What is it about?

The goal of hypospadias surgery is to provide a functionally and cosmetically normal penis. Whether this goal will be to the patient's satisfaction depends largely on the original anatomy, surgical technique and surgeon's experience. It has been suggested that androgen administration is associated with better outcomes in hypospadias repair; however, few studies have included control groups and the issue is still controversial.

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Why is it important?

Surgical repair of hypospadias is a challenging reconstructive surgery. The principal goals of this surgery are good cosmetic results and better functional outcomes. A number of complications, including urethrocutaneous fistula, meatal stenosis, urethral diverticulum and wound dehiscence, have been reported for different techniques of hypospadias repair. Androgen stimulation is often used to increase the penile size before hypospadias surgery. It is believed that the temporary increase in penile length, glans circumference and tissue vascularity that are induced by androgen administration make the hypospadias repair easier and improve functional and cosmetic results. The therapeutic effect of testosterone to increase the length of the penis is significantly greater than human chorionic gonadotropin (HCG). Both systemic and local administration of testosterone are capable of significantly increasing penile length, but the clinical outcomes in local form are unpredictable due to variability in the volumes applied and, therefore, absorbed.


Tubularized incised plate (TIO) urethroplasty is a popular reconstructive method for hypospadias repair and is widely accepted by pediatric urologists; it is a reliable and simple technique with low complication rates. In the present study, the TIP urethroplasty was performed for distal and midshaft hypospadias, with an overall complication rate of 9.34%, which is similar to previous studies. Snodgrass et al. reported a 7% complication rate for distal hypospadias repair.

Dr Mohammad Reza Safarinejad
University of Medical Sceices

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This page is a summary of: The effect of parenteral testosterone administration prior to hypospadias surgery: A prospective, randomized and controlled study, Journal of Pediatric Urology, June 2015, Elsevier, DOI: 10.1016/j.jpurol.2014.12.014.
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