Hormone therapy in hypospadias surgery: a survey on the current practice in Turkey

Nowadays surgical intervention is possible in smaller phalluses and younger children with hypospadias disease. Different hormone treatments with different doses, modalities, indications, and treatment times come along with some disputes. The aim of this study is to evaluate the management approaches in hypospadias surgery of surgeons in regards to hormone preparations.

Questionnaires were sent via e-mail to 110 actively working pediatric surgeons and urologists. The answers of 99 surgeons were evaluated (90%). Two surgeons declared that they did not perform hypospadias surgery.

When testosterone usage in penile surgery was questioned, 44.4% of participants (n = 44) answered positively. Small-short penis glans, narrow urethral plate, chordee, disorders of sexual development, buccal mucosa-graft operations, slight tissue, and defective ventral skin were the indications for usage. Forty of forty-four surgeons stated usage in proximal hypospadias, 18 of them in penile hypospadias, and 15 of them in distal hypospadias. The most common form was dihydrotestosterone (62%). According to the respondents, fistulas (83%), infections (78%), and wound dehiscence (77%) were reduced. Fifty-six percent of the surgeons stated that bleeding was increased and 39% stated easier dissection.

As a result of this questionnaire we can understand that there is no standard usage of testosterone in Turkey. Optimal points of usage can be introduced by increasing prospective randomized trials and education programs can ensure similar effective usage.