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Effect of parenteral testosterone therapy on penile development in boys with hypospadias
R J Davits1, E S van den Aker, R J Scholtmeijer
1Department of Paediatric Urology, Sophia Children's Hospital, Erasmus University, Rotterdam, The Netherlands.
Insights
Testosterone ester injections before hypospadias surgery improved penile development temporarily in boys. Effects on growth, bone maturation, and testosterone levels were not observed, with adverse effects resolving post-treatment.
Area of Science:
- Pediatric Urology
- Endocrinology
- Androgen Research
Background:
- Hypospadias is a congenital condition affecting male genital development.
- The role of androgens in penile development is critical.
- Previous research has explored hormonal interventions for hypospadias.
Purpose of the Study:
- To evaluate the efficacy of testosterone ester treatment in enhancing penile development in boys with hypospadias.
- To assess the impact of this treatment on growth, bone maturation, and hormonal levels.
- To investigate the potential link between androgen receptor deficiency and hypospadias.
Main Methods:
- Forty boys diagnosed with hypospadias were administered intramuscular testosterone esters (2 mg/kg).
- Injections were given 5 and 2 weeks prior to surgical correction.
- Penile development was assessed at multiple time points: 3 and 5 weeks post-injection, and 3 and 12 months post-surgery.
Main Results:
- A significant, albeit temporary, positive effect on penile development was observed.
- The beneficial effects on penile size diminished within the first year after treatment cessation.
- No significant impact was found on bone maturation, final height, or endogenous testosterone levels.
Conclusions:
- Preoperative testosterone ester administration can transiently improve penile growth in boys with hypospadias.
- This hormonal therapy does not appear to influence long-term growth or skeletal development.
- The findings do not support androgen receptor deficiency as a primary cause of hypospadias in this cohort.
Abstract:
Forty boys with hypospadias received 2 mg/kg testosterone esters intramuscularly 5 and 2 weeks before surgical correction of the hypospadias. The effects on penile development were determined 3 and 5 weeks after the first injection and 3 and 12 months post-operatively. A significant effect on penile development was shown. This effect disappeared during the first year following treatment. There was no effect on bone maturation, children's height and the ultimate testosterone level. All adverse effects disappeared after cessation of therapy. Androgen receptor deficiency as a possible cause of hypospadias is not supported by our observations.