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Testosterone therapy in microphallic hypospadias: topical or parenteral?
G Chalapathi1, K L N Rao, S K Chowdhary
1Department of Pediatric Surgery, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
Journal of Pediatric Surgery
|February 22, 2003
Summary
This study compared topical versus intramuscular testosterone for penile growth in hypospadias patients. Both methods showed significant growth, with no statistically significant difference between them, though topical application had more side effects.
Area of Science:
- Pediatric Endocrinology
- Urology
- Andrology
Background:
- Testosterone therapy is used to stimulate penile growth.
- Previous studies show variable efficacy for topical testosterone compared to intramuscular injections.
Purpose of the Study:
- To compare the efficacy of intramuscular versus topical testosterone administration for penile growth in children with hypospadias and small penis.
- To evaluate the safety and side effects associated with each route of administration.
Main Methods:
- A prospective study of 26 consecutive patients with hypospadias and small penis.
- Patients were randomized into two groups: Group A (topical testosterone) and Group B (intramuscular testosterone).
- Treatment duration was 3 weeks, with penile measurements and serum testosterone levels recorded before, during, and after therapy.
Main Results:
- Significant penile growth (P <.01) was observed in both groups, with maximum response in the third week.
- 75% of patients in the intramuscular group and 60% in the topical group experienced significant penile enlargement.
- Serum testosterone levels increased in all patients; however, 15% of the topical group showed levels exceeding the normal range, with associated reversible side effects.
Conclusions:
- Both topical and intramuscular testosterone administration achieved therapeutic penile growth in patients with hypospadias.
- No significant difference in efficacy was found between the two routes of administration.
- Topical testosterone application was associated with a higher incidence of elevated serum testosterone and reversible side effects.