Preoperative hormone stimulation; does it increase hypospadias postoperative complications?

Area of Science:

• Pediatric Urology
• Surgical Innovation
• Endocrinology

Background:

• Hypospadias, particularly proximal forms with chordee and small glans, presents surgical challenges.
• Glans size is a critical factor influencing surgical outcomes in hypospadias repair.
• Limited data exists on the efficacy of preoperative hormone stimulation (PHS) for glans augmentation in this specific patient group.

Purpose of the Study:

• To evaluate the impact of PHS on glans dimensions in children with proximal hypospadias and small glans.
• To determine if PHS is associated with an increased risk of postoperative complications.

Main Methods:

• A retrospective cohort study of 101 patients with proximal hypospadias and small glans (≤12 mm) undergoing two-stage repair.
• Patients were divided into two groups: Group A (no PHS) and Group B (received PHS 1-2 months before the second stage).
• Glans dimensions (length and width) were measured objectively under general anesthesia before and after PHS in Group B.

Main Results:

• PHS resulted in a statistically significant increase in glans length (p=0.042) and width (p=0.011).
• Approximately 70% of patients receiving PHS experienced a mean glans width increase of 2.78 mm.
• No significant difference in postoperative complication rates was observed between the PHS and non-PHS groups (p=0.556).

Conclusions:

• PHS is effective in augmenting glans size in a majority of patients with hypospadias and small glans.
• PHS can be safely administered without increasing the risk of surgical complications.
• This approach may improve surgical outcomes for hypospadias repair in selected cases.