with meatal stenosis in group 2 (5.2%), but no patient with meatal stenosis in group 1 (p>0.05). There were 16 cases (42.1%) with moderate to severe scar formation in group 2, whereas only two children (5.4%) had scar formation in the DHT group (p<0.05). There was a significant difference between the overall re-operation rates of group 2 (23.8%, 9 patients) and group 1 (2.7%, one patient) (p<0.05).ConclusionsPretreatment with DHT transdermal gel was found to be effective in decreasing the complications and improving the cosmetic results after hypospadias repair. |
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