Our Summary

This research paper is about a study that evaluated the impact of a treatment called preoperative hormonal stimulation (PHS) on complication rates following a type of surgery called hypospadias repair. To do this, the researchers looked at previous studies on the topic, collected their data, and conducted statistical analyses.

Hypospadias is a condition where the opening of the urethra is not at the tip of the penis. The surgery aims to correct this. PHS is a treatment that involves administering certain hormones (such as human chorionic gonadotropin, dihydrotestosterone, or testosterone) before the surgery, with the aim of improving the surgical outcome.

The researchers included data from six studies, which involved a total of 428 patients who underwent hypospadias repair surgery. About 40% of these patients received PHS. The surgeries were carried out using three different techniques.

The researchers compared the complication rates of surgeries where PHS was used to those where it was not. They found no significant difference – the likelihood of a complication happening was slightly higher when PHS was used, but this difference was not statistically significant.

The researchers also found that the studies they looked at varied quite a bit in their results, so they conducted further analysis to try to find out why. However, they did not find that the surgical technique used, the age of the patients, the type of PHS, or the quality of the studies were causing this variation.

In conclusion, the use of PHS before hypospadias repair surgery does not seem to increase the risk of complications after the surgery. However, the researchers suggest that more research is needed on this topic.

FAQs

  1. What is the impact of preoperative hormonal stimulation (PHS) treatment on complication rates after hypospadias repair surgery?
  2. What is the relative ratio (RR) for a complication occurring following PHS use in hypospadias repair surgery?
  3. Does the use of T, DHT, and HCG prior to hypospadias repair increase the incidence of postoperative complications?

Doctor’s Tip

A helpful tip a doctor might tell a patient about hypospadias repair is to discuss the possibility of preoperative hormonal stimulation (PHS) with their healthcare provider. While current evidence suggests that PHS does not increase the risk of postoperative complications, further research is necessary to fully understand its impact on surgical outcomes. It is important for patients to have open communication with their doctor and to ask any questions they may have about their treatment plan.

Suitable For

Patients with hypospadias who are recommended for repair surgery are typically those with mild to severe forms of the condition that can affect the function and appearance of the penis. In some cases, preoperative hormonal stimulation (PHS) treatment may be recommended to improve surgical outcomes, although further investigation is needed to determine its effectiveness.

Timeline

  • Patient is diagnosed with hypospadias during infancy or early childhood
  • Patient undergoes preoperative assessments and consultations with a urologist
  • Patient may undergo preoperative hormonal stimulation (PHS) treatment with human chorionic gonadotropin (HCG), dihydrotestosterone (DHT) or testosterone (T)
  • Patient undergoes hypospadias repair surgery, which can involve onlay island flap, tubularized incised plate, or Koyanagi urethroplasty techniques
  • Patient experiences postoperative recovery period, which may include pain management, wound care, and follow-up appointments with the urologist
  • Patient may experience complications following surgery, such as urethral stricture, fistula formation, or meatal stenosis
  • Further investigation and potential additional treatments may be necessary to address any complications and optimize surgical outcome

What to Ask Your Doctor

Some questions a patient should ask their doctor about hypospadias repair and preoperative hormonal stimulation (PHS) include:

  1. What are the potential benefits of undergoing preoperative hormonal stimulation (PHS) before hypospadias repair surgery?
  2. What types of hormones are typically used in PHS for hypospadias repair, and how are they administered?
  3. Are there any potential risks or side effects associated with PHS treatment?
  4. How will PHS affect the overall success rate of the hypospadias repair surgery?
  5. Are there any specific criteria or factors that make a patient a good candidate for PHS treatment?
  6. How long before the surgery will PHS treatment need to be started?
  7. Will I need to undergo any additional testing or monitoring while undergoing PHS treatment?
  8. What postoperative care or follow-up will be required after hypospadias repair surgery with PHS treatment?
  9. Are there any alternative treatment options available for hypospadias repair that do not involve PHS?
  10. Can you provide more information about the research and evidence supporting the use of PHS in hypospadias repair surgery?

Reference

Authors: Chao M, Zhang Y, Liang C. Journal: Minerva Urol Nefrol. 2017 Jun;69(3):253-261. doi: 10.23736/S0393-2249.16.02634-5. Epub 2016 May 10. PMID: 27163504