Effect of Preoperative Androgen Stimulation on Penile Size and Postoperative Complication Rate in Patients with Hypospadias: A Systematic Review and Meta-Analysis
Purpose: To systematically review and evaluate the beneficial effects of preoperative androgen stimulation (PAS) on penile length, glans width, and postoperative complications in patients with hypospadias using meta-analysis. Materials and Methods: A comprehensive search of the published literatur...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Korean Society for Sexual Medicine and Andrology
2023-07-01
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| Series: | The World Journal of Men's Health |
| Subjects: |
| Summary: | Purpose: To systematically review and evaluate the beneficial effects of preoperative androgen stimulation (PAS) on penile
length, glans width, and postoperative complications in patients with hypospadias using meta-analysis.
Materials and Methods: A comprehensive search of the published literature between 1980 and 2022 was done on PubMed,
Embase, Google Scholar, Scopus, Web of Science, and Proquest. Studies of patients with 5-alpha reductase deficiency, differentiation
sex disorder, or micro-penis without hypospadias were excluded. The full-text screening, quality assessment, and
data acquisition were done independently by two reviewers. Meta-analysis was done to quantify the penile growth and postoperative
complications.
Results: The initial literature search yielded 2,389 records, wherein 32 studies were eligible for the systematic review and
meta-analysis. Preoperative testosterone stimulation increased the penile length and glans width by 9.34 mm (95% CI: 6.71–
11.97) and 3.26 mm (95% CI: 2.50–4.02), respectively. A longer penis at the baseline led to greater length gain following
treatment (1 mm longer at the baseline was likely to gain 0.5 mm more). However, the increase in penile length was not associated
with the severity of hypospadias. While the treatment did not affect the overall complication rate, the postoperative
fistula risk was lower in those receiving PAS (RR=0.52, 95% CI: 0.30–0.91, p=0.02).
Conclusions: The beneficial effects of PAS on increasing the penile length and glans width were again confirmed. More gain
of penile length was expected in the larger penis at baseline. There are no reported increased postoperative complications in
association with PAS. |
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| ISSN: | 2287-4208 2287-4690 |