Our Summary

This research paper is about how testosterone, a hormone, can impact the results of a particular type of surgery in children. The surgery in question is called hypospadias repair with urethroplasty. Hypospadias is a birth defect in boys where the opening of the urethra is on the underside of the penis, instead of at the tip. Urethroplasty is a surgical procedure to repair this.

Doctors often give testosterone to children before this surgery, but the research team wanted to know if this actually helps reduce complications after the surgery. To find out, they looked at medical records of 368 patients who had this surgery between 2015 and 2021. Some of these patients received testosterone before the surgery, and some did not.

They found that the patients who got testosterone had wider penis heads at the time of surgery. Also, after taking into account factors like age, the size of the penis head at the first visit, and the length of the surgery, they found that the patients who got testosterone had fewer complications after surgery.

However, the benefits of testosterone might not be the same for all patients, so future research should look at specific groups of patients to see if testosterone is more beneficial for some than others.

FAQs

  1. What is hypospadias repair with urethroplasty and why is it performed?
  2. How does testosterone impact the results of hypospadias repair with urethroplasty?
  3. Will all patients benefit from receiving testosterone before hypospadias repair surgery?

Doctor’s Tip

One helpful tip a doctor might tell a patient about hypospadias repair is to discuss with your healthcare provider the potential benefits of receiving testosterone before the surgery. Testosterone may help reduce complications and improve outcomes, but it is important to consider individual factors and discuss the risks and benefits with your doctor before making a decision.

Suitable For

Patients who are typically recommended hypospadias repair with urethroplasty are male infants and children with hypospadias, a birth defect where the opening of the urethra is located on the underside of the penis. This condition can cause urinary issues and affect the appearance of the penis. Hypospadias repair is usually recommended to correct this condition and improve the function and appearance of the penis.

In some cases, patients may be recommended testosterone therapy before the surgery to potentially improve outcomes and reduce complications. Testosterone therapy may be recommended for patients with certain characteristics, such as a small penis head or other anatomical factors that could impact the success of the surgery.

Overall, patients who are recommended hypospadias repair with urethroplasty are those who have been diagnosed with hypospadias and could benefit from surgical correction to improve their quality of life and overall health. The decision to recommend testosterone therapy before surgery will depend on individual patient factors and should be discussed with a healthcare provider.

Timeline

Before hypospadias repair:

  • Patient is diagnosed with hypospadias, a birth defect where the opening of the urethra is on the underside of the penis.
  • Consultation with a urologist to discuss treatment options.
  • Patient may undergo tests or evaluations to determine the severity of the condition.
  • In some cases, patient may be prescribed testosterone before the surgery to help with penile growth.

After hypospadias repair:

  • Patient undergoes urethroplasty surgery to correct the placement of the urethral opening.
  • Recovery period where patient needs to keep the surgical site clean and avoid strenuous activities.
  • Follow-up appointments with the urologist to monitor healing and address any complications.
  • Patients who received testosterone before surgery may have wider penis heads and potentially fewer complications post-surgery.

What to Ask Your Doctor

  1. What is hypospadias and why is surgery necessary to repair it?
  2. What are the potential complications of hypospadias repair surgery?
  3. Why do some patients receive testosterone before hypospadias repair surgery?
  4. How does testosterone impact the results of hypospadias repair with urethroplasty?
  5. What are the potential benefits of receiving testosterone before surgery?
  6. Are there any potential risks or side effects of receiving testosterone before surgery?
  7. Are there specific groups of patients who may benefit more from receiving testosterone before surgery?
  8. How long before surgery should testosterone be administered?
  9. How will the effectiveness of testosterone be monitored before and after surgery?
  10. Are there any alternative treatments or approaches for patients who may not be suitable candidates for testosterone therapy before surgery?

Reference

Authors: Godlewski KF, Mittal S, Hyacinthe N, Fischer K, Weaver J, Van Batavia J, Weiss D, Srinivasan A, Shukla A, Zderic S, Kolon T, Zaontz M, Long C. Journal: J Urol. 2023 Aug;210(2):352-359. doi: 10.1097/JU.0000000000003548. Epub 2023 May 17. PMID: 37195856