Topical Testosterone Prior to Hypospadias Surgery – A Histological Evaluation of the Effects on Collagen and Elastic Fibers

Abstract

Purpose Success of hipospadias surgery depends, among other factors, on good quality of the prepuce. Androgen stimulation is suppose to improve cosmetic results and reduce complication rates after Hypospadias correction. Herein, we evaluate the collagen and elastic fibers of the prepuce after testosterone stimulation. Material and Methods Twenty-six boys (4 to 120 months old) were divided at random into two groups prior to hipospadias correction. Group 1 (G1) did not receive any treatment while the boys in group 2 (G2) used 1% propionate of testosterone cream on the penis twice a day for 30 days prior to surgery. During surgery a fragment of the prepuce was taken and sent to histological evaluation. Collagen fibers were evaluated with Masson's trichrome, and Elastic fibers with resorcin-fucsin of Weigert. Results Both groups were similar according to age and Hypospadias classification. Testosterone-treated foreskins (G2) had lower homogeneity (p=0.001) and surface density of the collagen fibers (0.3 ± 0.1 collagen fibers) than those untreated (G2) (0.4 ± 0.1 collagen fibers) (p Conclusions The use of 1% testosterone propionate cream produced a more immature collagen fibers and more homogeneous pattern of the elastic fibers which may be an important factor in producing a better scar formation with consequent less complication rates and better aesthetic results.