Does Preoperative Testosterone Administration Decrease Complications in Distal Hypospadias Repair With Urethroplasty? Reply.

No AccessJournal of UrologyPediatric Article17 May 2023Does Preoperative Testosterone Administration Decrease Complications in Distal Hypospadias Repair With Urethroplasty?This article is commented on by the following:Editorial CommentEditorial Comment Karl F. Godlewski, Sameer Mittal, Nathan Hyacinthe, Katherine Fischer, John Weaver, Jason Van Batavia, Dana Weiss, Arun Srinivasan, Aseem Shukla, Stephen Zderic, Thomas Kolon, Mark Zaontz, and Christopher Long Karl F. GodlewskiKarl F. Godlewski *Correspondence: Children’s Hospital of Philadelphia, 3401 Civic Center Blvd, Philadelphia, PA 19123 telephone: 215-590-4690; E-mail Address: [email protected] Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania More articles by this author , Sameer MittalSameer Mittal Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania More articles by this author , Nathan HyacintheNathan Hyacinthe Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania More articles by this author , Katherine FischerKatherine Fischer Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania More articles by this author , John WeaverJohn Weaver Rainbow Babies and Children’s Hospital, Cleveland, Ohio More articles by this author , Jason Van BataviaJason Van Batavia Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania More articles by this author , Dana WeissDana Weiss Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania More articles by this author , Arun SrinivasanArun Srinivasan Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania More articles by this author , Aseem ShuklaAseem Shukla Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania More articles by this author , Stephen ZdericStephen Zderic Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania More articles by this author , Thomas KolonThomas Kolon Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania More articles by this author , Mark ZaontzMark Zaontz Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania More articles by this author , and Christopher LongChristopher Long Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003548AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack Citations ShareFacebookLinked InTwitterEmail Abstract Purpose: Testosterone administration prior to hypospadias repair is common practice among pediatric urologists; however, its impact on surgical outcomes remains controversial. We hypothesize that testosterone administration prior to distal hypospadias repair with urethroplasty significantly decreases postoperative complications. Materials and Methods: We queried our hypospadias database for primary distal hypospadias repairs with urethroplasty from 2015 to 2021. Patients undergoing repair without urethroplasty were excluded. We collected information on patient age, procedure type, testosterone administration status, initial visit and intraoperative glans width, urethroplasty length, and postoperative complications. To determine the role of testosterone administration on incidence of complications, a logistic regression adjusting for initial visit glans width, urethroplasty length, and age was performed. Results: A total of 368 patients underwent distal hypospadias repair with urethroplasty. One hundred thirty-three patients received testosterone and 235 did not. Initial visit glans width was significantly larger in the no-testosterone vs testosterone group (14.5 mm vs 13.1 mm, P = .001). Testosterone patients had significantly larger glans width at the time of surgery (17.1 mm vs 14.6 mm [no-testosterone group], P = .001). On multivariable logistic regression analysis after controlling for age at surgery, preoperative glans width, testosterone status, and urethroplasty length, testosterone administration did show significant association with reduced odds of postoperative complications (OR 0.4, P = .039). Conclusions: This retrospective review of patients shows that on multivariable analysis there is significant association between testosterone administration and decreased incidence of complications in patients undergoing distal hypospadias repair with urethroplasty. Future studies on testosterone administration should focus on specific cohorts of patients with hypospadias as benefits of testosterone may be more evident in some subgroups than others. REFERENCES 1. . Ambiguous genitalia. In: , ed. Pediatric Endocrinology. 4th ed. WB Saunders; 2014:107. Crossref, Google Scholar 2. . Hypospadias: anatomy, etiology and technique. J Pediatr Surg.2006; 41(3):463-472. Crossref, Medline, Google Scholar 3. . Meatal advancement and glanuloplasty hypospadias repair after 1,000 cases: avoidance of meatal stenosis and regression. J Urol.1992; 147(3 Part 1):665-669. Link, Google Scholar 4. . Preoperative testosterone therapy prior to surgical correction of hypospadias: a review of literature. Cureus.2016; 8:e677. Medline, Google Scholar 5. . Glans size is and independent risk factor for urethroplasty complications after hypospadias repair. J Pediatr Urol.2015; 11:355e351. Crossref, Google Scholar 6. . Hormone therapy in hypospadias surgery: a systematic review. 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Front Pediatr.2020; 8:579364. Crossref, Medline, Google Scholar 18. . Proximal hypospadias: we aren't always keeping our promises. F1000Res.2016; 5:2379. Crossref, Google Scholar Submitted March 6, 2023; accepted May 4, 2023; published 000. Support: Research reported in this publication was supported by the National Center for Advancing Translational Sciences of the National Institutes of Health under award number TL1TR001880. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. Conflict of Interest: SZ: UroGenie. Ethics Statement: This study received Institutional Review Board approval (IRB No. 12-009259). Data Availability Statement: The data sets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request. © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetailsRelated articlesJournal of Urology31 May 2023Editorial CommentJournal of Urology31 May 2023Editorial Comment Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Karl F. Godlewski Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania *Correspondence: Children’s Hospital of Philadelphia, 3401 Civic Center Blvd, Philadelphia, PA 19123 telephone: 215-590-4690; E-mail Address: [email protected] More articles by this author Sameer Mittal Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania More articles by this author Nathan Hyacinthe Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania More articles by this author Katherine Fischer Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania More articles by this author John Weaver Rainbow Babies and Children’s Hospital, Cleveland, Ohio More articles by this author Jason Van Batavia Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania More articles by this author Dana Weiss Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania More articles by this author Arun Srinivasan Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania More articles by this author Aseem Shukla Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania More articles by this author Stephen Zderic Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania More articles by this author Thomas Kolon Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania More articles by this author Mark Zaontz Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania More articles by this author Christopher Long Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania More articles by this author Expand All Submitted March 6, 2023; accepted May 4, 2023; published 000. Support: Research reported in this publication was supported by the National Center for Advancing Translational Sciences of the National Institutes of Health under award number TL1TR001880. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. Conflict of Interest: SZ: UroGenie. Ethics Statement: This study received Institutional Review Board approval (IRB No. 12-009259). Data Availability Statement: The data sets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request. Advertisement PDF downloadLoading ...