Federal University of Juiz de Fora - UFJF, Av. Rio Branco, 2985/sl. 605, Juiz de Fora, MG 36010012, Brazil.
J Pediatr Urol. 2013 Dec;9(6 Pt B):971-9. doi: 10.1016/j.jpurol.2013.03.009. Epub 2013 Apr 19.
Surgical correction of hypospadias is proposed to improve the aesthetic and functional quality of the penis. Hormone therapy preceding surgical correction is indicated to obtain better surgical conditions. However, there is divergence in the literature regarding the hormone therapy of choice, time of its use before surgery, appropriate dose, and route of application. To try to elucidate this matter, an electronic survey of the databases PubMed and Cochrane Central Library was conducted, limited to articles in English published since 1980. Search strategy identified 14 clinical trials that matched the inclusion criteria. Analysis was made in terms of study design, classification of hypospadias, association with chordee and cryptorchidism, type of hormone, route of application, dose and duration of treatment, penile length before and after hormone therapy, glans circumference before and after hormone therapy, adverse effects, and surgical complications. From the trials evaluated it was not possible to determine the ideal neoadjuvant treatment. A preference for use of testosterone was observed. Intramuscular administration seems to have fewer adverse effects than topical treatment. Side effects were seldom described, and treated patients were not followed on a long-term basis. The scarcity of randomized and controlled clinical trials regarding the topic impairs the establishment of a protocol. In conclusion, although preoperative hormone therapy is currently used before hypospadias surgery, its real benefit in terms of improvement of the penis and surgical results has not been defined.
尿道下裂的手术矫正是为了提高阴茎的美观和功能质量。在手术矫正前进行激素治疗，以获得更好的手术条件。然而，在选择激素治疗、手术前使用时间、合适剂量和应用途径方面，文献存在分歧。为了阐明这一点，我们对 PubMed 和 Cochrane 中心图书馆的电子数据库进行了调查，仅限于 1980 年以来发表的英文文章。搜索策略确定了符合纳入标准的 14 项临床试验。分析的内容包括研究设计、尿道下裂分类、与阴茎下弯和隐睾的关系、激素类型、应用途径、治疗剂量和时间、激素治疗前后的阴茎长度、激素治疗前后的龟头周长、不良反应和手术并发症。从评估的试验中，无法确定理想的新辅助治疗方法。观察到人们更喜欢使用睾酮。肌肉内给药似乎比局部治疗的不良反应更少。很少描述副作用，并且未对接受治疗的患者进行长期随访。关于该主题的随机对照临床试验稀缺，影响了方案的制定。总之，尽管术前激素治疗目前用于尿道下裂手术前，但尚未确定其在改善阴茎和手术结果方面的真正益处。
