Chalapathi G, Rao K L N, Chowdhary S K, Narasimhan K L, Samujh Ram, Mahajan J K
Department of Pediatric Surgery, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
J Pediatr Surg. 2003 Feb;38(2):221-3. doi: 10.1053/jpsu.2003.50047.
BACKGROUND/PURPOSE: Local or systemic application of testosterone is reported to stimulate penile growth. Intramuscular testosterone has been found to be effective in 50% of patients; however, variable results have been reported with topical testosterone. The current study is an attempt to compare the efficacy of intramuscular versus topical testosterone application.
A total of 26 consecutive patients with hypospadias and small penis (<2SD for given age) were studied prospectively. These patients were recruited alternately into group A or group B. Each group consisted of 13 patients. In group A, penile growth was accomplished by topical application of testosterone (Testoviron, oily solution containing testosterone propionate, 25 mg, and testosterone enanthate, 110 mg, equivalent to about 100 mg of testosterone, Schering, Germany) with a dose of 2 mg/kg/wk, for 3 weeks. While in group B, testosterone (same preparation as above) was administered by intramuscular injection weekly for 3 consecutive weeks. Penile length, diameter, and secondary effects were recorded before, during, and 3 weeks after the therapy by a single observer.
Significant penile growth (P <.01) was noticed in both the groups of patients when compared with pretherapy with maximum response observed during the third week of therapy (reaching from an average pretherapy length of 2.0 cm and 1.8 cm to 3.18 cm and 3.11 cm posttherapy in group A and B patients, respectively). Seven patients in each group had growth of at least 50% compared with the initial size. The basal serum testosterone was within the normal range in both the groups. During therapy the serum testosterone was elevated above the basal level in all patients, but within the normal range except in 2 patients of group A. In these 2 children the serum testosterone level crossed the normal range. Linear growth did not alter significantly for the chronological age. Two patients of group A went on to have pubic hair, one of them had elevated testosterone level above the normal range. There was a surge in serum testosterone in all children, although significant penile enlargement was observed in 60% children in group A and 75% in group B.
Although the desired therapeutic effect of testosterone was achieved in both the groups, this study failed to show any significant difference between the 2 routes of administration. However, in group A, (topical) serum testosterone crossed the normal range in 15% of patients and was associated with significant reversible side effects.
背景/目的：据报道，局部或全身应用睾酮可刺激阴茎生长。已发现肌肉注射睾酮对50%的患者有效；然而，外用睾酮的效果报道不一。本研究旨在比较肌肉注射与外用睾酮的疗效。
前瞻性研究了26例连续的尿道下裂和小阴茎（低于给定年龄的2个标准差）患者。这些患者交替被纳入A组或B组。每组13例患者。A组通过外用睾酮（Testoviron，含25mg丙酸睾酮和110mg庚酸睾酮的油溶液，相当于约100mg睾酮，德国先灵公司生产），剂量为2mg/kg/周，持续3周来促进阴茎生长。而B组则通过每周肌肉注射睾酮（与上述制剂相同），连续注射3周。由一名观察者在治疗前、治疗期间和治疗后3周记录阴茎长度、直径和副作用。
与治疗前相比，两组患者均出现显著的阴茎生长（P<.01），在治疗的第三周观察到最大反应（A组和B组患者治疗后平均长度分别从治疗前的2.0cm和1.8cm增加到3.18cm和3.11cm）。每组有7例患者的阴茎生长至少达到初始大小的50%。两组患者的基础血清睾酮均在正常范围内。治疗期间，所有患者的血清睾酮均高于基础水平，但除A组的2例患者外均在正常范围内。在这2名儿童中，血清睾酮水平超过了正常范围。按实际年龄计算，线性生长没有明显变化。A组有2例患者出现阴毛，其中1例患者的睾酮水平高于正常范围。所有儿童的血清睾酮均有升高，尽管A组60%的儿童和B组75%的儿童观察到阴茎显著增大。
虽然两组均达到了睾酮的预期治疗效果，但本研究未能显示两种给药途径之间有任何显著差异。然而，在A组（外用）中，15%的患者血清睾酮超过正常范围，并伴有明显的可逆性副作用。
