The Efficacy of Dihydrotestosterone Transdermal Gel Pretreatment in Primary Hypospadias Surgery: A Prospective, Controlled Randomized Study

Abstract

PURPOSE Efficacy evaluation of transdermal dihydrotestosterone (DHT) treatment based on the results of hypospadias repair in children with primary hypospadias. MATERIAL AND METHODS Between September 2004 and April 2006, a randomized total of 75 children with primary hypospadias with a mean age of 33.4±3.7 months were evaluated. While 37 children (Group 1) were treated with a daily application of 2.5% DHT transdermal gel for 3 months, 38 children of group 2 did not receive DHT before operation. All children underwent hypospadias repair using tubularized incised plate urethroplasty. Postoperative complications of the children were analysed using the Mann-Whitney U test with respect to fistula, urethral strictures, meatal stenosis, glandular dehiscence and scar formation. RESULTS 4 patients (10.5%) of group 2 developed urethrocutaneous fistulae compared to group 1 in which only one fistula was found (2.7% p>0.05). While 3 patients (7.8%) in group 2 had glandular dehiscence, no patients in the DHT group had one (p<0.05). There were 2 cases with meatal stenosis in group 2 (5.2%), but no patient with meatal stenosis in group 1 (p>0.05). There were 16 cases (42.1%) with moderate to severe scar formation in group 2, whereas only two children (5.4%) had scar formation in the DHT group (p<0.05). There was a significant difference between the overall re-operation rates of group 2 (23.8%, 9 patients) and group 1 (2.7%, one patient) (p<0.05). CONCLUSIONS Pretreatment with DHT transdermal gel was found to be effective in decreasing the complications and improving the cosmetic results after hypospadias repair.