Does administration of transdermal dihydrotestosterone gel before hypospadias repair improve postoperative outcomes?

In an effort to improve the outcome of hypospadias repair, Kaya et al. performed a prospective, randomized study of transdermal dihydrotestosterone (DHT) gel as a preoperative adjunct to surgery. They found that patients who received DHT gel had fewer complications and better cosmesis than patients who underwent surgery alone. The authors attribute the differences between the two groups to an increased blood flow produced by the gel. The series of patients was small, and a larger sample size might have produced different results. Some of the outcomes measured were subjective, and the methods used to assess these outcomes were not clear. If a larger study confirms the results obtained by Kaya and colleagues, transdermal DHT gel might prove to be a valuable adjunct to hypospadias surgery.